Birth stories, support and perinatal emotional health among minority, adolescent mothers: a mixed methods study.

Abstract

STUDY OBJECTIVE\nTo explore minority, adolescent birth and perinatal experiences to inform and improve quality of care for this unique group.\n\n\nDESIGN\nMixed quantitative and qualitative study guided by Bourdieu s Social Fields framework.\n\n\nSETTING\nClinic dedicated to parenting adolescents, and a local charter school founded to serve pregnant and parenting young adults.\n\n\nPARTICIPANTS\nSample size for quantitative data: n=27; qualitative data: n=14. Average age: 16.39 years-old (SD=1.29); majority self-identified as Latina/Hispanic or African American/Black/Afro-Caribbean/African.\n\n\nINTERVENTIONS AND OUTCOME MEASURES\nTwo validated surveys: Birth Satisfaction Scale-Revised (BSS-R), and the Postpartum Worry Scale-Revised (PWS-R). The BSS-R has 10-items, and quantifies labor and delivery experiences. The Postpartum Worry Scale-Revised (PWS-R) has 20-items, and quantifies maternal, infant, and social-emotional worries. The qualitative, semi-structured 30-minute interviews with a subset of survey respondents further explored perinatal mental health, labor experiences and support networks.\n\n\nRESULTS\nBirth Satisfaction Scale-Revised data resulted in an average score of 25.14 (SD=5.35), which correlated to moderate satisfaction with birth experience (range 0-40, 0=most negative). Postpartum Worry Scale-Revised average score of 55.79 (SD=21.06) indicated elevated postpartum worries (range 20-100, 20=most worries). Qualitative interviewees worried about relationships and newborn well-being; support networks fluctuated; distinct events, pain, and fear during labor dominated birth stories. Advice for peers included: tending to social support, stress, and self-care. Nonjudgmental communication, empathy, and emotional connection were desired attributes of their healthcare team. Participants had anxiety related to social networks and newborn care. While birth experiences were moderately positive, they were also described as stressful. Yet, participants were resourceful, insightful, and took advantage of social supports.\n\n\nCONCLUSIONS\nBirth experiences, patterns of stress, and support networks are uniquely identified and utilized by adolescent mothers. Being heard and feeling connected to providers empowered this group of young, minority adolescents. Participant advice could inform future educational courses, programs, and hospital innovations for perinatal adolescents.