Teenage childbearing in Sweden : support from social network and midwife
Author: Hertfelt Wahn, Elisabeth
Date: 2007-09-27
Location: Skandiasalen, Astrid Lindgrens Barnsjukhus, Karolinska Universitetssjukhuset, Stockholm
Time: 10.00
Department: Institutionen för kvinnors och barns hälsa / Department of Women's and Children's Health
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thesis.pdf (354.7Kb)
Abstract
The aim of this thesis was to contribute to the knowledge and
understanding of Swedish- speaking pregnant and parenting teenage girls
situation and experiences of becoming mothers in the Swedish context as
well as midwives reflections on their experiences of caring for teenage
girls during pregnancy and childbirth.
Specific aims were to describe Swedish teenage girls perspectives, experiences and thoughts about becoming and being a teenage mother (I); to describe Swedish midwives reflections on their experiences of caring for teenage girls during pregnancy and childbirth (II); to describe and compare a group of Swedish-speaking teenage mothers, aged 15-19, with adult mothers, aged 25-29, all of whom gave birth in hospital, in terms of sociodemographic background, perception of health during pregnancy, and social support (III); to describe and compare the perception of received social support, self-esteem and different background factors among teenage mothers, aged15-19, with and without depressive symptoms (IV).
Methods: The studies were conducted in a county in south western Sweden during 2003 and 2004. Both qualitative and quantitative methods were used: individual semi-structured interviews with 20 teenage mothers (I); three focus group discussions (FGDs) with 24 midwives; and a questionnaire developed specifically for this study given to 97 teenage mothers and 97 adult mothers 1-3 days postpartum (III, IV). Content and hermeneutical text analyses were applied to qualitative data (I, II), and descriptive statistics were used to analyse quantitative data (II, IV).
Results from studies showed that there were two main reasons for Swedish-speaking teenagers to become mothers (I, II, III). It was seen as a way out of a difficult psychosocial situation, or it was seen as something natural because of a family pattern of early motherhood (I, II). Teenage mothers had more often had an early experience of parental separation, had experienced physical and/or psychological violence, were more often inclined to engage in risky behaviours, and smoked more often during pregnancy. In addition they perceived less support from their social network, had lower self-esteem, and had more depressive symptoms than adult mothers (III). Teenage mothers with depressive symptoms had lower self-esteem, perceived less support from family and friends, had more often been exposed to violence, and were more often smokers than teenage mothers without depressive symptoms (IV). Support from the midwives was generally well perceived by teenage mothers, but support from the midwife attending delivery was less well perceived in teenage mothers with depressive symptoms (IV). Reflections by the midwives about their experience of caring for teenage mothers revealed a true presence in the encounters with teenage mothers (II).
Conclusions: Our findings provide midwives and other health care providers with a picture of the experience of teenage motherhood, which highlights the importance of antenatal assessment of each teenage mother s strengths, weaknesses, hopes, self-esteem, depressive symptoms, health risk behaviours, social support networks, and satisfaction with social support prior to care planning. The midwife needs to lend a listening ear to the teenage mother, giving her time, showing that she is taking her seriously and trying to understand her complex situation. Teenage mothers need acceptance and clear communication.
Specific aims were to describe Swedish teenage girls perspectives, experiences and thoughts about becoming and being a teenage mother (I); to describe Swedish midwives reflections on their experiences of caring for teenage girls during pregnancy and childbirth (II); to describe and compare a group of Swedish-speaking teenage mothers, aged 15-19, with adult mothers, aged 25-29, all of whom gave birth in hospital, in terms of sociodemographic background, perception of health during pregnancy, and social support (III); to describe and compare the perception of received social support, self-esteem and different background factors among teenage mothers, aged15-19, with and without depressive symptoms (IV).
