Friday, 28 July 2017
Purpose: Infrequent or delayed attendance for antenatal care is likely to exacerbate the health risks associated with pregnancy in adolescence ADDIN EN.CITE
<EndNote><Cite><Author>Muhwava</Author><Year>2016</Year><RecNum>2872</RecNum><DisplayText>(Muhwava,
Morojele, & London,
2016)</DisplayText><record><rec-number>2872</rec-number><foreign-keys><key
app="EN" db-id="d9v0dv9emtpvviezazpv5at9tpara0pafste"
timestamp="1480993140">2872</key></foreign-keys><ref-type
name="Journal Article">17</ref-type><contributors><authors><author>Muhwava,
L. S.</author><author>Morojele,
N.</author><author>London,
L.</author></authors></contributors><titles><title>Psychosocial
factors associated with early initiation and frequency of antenatal care (ANC)
visits in a rural and urban setting in South Africa: a cross-sectional
survey</title><secondary-title>BMC Pregnancy and
Childbirth</secondary-title></titles><periodical><full-title>BMC
pregnancy and childbirth</full-title></periodical><pages>18</pages><volume>16</volume><section>18</section><dates><year>2016</year></dates><urls></urls><remote-database-name>WorldCat.org</remote-database-name></record></Cite></EndNote>(Muhwava, Morojele, & London, 2016). Poor health literacy and inadequate understanding into the role midwives have in maintaining healthy pregnancy, can result in an erosion of midwifery support ADDIN EN.CITE
<EndNote><Cite><Author>Docherty</Author><Year>2012</Year><RecNum>2871</RecNum><DisplayText>(Docherty,
Bugge, & Watterson, 2012)</DisplayText><record><rec-number>2871</rec-number><foreign-keys><key
app="EN" db-id="d9v0dv9emtpvviezazpv5at9tpara0pafste"
timestamp="1480993140">2871</key></foreign-keys><ref-type
name="Journal Article">17</ref-type><contributors><authors><author>Docherty,
Angie</author><author>Bugge,
Carol</author><author>Watterson,
Andrew</author></authors></contributors><titles><title>Engagement:
an indicator of difference in the perceptions of antenatal care for pregnant
women from diverse socioeconomic
backgrounds</title><secondary-title>Health
Expectations</secondary-title></titles><periodical><full-title>Health
Expectations</full-title></periodical><pages>126-138</pages><volume>15</volume><number>2</number><section>126</section><dates><year>2012</year></dates><isbn>1369-6513</isbn><urls></urls><remote-database-name>WorldCat.org</remote-database-name></record></Cite></EndNote>(Docherty, Bugge, & Watterson, 2012). The result of this is a failure for this group to make optimal use of midwifery services provided. In this context potential alienation from midwives may further increase risks already associated with entrenched health behaviours resulting in poor ongoing outcomes for individuals, pregnancies and child development ADDIN EN.CITE
<EndNote><Cite><Author>Kim</Author><Year>2014</Year><RecNum>2830</RecNum><DisplayText>(Kim,
Connolly, & Tamim,
2014)</DisplayText><record><rec-number>2830</rec-number><foreign-keys><key
app="EN" db-id="d9v0dv9emtpvviezazpv5at9tpara0pafste"
timestamp="0">2830</key></foreign-keys><ref-type
name="Journal Article">17</ref-type><contributors><authors><author>Kim,
Theresa</author><author>Connolly,
Jennifer</author><author>Tamim,
Hala</author></authors></contributors><titles><title>The
effect of social support around pregnancy on postpartum depression among Canadian
teen mothers and adult mothers in the maternity experiences
survey</title><secondary-title>Pregnancy and
Childbirth</secondary-title></titles><pages>162</pages><volume>14</volume><number>1</number><dates><year>2014</year></dates><isbn>1471-2393</isbn><accession-num>doi:10.1186/1471-2393-14-162</accession-num><urls><related-urls><url>http://www.biomedcentral.com/1471-2393/14/162</url></related-urls></urls><electronic-resource-num>10.1186/1471-2393-14-162</electronic-resource-num></record></Cite></EndNote>(Kim, Connolly, & Tamim, 2014). Taken from the authors PhD studies, this presentation will discuss the experiences and cultural behaviours of a group of pregnant adolescents that displayed the ways in which they made sense of their pregnancy health needs. Examining the resulting knowledge may assist midwives to plan equitable approaches to antenatal care and create occasions that strengthen engagement strategies with adolescents ADDIN EN.CITE
<EndNote><Cite><Author>Guliani</Author><Year>2014</Year><RecNum>2632</RecNum><DisplayText>(Guliani,
Sepehri, & Serieux,
2014)</DisplayText><record><rec-number>2632</rec-number><foreign-keys><key
app="EN" db-id="d9v0dv9emtpvviezazpv5at9tpara0pafste"
timestamp="0">2632</key></foreign-keys><ref-type
name="Journal
Article">17</ref-type><contributors><authors><author>Guliani,
H.</author><author>Sepehri, A.</author><author>Serieux,
J.</author></authors></contributors><auth-address>Department
of Economics, 553 Fletcher Argue Building, University of Manitoba, Winnipeg,
MB, Canada R3T 5V5 Harminder.Guliani@uregina.ca.
