Teenage mothers: A pilot study

Teenage mothers: A pilot study

TEENAGE MOTHERS: A PILOT STUDY. Carol McVeigh RN RM Ph.D. FRCNA FACM,Associate Professor rt Midwifery Convenor, Griffith University School of Nursing,...

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TEENAGE MOTHERS: A PILOT STUDY. Carol McVeigh RN RM Ph.D. FRCNA FACM,Associate Professor rt Midwifery Convenor, Griffith University School of Nursing, University Drive Meadowbrook, Logan Campus, Queensland 4131, email: C.McVeigh@mai[box.gu.edu.au

ABSTRACT

teenage pregnancy has on the teenager and society are

This paper presents the findings of a pilot study carried

occurs in young women, the evolving mother-infant

immense (Shaefer ~t Emerling, 1997). When pregnancy out in one regional center in Queensland, Australia.

relationship may be negatively influenced (Koniak-

The study aimed to develop a snapshot image of

Griffin ~ Turner-Pluta, 2001 ) and both mother and

teenage mothers. Of the thirty mothers who participated; just over half (16/30; 53%) reported using

infant could face Long-term social and economic disadvantage (Kenny, 1995). Despite this, little

contraceptives, less than a third (8/30; 27%) used

information is currently available on Australian

condoms to protect themselves from STDs and the

teenage mothers and their immediate social networks.

majority (23/30; 77%) said their pregnancy was

In addition, most of the literature examining issues

unplanned. Despite this, 16 (53%) attended prenatal

related to teenage sexual activities and pregnancy is

classes, 16 (53%) breast-fed their infants and 27 (90%)

American and may not accurately represent current

were satisfied with motherhood. On average the fathers were almost four years older than the mother were (range 17 to 29 years), most fathers (23/30; 77%) were not teenagers themselves and only 11 (37%) were resident fathers following the birth of the baby. Exploratory analysis suggests that the fathers were

Australian trends. To address this shortfall in information and determine if further research is required, this pilot study was carried out in one regional centre in Queensland, Australia. Primarily this study aimed to capture a snapshot image of teenage mothers.

significantly older than the teenage mothers were (t = -6.73, df 29, p = 0.0001). Although these preliminary results are similar to those reported in the American literature further research is needed to confirm if the findings presented are representative of teenage mothers in Australia. White we await the results of future studies, practitioners are encouraged to continue to educate young women about appropriate and safer sexual practices.

Over the past decade much has been written about teenage pregnancy and birth rates internationally. Although both the United States and Australia have seen a decline in teenage pregnancy and birth rates in recent years (Brown, 2000; Nassar, Sullivan, Lancaster, Ft Day, 2000; Siedlecky, 1996) the situation continues to constitute a significant public health problem in Australia (Adelson, Frommer, Pym ~t Rubin, 1992). Each year a quarter of a million women give birth in Australia and over 13,000 of those births are to

Acknowledgments:

teenage mothers. In Queensland alone over 3,000

This study was supported by a grant from the

teenage mothers give birth annually (Day, Sullivan,

Australian College of Midwives Incorporated.

Ford, ~ Lancaster, 1999) and the early move into motherhood is of concern as it may forever alter a

Ms. Elizabeth Hea[y assisted with data gathering.

INTRODUCTION Irrespective of age, the transition to motherhood may be unpredictable and stressful. Parenting is difficult under the best of circumstances and the effects

young woman's future (Raphael-Left, 1994). Sexual intercourse prior to adulthood and outside marriage has become the norm (Henshaw, 1998; The Guttmacher Institute, 1999a). While most teenagers report using contraceptives, 22% of sexually active teens become pregnant each year and up to 50% of those pregnancies end as termination (Darroch, Landry,

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AUSTRALIAN COLLEGE OF MIDWIVES INCORPORATED

F~Ostak, 1999; Day et aL, 1999; Lindberg, Sonenstein,

American [iterature is also commonplace in Australia.

