Factors Associated with Adolescent Pregnancy, Psychological Distress, and Suicidal Behavior in Jamaica: An Exploratory Study

Abstract

Purpose of the StudyTo describe the sociodemographic profile and explore the personal experiences of pregnant Jamaican adolescents and the impact of pregnancy on their psychological health.BackgroundThe Jamaican Global School‐based Health Survey (2010) found that 23% of adolescents aged 13 to 15 years reported seriously considering suicide, and 22% had actually attempted suicide one or more times during the last 12 months. The 2008 Jamaica Reproductive Health Survey has shown a teen pregnancy rate of 72 per 1000. The survey shows concerns about the high rate of maternal mortality, premature newborns, labor complications, low birth weight, and low and poor utilization of antenatal health care. Research that links adolescent pregnancy and suicidal behavior is lacking in Jamaica. Adolescent pregnancy and psychosocial health have been priorities for both the International Confederation of Midwives and the World Health Organization. Research within the Caribbean and Latin America has noted psychological distress and suicidal behaviors reaching prevalence of between 13% and 67% among pregnant adolescents. This study, which explores the self‐reported perceptions of pregnant adolescents, seeks to inform policy and practice as it pertains to adolescent maternity health care.MethodsMethods used include guided individual and focus group interviews of adolescents attending the multidisciplinary Teen Pregnancy Clinic at the Victoria Jubilee hospital and the traditional adult antenatal clinic at Spanish Town Hospital to elicit themes regarding perceptions, values, resilience, knowledge of community resources, perceptions of social support, and psychological distress. University and Ministry of Health ethics approval was obtained. Grounded theory analysis with NVIVO software was utilized.FindingsFindings of our pilot of 30 participants is presented utilizing thematic analysis. Comparisons will be made between the outcomes of teens who participate in a specialized adolescent prenatal care program compared to the traditional antenatal care model. The following preliminary themes have been identified: perceptions of self, values, resilience, knowledge of community resources, perceptions of social support, psychological distress, powerlessness, motherhood. Although motherhood is valued, most of these pregnancies are unplanned by the mother and sexual activity is forced in 1 out of 5 of teens aged 15 to 19 years.DiscussionMany Jamaican adolescent mothers face barriers to education, self‐determination, and family planning. Adolescent‐centered health care could mitigate stressors.