Teenage Pregnancy Research Report - 3p Consulting

• There is a lack of understanding about what constitutesa healthy diet or why good nutrition is important duringpregnancy. While many young people named up achange to a healthier diet as something important oncethey found out they were pregnant, when asked howthey had changed their diet, many young people saidthings like “I cut back on takeaways”, “just ate the same”or “ate what was recommended” but were unable toarticulate or remember what food groups they ate.As illustrated by the lack of understanding about thecorrect use of contraception, it seems young people needexplicit, concrete and precise information repeated oftenacross multiple providers they engage with if they aregoing to translate health advice into day-to-day practicein their lives. The issue of health literacy more broadly inadolescence is an area for potential research.Antenatal CareAntenatal education is part of the maternity culture,but teenagers are neither consistent nor committedattendees. 23 This is consistent in the Northern Tasmaniaresearch with many young people and service providersdescribing an ad-hoc and inconsistent approach toaccessing and maintaining antenatal care.The most common theme that emerged during theresearch was the extent to which other aspects of theirlives were organised. In addition, the level of supportavailable by an adult was considered critical in accessingand maintaining support. The young people that missedantenatal appointments cited the following as the keyreasons:• Lack of transport (including the person that drovethem to appointments was sometimes too busy).• Feeling intimidated by the system if they were alone.• Feeling awkward and embarrassed in having detailedconversations with service providers.• Something more critical to deal with: i.e. appointmentwith Centrelink, organising housing etc.Midwives from the Launceston General Hospitalteenage antenatal clinic confirmed that keepingappointments is often problematic for young people.Their perception of this is not based on accessibilityto the service or feeling intimidated by the hospitalenvironment. They had put in place a range ofoptions to address the low attendance rate and asan example, establishing an outreach clinic did notchange attendance patterns. However, they did relatethat many teenagers come to appointments withtheir mother or a friend and that they are more likelyto come if there is an incentive such as a visit to thelabour ward.Birth preparation classes run specifically forteenagers were not well attended and are no longerin place. Young parents interviewed said that they feltacutely uncomfortable going to classes and preferredto speak about having the baby with someone closeto them. Preparation and knowledge about the birthprocess was an obvious gap for young people. Whenasked about how they went about preparing to be aparent, one very involved young father said that whilehe was able to access pregnancy and parentingadvice online or via his family, he felt completely ata loss during labour and extremely frightened. Othercomments from the young women ranged from “don’twant to think about it, “I was scared and didn’t haveany idea about what was happening”.A model of good practice and an alternative way ofdelivering antenatal services is the centre-basedand/or home visiting midwifery model run from theTasmanian Aboriginal Health Service. Continuity ofstaff means that each young person is more easilytracked if appointments are missed and informationand advice can be specifically tailored to individualneed. In essence the midwife becomes the “trusted”adult to the young person.All service providers spoke of what they described as“a lack of emotional maturity” in pregnant teenagersthat had more of an impact the younger they were.This lack of maturity was an issue that serviceproviders said impacted a young person’s ability tomake good choices, to prioritise their time, and tokeep appointments. cu@home workers for examplesay that they have learnt over time that many of theirclients will agree to schedules and activities thatthey do not want or are unable to do as they areuncomfortable about saying no. This then results inthem not being at home at agreed times. This mayexplain in part, why young people are considered bysome services to be “unreliable” clients.This is not a new issue or an issue confined toThe local context69