Ku, ~ Martinez, 1997). Once sexually active, teenage

Armed with greater information about teenage

women are at greater risk of experiencing an

mothers and their immediate sociat networks,

unplanned pregnancy (Henshaw, 1998) and acquiring a

inc[uding the fathers of their infants, midwives should

sexua[ty transmitted disease (The Guttmacher

be better abte to meet the unique needs of teenage

Institute, 1998). The majority of teenagers who give

c[ients. In addition, midwives would be we[[ placed to

birth are from disadvantaged families, have few

inform other practitioner groups (i.e. schoot nurses and

prospects for future development and the majority see

genera[ practitioners) about the educational needs of

little reason to detay childbearing (Donovan, 1997;

young women while they are still at school To that

Koniak-Griffin ~ Turner-P[uta, 2001).

end, this pilot study explored a previousty neglected

When pregnancy occurs, most teenagers experience a normal delivery, however, young mothers are significantty more likely to encounter adverse

area by developing a snapshot image of teenage mothers. In addition, the need for further in-depth research was examined.

pregnancy outcomes such as low birth weight, perinata[ death and pregnancy induced hypertension

M E T H O D 8: PROCEDURE

(Ade[son, et aL, 1992; Nassar et aL, 2000; NSW Hearth Department, 1995). A large proportion of teenage

This quantitative descriptive study aimed to gather

mothers experience social and economic hardships

persona[ and demographic information about teenage

(Fernandez, Ruch-Ross, ~ Montague, 1993; Mercer,

mothers. A non-representative convenience sampte of

1995), become social security recipients (The

teenage mothers aged 15 to 19 years were invited to

Guttmacher Institute, 1999a) and 25% wi[[ give birth to

participate. AIr had delivered heatthy infants at or

a second chitd within 2 years (The Guttmacher

near term and air resided in one regional centre in

Institute, 1998). In addition, the children of teenage

Queensland, Austratia. Participants were recruited by

mothers are predisposed to being the victim of child

invitation white attending a youth health centre; they

abuse (Kenny, 1995), failing to complete their high

were provided with detailed information about the

school education and becoming teenage parents

study, informed of their right to refuse to participate

themselves (Fetice, 1998).

as weir as their right to withdraw at any time. Only

Although much is known about teenage mothers and their babies, far less is known about the infant's father. American studies indicate that adult men are responsible for up to 50% of a[[ births to teenage mothers in that country (Landry ~ Forrest, 1995; Larson, Hussey, Gittmore, ~ Gi[christ, 1996; Taylor, Chavez, Chabra, ~ Boggess, 1997). When a large age difference exists between the teenager and her partner she is more likely to experience an unintended

Gi[tick competent teenage mothers, namely those able to understand the implications of their actions, were recruited (Forrester Et Griffiths, 2001; The British Council, 1999). Fuji ethics approval was obtained from Griffith University and the participating hearth centre and written informed consent was obtained. The mothers were surveyed on one occasion during the first six months postpartum and to protect their anonymity no identification codes were used.

pregnancy and, once pregnant, continuing the

A 40-item questionnaire was developed specifica[ty for

pregnancy rather than opting for a termination

this study. The toot was designed to gather persona[

(Darroch et aL, 1999). In age disparate relationships

and socio-demographic information about the mother,

the teenage mother's access to economic, social and

her infant and the father of her child. The

educationat resources may be limited (Fernandez et

questionnaire also asked mothers to evatuate the

a[., 1993) and contact with and support from the

support they received from the father of their child,

infant's father usuat[y decreases as time passes (Larson

their [eve[ of satisfaction with motherhood and their

et at., 1996; McVeigh, 2000). Although no dear

current quatity of life. Additiona[ questions about

definition of 'large age difference' or 'age disparate

contraceptive use, planned versus unplanned

relationships' is offered within the literature, concerns

pregnancy, participation in parenting programs and

have been raised about the potential for pressure and

current living arrangements were included. A pane[ of

abuse when the mate partner is significantly order than

midwifery experts reviewed the too[; content vatidity

the teenage mother (Darroch eta[., 1999; Landry

was confirmed. Due to the descriptive nature of the

Forrest, 1995).

too{ no further testing was carried at this time.

