Introduction
Teenage pregnancy and childbirth is a burning issue in Australia. Statistical data showcase detrimental effects of being an adolescent mother, since young mothers appear to experience long-term psychological impairments, serious developmental crisis and physical problems (Bishop, 2007). The Australian teenage pregnancy rates are not as high as the American, yet, they are four times higher than Spain, Italy, Japan and the Netherlands (Bishop, 2007). Based on the United Nations Population Fund handout that was released in December 2012, 16 million adolescent girls give birth annually, which is approximately 11 percent of all worldwide births, and thousands of teenage girls between the ages of 15 and 19 die each year in low-to-middle-income countries due to complication during their pregnancy or childbirth (unfpa.org). In the developing world, adolescent marriages occur with a high rate: one in three adolescent girls get married before they reach 18 years of age (unfpa.org). If that trend continues, it is estimated that by 2030 there will be about 15 million adolescent girls being married at a young age and getting pregnant (unfpa.org).
Major Health Needs of Adolescent Mothers and Their Children
Of course, being married at such young ages hides hazards that a young girl cannot see or has never been educated before. Statistics have shown that young girls that commit into marriage are more prone to regular unprotected sex, which means that there are increased levels of exposing themselves to HIV, violence and adverse pregnancy outcomes, among others (unfpa.org).
Also, girls under 15 years old run a higher risk of maternal mortality; in fact, the younger a girl gets pregnant, the higher the risk for her life is (unfpa.org). A pregnancy in adolescent years can bring devastating results to the mother, since there are socioeconomic consequences of having a pregnant adolescent at home, in a community and a nation (unfpa.org). Societies are not welcoming towards adolescent pregnancies, as they are conceived as unsanctioned. Abortions are in much higher rates within that age group; it is estimated that about 3 million unsafe abortions have occurred in developing countries, in 2008 alone, and in most cases girls have experienced serious complications during abortion procedure, even death in 13 percent of those cases (unfpa.org).
According to facts released from the World Health Organization, over 500,000 pregnant women experience fatal implication during their pregnancy or when delivering their child (Stephenson, 2006). Proper maternal health care is crucial both for the woman that gave birth to an infant and the infant itself. The International Conference on Population and Development that was held in 1994, decided to promote the reproductive health care needs of adolescent mothers (Rice, 2000). However, adolescent mothers that seek for health care and reproductive health services appear to be rather disadvantaged compared to adult mothers.
Teenage mothers also face far more hardships not only during their pregnancy, but also while experiencing their early motherhood, due to sociological and health-related problems. Adolescent mothers are usually marginalized, drop out of school and have little chances to earn a salary. Furthermore, they only attend up to four care visits during their pregnancy, when antenatal care visits in adult mothers are far more (Myer & Harrison, 2003).
What is more, it is highly likely that adolescent mothers will not get their infant vaccinated with the second and third dose of Diphtheria and Poliomyelitis, which jeopardizes its health, and they will probably not have a childhood-disease vaccination card (Luther, 1998). Finally, adolescent mothers run the risk of giving birth to a low-weight infant, while there are also increased rates of maternal and infant deaths, due to poor maternal health care services (LeGrand & Mbacke, 1993)
Among the most commonly seen health problems adolescent mothers face during their pregnancy, other than the usual morning sickness, are malaria fever, anemia and puffy legs (Atuyambe et.al, 2008), while there have been cases when teenage mothers have reported being under nourished during pregnancy. Additionally, they had to face societal problems, as they were found more prone to victimization by partners and parents and/or being rejected from the school community and/or their family (Mngadi et.al, 2003), not to mention the fear and uncertainty they feel about whether their child will survive or not.
Another issue that arises from teenage pregnancies and brings new hazards to the health of adolescent mothers and their children is home delivery. In 2006, 58 percent of pregnant adolescents have given birth at home (UBOS, 2006). That rate dropped to 10 percent by 2008 (UBOS, 2006); however, studies have shown that home deliveries have been directly linked to negative outcomes in terms of neonatal and maternal care, since there have been many cases when emergency obstetric care was intense (Tsu, 1994). For that reason, antenatal care and specially designed treatment programs are delivered as a means to provide high maternal care.