Methods: The studies were conducted in a county in south western Sweden during 2003 and 2004. Both qualitative and quantitative methods were used: individual semi-structured interviews with 20 teenage mothers (I); three focus group discussions (FGDs) with 24 midwives; and a questionnaire developed specifically for this study given to 97 teenage mothers and 97 adult mothers 1-3 days postpartum (III, IV). Content and hermeneutical text analyses were applied to qualitative data (I, II), and descriptive statistics were used to analyse quantitative data (II, IV).
Results from studies showed that there were two main reasons for Swedish-speaking teenagers to become mothers (I, II, III). It was seen as a way out of a difficult psychosocial situation, or it was seen as something natural because of a family pattern of early motherhood (I, II). Teenage mothers had more often had an early experience of parental separation, had experienced physical and/or psychological violence, were more often inclined to engage in risky behaviours, and smoked more often during pregnancy. In addition they perceived less support from their social network, had lower self-esteem, and had more depressive symptoms than adult mothers (III). Teenage mothers with depressive symptoms had lower self-esteem, perceived less support from family and friends, had more often been exposed to violence, and were more often smokers than teenage mothers without depressive symptoms (IV). Support from the midwives was generally well perceived by teenage mothers, but support from the midwife attending delivery was less well perceived in teenage mothers with depressive symptoms (IV). Reflections by the midwives about their experience of caring for teenage mothers revealed a true presence in the encounters with teenage mothers (II).
Conclusions: Our findings provide midwives and other health care providers with a picture of the experience of teenage motherhood, which highlights the importance of antenatal assessment of each teenage mother s strengths, weaknesses, hopes, self-esteem, depressive symptoms, health risk behaviours, social support networks, and satisfaction with social support prior to care planning. The midwife needs to lend a listening ear to the teenage mother, giving her time, showing that she is taking her seriously and trying to understand her complex situation. Teenage mothers need acceptance and clear communication.
List of papers:
I. Hertfelt Wahn E, Nissen E, Ahlberg MB (2005). "Becoming and being a teenage mother: a qualitative study of teenage girls in a county in south western Sweden." Health Care for Women International 26(7): 591-603.
Fulltext (DOI)
Pubmed
II. Hertfelt Wahn E, von Post I, Nissen E (2007). "A description of Swedish midwives reflections on their experience of caring for teenage girls during pregnancy and childbirth." Midwifery 23(3): 269-78.
Pubmed
Fulltext (DOI)
View record in Web of Science®
III. Hertfelt Wahn E, Nissen E (2007). "Sociodemographic background, lifestyle, and psychosocial conditions of Swedish teenage mothers and their perception of health and social support during pregnancy and childbirth." Scandinavian Journal of Public Health. [Accepted]
Fulltext (DOI)
Pubmed
View record in Web of Science®
IV. Hertfelt Wahn E, Matthiesen AS, Nissen E (2007). "Swedish teenage mothers with and without depressive symptoms and their perception of support from network and midwife." [Submitted]
I. Hertfelt Wahn E, Nissen E, Ahlberg MB (2005). "Becoming and being a teenage mother: a qualitative study of teenage girls in a county in south western Sweden." Health Care for Women International 26(7): 591-603.
Fulltext (DOI)
Pubmed
II. Hertfelt Wahn E, von Post I, Nissen E (2007). "A description of Swedish midwives reflections on their experience of caring for teenage girls during pregnancy and childbirth." Midwifery 23(3): 269-78.
Pubmed
Fulltext (DOI)
View record in Web of Science®
III. Hertfelt Wahn E, Nissen E (2007). "Sociodemographic background, lifestyle, and psychosocial conditions of Swedish teenage mothers and their perception of health and social support during pregnancy and childbirth." Scandinavian Journal of Public Health. [Accepted]
Fulltext (DOI)
Pubmed
View record in Web of Science®
IV. Hertfelt Wahn E, Matthiesen AS, Nissen E (2007). "Swedish teenage mothers with and without depressive symptoms and their perception of support from network and midwife." [Submitted]
Issue date: 2007-09-06
Rights:
Publication year: 2007
ISBN: 978-91-7357-289-7
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