Since the long-term outcome for both the teenage

Data obtained was analysed using SPSS-PC (Statistical

mother and her infant can be unpredictable it is

Package for the Social Sciences Version 10) software.

important to know if the situation reported in the

Frequency distributions and descriptive statistics were

VOL 15

NO I

MARCH2002

27

used to describe the sampte. Exptoratory t-tests were used to determine emerging tends within the data.

Table 1: Maternal Characteristics No

%

15 yrs

3

10

16 yrs

2

7

Thirty teenage mothers were surveyed during the first

17 yrs

5

17

6 months for[owing the birth of their baby. The

18 yrs

I0

33

participants mean age was 17.7 years (range 15 to 19

19 yrs

I0

33

Angto-ce[tic

28

90

2

10

Primiparae

27

93

Muttigravid

2

7

< year 12

20

67

> year 12

10

33

RESULTS

years, sd 1.37) and 27 (90%) of the mothers were

Characteristics Age:

Ethnicity:

primiparas. Interestingly, ontyl6 (53%) had used contraceptives, just 8 (27%) used condoms when sexua[ty active and 23 (77%) had experienced an

AboHginat/TSSI Parity:

unplanned pregnancy. Despite the chance nature of their pregnancy, 25 (83%) said they were happy when

Education:

informed about the pregnancy, 22 (73%) attended chitdbirth and parenting education programs and 16

Return to Schoot:

(53%) continued to breast-feed their infant fottowing discharge from hospital Most of the respondents used a variety of resources when seeking information about

Emptoyment:

pregnancy, childbirth and parenting. Midwives, prenatat educators and their own parents were sources most frequently cited.

Income:

While onty 11 (37%) of the mothers rived with the father of their baby, not art-current relationships were with the bio[ogicat father of their chitd. Although most

Living Arrangements:

2

6

No/Undecided

28

94

Unemployed

28

93

Yes

Emptoyed

2

7

At School

0

0

< 510,000

18

67

51o,ooo~519,999

8

30

> 520,000

I

3

Atone

3

10

13

43

I

3

11

37

of the mothers (20130; 71%) had tess than 12 years of

With parents

education, only 2 were attending schoot and none of

Cummt boyfriend

the remaining mothers ptanned to return to schoot in

With infant's

the immediate future. In addition, 18 (67%) were sociat

father

security recipients and a[[ reported annual incomes of

Extended

less than 520,000 Australian. Of interest, most of the

family

2

7

None

14

47

mothers (25/30; 83%) believed their quality of life was

Contraceptive use:

good, 27 (90%) were very satisfied with motherhood,

Condom

8

27

however, most (27/30; 90%) reported being less than

OCP

7

23

satisfied with the support they received from the

Diaphragm

I

3

No.

%

father of their baby. See Table 1 for maternal characteristics. At( of the participants provided useful information

Table 2: Father's Characteristics

about the father of their infant. The fathers' mean age was 21 years (range 17 to 29 years, sd 3.10), most (23/

Factor:

30; 77%) were not teenagers themsetves and the

Age

17-19 yrs

7

23

greatest age difference in one relationship was 10

20-24 yrs

19

63

years. Many of the fathers (21/30; 72%) had not

25-29 yrs

4

14

< year 12

21

72

> year 12

9

28

compteted high school, 9 (30%) were currentty unemployed, 7 (23%) received sociat security benefits

Education:

and most (24127; 89%) reported annua[ incomes of tess than 529,000 Austratian. On average the fathers had

Employment:

known the teenage mothers for more than two years, however, most (19130; 63%) were absentee fathers

9

30

Employed

21

70

< 510,000

7

26

for[owing the birth of their child. Exptoratory anatysis

510,000 19,999

11

41

suggests that the fathers were significantly order than

520,000-29,999

6

22

the teenage mothers were (t=-6.74, df 29, p = 0.0001 ).