Department of
Economics, 553 Fletcher Argue Building, University of Manitoba, Winnipeg, MB,
Canada R3T 5V5.</auth-address><titles><title>Determinants of
prenatal care use: evidence from 32 low-income countries across Asia,
Sub-Saharan Africa and Latin America</title><secondary-title>Health
Policy Plan</secondary-title><alt-title>Health policy and
planning</alt-title></titles><pages>589-602</pages><volume>29</volume><number>5</number><edition>2013/07/31</edition><dates><year>2014</year><pub-dates><date>Aug</date></pub-dates></dates><isbn>1460-2237
(Electronic)
0268-1080
(Linking)</isbn><accession-num>23894068</accession-num><urls></urls><electronic-resource-num>10.1093/heapol/czt045</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>(Guliani, Sepehri, & Serieux, 2014). Furthermore the integration of this knowledge into midwifery practice may potentially exert positive influences to reduce the continuing cyclic health risks to this group of often marginalised women and their children ADDIN EN.CITE
<EndNote><Cite><Author>Hadley</Author><Year>2016</Year><RecNum>2865</RecNum><DisplayText>(Hadley,
2016)</DisplayText><record><rec-number>2865</rec-number><foreign-keys><key
app="EN" db-id="d9v0dv9emtpvviezazpv5at9tpara0pafste"
timestamp="1480992703">2865</key></foreign-keys><ref-type
name="Journal
Article">17</ref-type><contributors><authors><author>Hadley,
Alison</author></authors></contributors><titles><title>Teenage
pregnancy: Great progress, but no room for
complacency</title><secondary-title>British Journal of
Midwifery</secondary-title></titles><periodical><full-title>British
Journal of Midwifery</full-title></periodical><pages>238-239</pages><volume>24</volume><number>4</number><section>238</section><dates><year>2016</year></dates><isbn>0969-4900</isbn><urls></urls><remote-database-name>WorldCat.org</remote-database-name></record></Cite></EndNote>(Hadley, 2016).
Methods: The qualitative approach of interpretive ethnography was utilised incorporating participate observation as a means of data collection. The author was for nine months positioned alongside pregnant adolescents in the waiting area of a dedicated “young women’s” antenatal clinic. Observations and cultural behaviours recorded during this time were supported by personal stories and validated using in-depth interviews at spaced intervals. Data collection and analysis was a concurrent approach following Spradley’s (1980) systematic approach to research development. This methodological analysis exposed four major themes influencing adolescents’ health related actions during pregnancy:
- State of mind. This theme was generated from actions prior to pregnancy disclosure, pregnancy discovery, incidents that occurred during antenatal clinic attendance and the social influences prevalent at the time.
- Searching for information. Adolescents are not different from other primiparae in wanting information relevant to their pregnancy, however, this theme identified where information was sourced by adolescents, where it was ‘given’ and the means by which the information was provided.
- Sources of support. Support took different connotations for individuals. Adolescence is a time of life with varying levels of parenting support i.e. very young to independent living. Adolescents often were estranged from supportive relationships, neither were they always exposed to consistent relationships. What adolescents considered to be essential support was distilled in this theme.
- Engaging with pregnancy. This theme took the context of ‘developing a mothering role’. Considering stage of life, cognition, social determinants and ability to plan for their future mothering, were included in this theme.
Results: The information gained from these themes includes reasons why adolescents delayed their pregnancy disclosure, the sources of information they considered to be of most use to them and who they relied upon for guidance during pregnancy. The traditional medicalised structured approach to antenatal care had little influence on adolescents’ reasons to attend for antenatal care. Midwifery contact was a polarising experience for some adolescents and the manner in which they were provided services strongly influenced their continued antenatal attendance. Personal and emotional milestones within their pregnancy were pivotal to their engagement with their pregnancy and as such identified moments of increased connectedness.
Conclusion: This presentation will build on what are known barriers and enhancements to providing antenatal care to adolescents, further the presenter will provide new insights into how influential antenatal care may be delivered to adolescents. While this research was conducted in Australia its message is very applicable globally to midwives wishing to enhance their approach to providing effective antenatal care to this group.