Delaying the Second Pregnancy Among Teen Mothers: An Innovative Community Collaboration

Sunday, 30 July 2017

Ainat Koren, PhD
School of Nursing, University of Massachusetts, Lowell, Lowell, MA, USA
Annette McDonough, PhD
University of Massachusetts, Lowell, Lowell, MA, USA


Nearly one in five births to teens, ages fifteen to nineteen, are repeat births. Most (Eighty six percent) are second births. (MMWR, 2013). Teen pregnancies and births have a negative effect on the physical, psychological, and social wellbeing of all teen mothers and their offspring (Martinez & Abma, 2015). Teenage mothers who have a rapid second birth have substantially poorer socioeconomic and familial outcomes than do those who delay subsequent childbearing. The likelihood that a teen mother will finish high school, break the cycle of welfare dependency, and rise above her social standing, all diminish rapidly with the arrival of each succeeding infant. Early intervention programs for teen parents and their babies during pregnancy significantly reduced the rate of second pregnancies for high-risk mothers (Klerman,2004). Further, initiation of home visits (as a part of the program) prior to the birth of the infant was associated with a lower rate of subsequent childbearing. Parenting teens’ access to contraceptive services, in and of itself, does not decrease subsequent birth rates during adolescence. These rates are reduced, however, when access is combined with defined educational goals and support provided by schools and programs.The program goals were:

  1. to delay a second pregnancy among first-time adolescent mothers,

  2. to encourage consistent and correct contraceptive use

  3. to assist the young mothers with continuing their education and graduating from high school or equivalency programs, and

  4. to support positive motherhood.

The program consisted of two components: bi-monthly group meeting for support and content delivery, and ongoing, individual support provided by a role model case manager.

This poster will share an innovative and sustainable community collaboration to develop a comprehensive support model for pregnant and parenting teen mothers in a city in Northern Massachusetts with disproportionately high teen birth rates.


Program evaluation consisted process and outcome evaluations. Team meeting were documented to track the process of program development. Collaboration strategies, challenges and solutions in program implementation were summarized. Individual interviews were conducted with the participating teen mothers and the program staff.


Nine organization from the community collaborated to develop and execute the program. The organization included the state university, community health center, local hospital, women and children (WIC), two high schools, and 4 non profits in the area that serves high risk families and children. Process evaluation identified that program sustainability is essential to the survival of a program. Sustainability has been defined as the capacity to maintain program services at a level that will provide ongoing prevention and treatment for a health problem. Non profit housed the case management project to overcome the challenge of low budget and legal implications. Teen groups were held at the high schools to increase participation. Outreach and collaborations were established with organizations with competing services in the community.


In today's reality where funding is sparse, community organization collaboration is essential. This program is unique by incorporating the case management under existing non-profit organizations. In addition the groups were provided where the teen mothers were, namely the high school.