>530,000

3

11

See Tabte 2 for the father's characteristics.

28

Income

Unemptoyed

AUSTRALIAN COLLEGE OF MIDWIVES INCORPORATED

DISCUSSION

REFERENCES

This pilot study examined available data in order to

Adelson, R, Frommer, M., Pym, M., 8: Rubin, G. (1992)

develop an image of Australian teenage mothers. Given

Teenage pregnancy and ferti[ity in New South Wales: An

the sample size, sampling techniques and because only

examination of fertility trends, abortion and birth

one youth centre participated, no attempt is made to

outcomes. Austra[ian Journal of Public Health. 16(3),

genera[ise these results. The results do however offer

238-244.

information not previously available in Australia and it supports the notion that further investigations are warranted. Discovering that so few of these young women used contraceptives, and tess than a third used condoms as a barrier method of choice, is alarming. Although these results are similar to those reported for the United

Brown, B. (2000) U.S. births rise for the first time in eight years; births to teenagers stilt fatting. Family Planning Perspectives. 32(5), 263-264. Darroch, J., Landry, D., ~t Ostak, S. (1999) Pregnancy rates among U.S. women and their partners in 1994. Family Planning Perspectives. 31(3), 122-126 ~t 136.

States (The Guttmacher Institute, 1999b); clinically it

Day, R, SulLivan, E., Ford, J., ~ Lancaster, R (1999)

is of concern that so few of the young women and their

AustraLian mothers and babies 1997. AIH Cat. No. PER

partners protect themselves against STDs and an

12. Sydney: AIHW National Perinata[ Statistics Unit

unplanned pregnancy. White this may be typical risk

(Perinata[ Statistics Series No. 9).

taking behaviour for this age group much more

Donovan, R (1997) Can statutory rape taws be effective

information is needed to improve our understanding

in preventing adolescent pregnancy? Family Planning

about why some young women protect themselves and others do not.

Perspectives. 29(1), 30-34.

Finding that the fathers were older than the teenage

babies. [On Line]. http: //hhd.csun.edu/sheitia/436/

mothers was not unexpected, however, discovering

lecture1001 .htm[

that more than three quarters of the men were themselves not teenagers and only one third were resident fathers is noteworthy. Similar to previous findings (Landry Et Forrest, 1995; Larson et at., 1996; Taylor et at., 1997) these results suggest that young

Fetice, M. (1998) Fact sheet on adolescents who have

Fernandez, M., Ruch-Ross, H., Et Montague, A. (1993) Ethnicity and effects of age gap between unmarried adolescent mothers and partners. Journal of Adolescent Research. 8(4), 439-466.

women in Australia, like their American counterparts,

Forrester, K., ft Griffiths, D. (2001) Essential of taw for

may engage in unprotected sexual activities with men

health professionals. Sydney: Harcourt.

years older than themselves. Once pregnant, Australian

Henshaw, S. (1998) Unintended pregnancy in the United

teenage mothers may also be at risk of the same [eve[

States. Family Planning Perspectives. 30(1), 24-29 Et 26.

of socioeconomic and educational disadvantage reported by Koniak-Griffin and Turner-Pluta (2001).

Kenny, D. (1995) Adolescent pregnancy in Australia. In D. Kenny ~ R. Job (Eds.). Australia's adolescents: A

Sexual relationships between adult mates and younger

health psychology perspective (pp. 239-245). Armidate,

teenage women may be more commonplace in

Australia: University of New England Press.

