Lois S. Sadler

The adolescent parent: A dual developmental crisis.

This paper examines salient developmental characteristics of adolescents and beginning parents. In the case of many teenage parents, specific developmental tasks of adolescence affect and may potentially conflict with the tasks of early parenthood. A conceptual framework is presented which describes this conflict and serves as the basis for examining and explaining certain unique behaviors observed in young adolescent parents.

Women’s Experience of Group Prenatal Care

Group prenatal care (GPNC) is an innovative alternative to individual prenatal care. In this longitudinal study we used ethnographic methods to explore African American and Hispanic women’s experiences of receiving GPNC in two urban clinics. Methods included individual, in-depth, semistructured interviews of women and group leaders in GPNC, participant observation of GPNC sessions, and medical record review. GPNC offered positive experiences and met many of women’s expressed preferences regarding prenatal care. Six themes were identified, which represented separate aspects of women’s experiences: investment, collaborative venture, a social gathering, relationships with boundaries, learning in the group, and changing self. Taken together, the themes conveyed the overall experience of GPNC. Women were especially enthusiastic about learning in groups, about their relationships with group leaders, and about having their pregnancy-related changes and fears normalized; however, there were also important boundaries on relationships between participants, and some women wished for greater privacy during physical examinations.

Lasting Effects of an Interdisciplinary Home Visiting Program on Child Behavior: Preliminary Follow-Up Results of a Randomized Trial

Child mental health is of great concern requiring effective and appropriate parenting interventions. This pilot study was the first attempt to examine the intermediate effects of an ongoing parenting home visiting program, Minding the Baby (MTB), on parental reflective functioning (RF) and child behavior. Results indicated that the women who participated in the MTB intervention described their children-when assessed post-intervention-as having significantly fewer externalizing child behaviors. However, there was no significant difference between the two groups on parental RF from the end of the intervention to follow-up. The central finding that children who participated with the MTB program were reported to have significantly fewer externalizing behaviors following the intervention has important clinical and public health implications. Recommendations for the design of future follow-up studies and for further exploration of parental RF as it relates to the MTB outcomes are discussed.

Ambivalent Grandmothers Raising Teen Daughters and Their Babies

The study’s purpose was to describe the experience of young grandmothers in families with teen mothers. Cross-sectional surveys and phone interviews were conducted with a multiethnic sample of 25 mothers or guardians of teen mothers enrolled in an urban high school. Participants and their daughters completed measures of mother-daughter conflict, self-esteem, and motherdaughter relationships. Adescriptive thematic analysis was conducted with grandmothers’ transcribed responses to open-ended interview questions. 69% of grandmothers rated their overall relationship with their daughters as positive, and 46% indicated an improved relationship since the birth of the baby. Areas of mother-daughter conflict included childrearing decisions, time with friends, household chores, and teens’ choices/priorities. Interview data revealed themes of identity confusion in young grandmothers, the many stresses of early grandparenthood, pride and joy in grandchildren, family social support, and limited coping resources. Community and home-based multigenerational parent support interventions may address some of these grandmothers’ concerns.

A Review of Attachment Theory in the Context of Adolescent Parenting

The purpose of this article is to review attachment theory and relate the attachment perspective to adolescent mothers and their children. Attachment theory explains positive maternal-infant attachment as a dyadic relationship between the infant and mother that provides the infant with a secure base from which to explore the world. With respect to cognitive, social, and behavioral domains, securely attached infants tend to have more favorable long-term outcomes, while insecurely attached infants are more likely to have adverse outcomes. Adolescent parenthood can disrupt normal adolescent development, and this disruption influences development of the emotional and cognitive capacities necessary for maternal behaviors that foster secure attachment. However, it appears that if specialized supports are in place to facilitate the process of developing attachment, infants of adolescent mothers can obtain higher rates of secure attachment than normative samples in this population.

Original ArticleThe adolescent parent: A dual developmental crisis

This paper examines salient developmental characteristics of adolescents and beginning parents. In the case of many teenage parents, specific developmental tasks of adolescence affect and may potentially conflict with the tasks of early parenthood. A conceptual framework is presented which describes this conflict and serves as the basis for examining and explaining certain unique behaviors observed in young adolescent parents.

A model of teen-friendly care for young women with negative pregnancy test results☆

Sexually active adolescents, and especially those who receive negative pregnancy test results, are a self-identified group at particularly high risk for STIs and unintended pregnancies. Although reproductive health care alone will not totally prevent the occurrence of teen pregnancy and STIs, providing care that is accessible and designed to be teen-friendly will help diminish this area of health risk for hundreds of thousands of U.S. adolescents. Clinical interventions that are theoretically sound and based on research allow for the development of innovative, individualized, and evolving models of adolescent health care to address the needs of a challenging group of patients within a changing and competitive health care environment.

The Intersection of Everyday Life and Group Prenatal Care for Women in Two Urban Clinics

Women from vulnerable populations encounter challenging circumstances that generate stress and may adversely affect their health. Group prenatal care (GPNC) incorporates features that address social stressors, and has been demonstrated to improve pregnancy outcomes and prenatal care experiences. In this qualitative study, we describe the complex circumstances in the lives of women receiving care in two urban clinics and how GPNC attenuated them. Stressors included problems with transportation and child care, demanding jobs, poverty, homelessness, difficult relationships with partners, limited family support, and frustrating health care experiences. Receiving prenatal care in groups allowed women to strengthen relationships with significant others, gain social support, and develop meaningful relationships with group leaders. By eliminating waits and providing the opportunity to participate in care, GPNC also offered sanctuary from frustrations encountered in receiving individual care. Reducing such stressors may help improve pregnancy outcomes; however, more evidence is needed on mechanisms underlying these effects.

Parental Reflective Functioning: An Approach to Enhancing Parent-Child Relationships in Pediatric Primary Care

The current state of science suggests that safe, responsive, and nurturing parent-child relationships early in childrens lives promotes healthy brain and child development and protection against lifelong disease by reducing toxic stress and promoting foundational social-emotional health. Pediatric health care providers (HCPs) have a unique opportunity to foster these relationships. However, such a role requires a shift in pediatric health care from a focus only on children to one that includes families and communities, as well as the inclusion of childrens social and emotional health with their physical health. To foster healthy parent-child relationships, HCPs must develop the expertise to integrate approaches that support the familys socioemotional health into pediatric primary care. This article suggests ways in which pediatric HCPs can integrate a focus on parental reflective functioning into their clinical work, helping parents to understand some of the thoughts and feelings that underlie their childrens behavior.

Tailoring Clinical Services to Address the Unique Needs of Adolescents from the Pregnancy Test to Parenthood

Clinicians across disciplines and practice settings are likely to encounter adolescents who are at risk for a pregnancy. In 2010, 34.2/1000 15-19-year-old teens had a live birth in the United States, many more will seek care for a pregnancy scare or options counseling. Teen mothers are also at risk for a second or higher-order pregnancy during adolescence. This paper provides clinicians with adolescent-friendly clinical and counseling strategies for pregnancy prevention, pre- and post-pregnancy test counseling, pregnancy-related care, and a review of the developmental challenges encountered by teens in the transition to parenthood. Clinicians are in a better position to approach the developmental, health and mental health needs of adolescents related to pregnancy if they understand and appreciate the obstacles adolescents may face negotiating the healthcare system. In addition, when clinical services are specially tailored to the needs of the adolescent, fewer opportunities will be lost to prevent unintended pregnancies, assist teens into timely prenatal services, and improve outcomes for their pregnancies and the transition to parenthood.