Teenage childbearing in Sweden support from social network and midwife

Sammanfattning: 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.