Australia than previously anticipated. What, if anything, engaging in such relationships means longterm to teenage mothers and their infants remains unknown? Due to this study's [imitations it seems important to gain a better understanding of why these

Koniak-Griffin, D., ft Turner-Ptuta, C. (2001) Health risks and psychosociat outcomes of early childbearing: A review of the literature. Journal of Perinata[ and Neonatal Nursing. 15(1), 1-17.

relationships develop and ultimately what impact, if

Landry, D., & Forrest, J. (1995) How old are U.S.

any, they may have on the young woman's future

fathers? Family Planning Perspectives. 27(4) 159-165.

opportunities. Clearly further research is needed to

Larson, N., Hussey, J., Giltmore, M., ~t Oitchrist, L.

determine if the findings presented here are upheld by a national study. White we await the results from that

(1996) What about Dad? Fathers of children born to school-age mothers. Families in Society. 77(5), 279-289.

investigation it is important for midwives to continue to offer safer sex and pregnancy prevention

Lindberg, L., Sonenstein, F., Ku, L., Et Martinez, G.

information to their clients through schools and medical practitioners.

and their adult partners. Family Planning Perspectives.

(1997) Age differences between minors who give birth 29(2), 61-66.

VOL 15

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MARCH 2002

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McVeigh, C. (2000) Investigating the retationship between satisfaction with social support and functional status after childbirth. The American Journa[ of

Book Review

Materna[/Chitd Nursing. 25(I ), 25-30. Mercer, R. (1995) Becoming a mother: Research on maternal identity from Rubin to the present. New York: Springer Pubiishing. Nassar, N., Suitivan, E., Lancaster, P., E Day, P. (2000) Austratian mothers and babies 1998. AIH Cat. No. PER 15. Sydney: AIHW Nationa[ Perinata[ Statistics Unit (Perinata[ Statistics Series No. 10). NSW Department of Hearth. (1995). Midwives Data Coitection: Pubtic health buttetin (Vot. 7, No. $I). Raphae[-Leff, J. (1994)Psychotogica[ processesof chitdbearing. London: Chapman Et Hail. Shaefer, S., Et Emeriing, J. (1997) Homebound pregnant adolescents. Home Heaith Care Management Et Practice. 9(3), 23-32. Siedtecky, S. (1996) Teenage pregnancy: What is

GIVING SORROW WORDS Women's stories of grief

happening? On The Road. 4(2), 3-8.

after abortion

Taytor, D., Chavez, G., Chabra, A., Ft Boggess, J. (1997) Risk factors for adult paternity in births to ado[escents. Obstetrics Et Gynecology. 89(2), 199-205. The British Council (1999) Chitdren's rights: a nationa[ and international perspective. [On Line] www.britcoun.org/governance/jusrig/human/chitdrig/ crO2a.htm[

Metinda Tankard Reist (2000) Duffy E Snettgrove, Potts Point ,519.95

This is a very sad book. Sad for two reasons, the first is that these women are so traumatised and that they regret their decisions. The second reason is more insidious and it is that the author has assumed that

The Guttmacher Institute. (1998) Teen sex and pregnancy. Author. [On Line] www.agi-usa.org/pubs/fbteen-sex.htm[

women are not abte to make 'informed' decisions and

The Guttmacher Institute. (1999a) Teenage pregnancy and the welfare reform debate. Author. [On Line] www.agi-usa.org/pubs/ibS.htm[

Those of you who are anti-abortion wi[[ appiaud this

The Guttmacher Institute. (1999b) Teen sex and pregnancy. Author. [On Line] www.agi-usa.org/pubs

concerned and disturbed with the assumptions and lack

so are victims of their partners, relatives, and the medical and regal systems.

book and feel that it is an affirmation of a[[ that you beJieve. Those of you who are pro-choice wi[[ be of any criticat analysis that it makes. This book is ciearty anti-abortion and it would appear, that there are targe numbers of women who are suffering post traumatic stress because they were coerced into having a procedure that they did not want. This is despite rigorous research which shows that most women who have abortions believe that their choice was the correct one. We must remember that there are occasions in our lives that we make decisions that we do regret and sometimes these decisions are very profound. An exampte of such a decision is deciding to drive when under the influence of drugs and/or aicohot and the driver is responsible for killing one or more people. What is significant with these women's stories is that they were air coerced into having abortions by either

30

AUSTRALIAN COLLEGE OF MIDWIVES INCORPORATED