An Australian report released by the The National Youth Affairs Research Scheme, which cooperates with and operates under the guidelines of the Ministerial Council on Education, Employment, Training and Youth Affairs, mentions that there are three main groups of barriers to service delivery in adolescent girls that are pregnant (Loxton, Williams & Adamson, 2007). According to the report, there is major lack of available services to provide family and social support, such as accommodation and housing, not to mention child care, which is scarce (Loxton, Williams & Adamson, 2007). Secondary and tertiary education is rather far-fetched for adolescent mothers, with the low social support, lack of transport and expenses (Loxton, Williams & Adamson, 2007). Adolescent mothers avoid health centres and mothers’ support and play groups out of fear of being the only young mother in the group and due to inappropriate judgemental behaviours of medical staff (Loxton, Williams & Adamson, 2007). Women with diverse backgrounds, in terms of culture and language, find delivery services that were meant to meet their culture and religious needs, hard to get for various reasons, including lack of Indigenous social workers and health care providers (Loxton, Williams & Adamson, 2007). Finally, adolescents with “mental health and/or substance use problems, and/or intellectual disabilities were found to be in need of a multitude of services, and yet were the least likely to have consistently used services” (Loxton, Williams & Adamson, 2007). Perhaps the only youth-parenting supporting program is the Red Cross program, which mainly focuses on providing services to young mothers that are mentally ill or have substance abuse problems (Loxton, Williams & Adamson, 2007). Another reason why service delivery fails is because young mothers fear of being found by a family member that has violently abused them, while at the same time there are services that close their doors to violently abused young mothers (Loxton, Williams & Adamson, 2007). Of course, a major fear of young mothers that avoid delivery services is that they might be judged as inappropriate mothers and loose custody of their children because they do not have the required knowledge and experience to cope with parenting (Loxton, Williams & Adamson, 2007).
A Nurse’s Role on Primary Heath Care for Adolescent Mothers
Evidence and research has shown that if there was trained medical staff present in childbirth, most maternal deaths would have been significantly reduced (Howlader, Kabir & Bhuiyan, 1999). Other than that, whether a parent has the ability to create a harmonious family environment or not, greatly influences childhood and contributes to a smooth transition between developmental stages (Bishop, 2007).
Nurses can play a significant role in improving outcomes for adolescent mothers and their off springs and balance the health and social disparities that are commonly noticed within that particular group (Bishop, 2007). Nurses can help teenage mothers enhance their parenting skills and raise their self-esteem so they can then be able to properly raise their child. Nursing intervention can be achieved by providing practical assistance alongside social support and parenting help (Bishop, 2007). “There is evidence that postnatal support can ameliorate adverse environmental impacts in teenage parenting outcomes [and] the leading strategy for improving postnatal support is sustained home visitation by nurses” (Bishop, 2007). Nurses can join home visiting programs and establish a good therapeutic relationship with the future young mothers that encourage the adolescent pregnant to learn about contraception, as a preventive means for future pregnancies, familiarize themselves with proper parenting, which would help reduce any potential child behavioral issues, including neglect and abuse (Bishop, 2007). That way, teenage mother get to know their true potential and stand a good chance to raise healthy and happy children, while they themselves experience motherhood with balance and joy. As a matter of fact, the South Australian Government has initiated a global program, in 2006, according to which all mothers with newborns, including adolescent ones, will get up to 34 home visits for the first 24mnths of their infant’s life by qualified nurses that will provide support and extra help to all families in need (Bishop, 2007). Parents that experience lack of social support and/or isolation and loneliness will most likely neglect their children, compared to parents that receive strong social support (DePanfilis, 2006). It is proven that child health nurses who provide regular home visits and interact with adolescent mothers and their infants, for a long time span, not only help and educate young mothers towards parenting, but also assist in preventing any negative issues on the long run and build strong social supports (Bishop, 2007). By promoting self-esteem and allowing young mothers feel they are part of a welcoming community, motivates adolescent mothers go along with social norms (DePanfilis, 2006).
A nurse’s role in ensuring communities are viable is significant (McMurray and Clendon, n.d). when caring for the community, nursing supports people’s wellbeing and health, by bringing to families and communities an “evidence-base of knowledge that includes understanding physical and psychological health, the social and cultural determinants that support or impinge on health, and features of the community that support health” (McMurray and Clendon, n.d). Nursing support combined with other early family services in Australia can help teenage mother transit to motherhood without having to face serious challenges in terms of social and other deriving problems.
Conclusion
Adolescent pregnancy is commonly seen in Australia and even though teenage pregnancy rates are nothing close to the overwhelming rates of the U.S, by the end of 2030 it is highly likely that there will be about 15 million adolescent mothers worldwide, which makes teenage pregnancy a global issue that needs to be attended. Teenage mothers face numerous challenges during and after their pregnancy, including enhanced risk for mental disorders and depression and increased levels of stress that affect their parenting and child care. Other than that, they also need to confront with social isolation, which is why a huge number of young mothers never make it to their child’s second and third vaccination dose, to avoid social discrimination. For the same reason, a number of adolescent mothers prefers to give birth at home, increasing the risk to complications that may even cost them their own and/or child’s life. Of course, inequality reins and the very few youth-parenting programs are not sufficient to cover the needs of all teenage mothers, mostly due to lack of means. Nurse support is proven to be effective in helping young mothers cope with the societal issues that arise from their pregnancy. Also, programs, where nurses provide at home child care visits are found to have positive outcomes in terms of educating the young mothers towards parenting and contraception, enhance their self-esteem and allowing them to handle the hazards that come with parenting. All in all, the nurse’s role in ensuring a community’s wellbeing is more than important.
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