Adolescent Childbirth Research Articles

Adolescent Childbirth at Gao Hospital in Mali

The aim was to assess the prevalence and maternal and perinatal prognosis of adolescent childbirth at the Gao Hospital. Materials and methods: This was a prospective and cross-sectional study from January 1, 2020 to December 31, 2020. Results: we recorded 655 cases out of 3010 deliveries, i.e. a prevalence of around 21.7% with an average age of 17.39 years. The majority of them were married (92.5%), and the pregnancy was not followed in 33.3% of cases. On admission for delivery, they had anaemia (19%), high blood pressure (2.6%), pre-eclampsia (1.2%) and even eclampsia (4.5%). Prematurity accounted for 10.1%. Deliveries were conducted vaginally (84%). The main indications for caesarean sections were immature pelvis (32.3%) and eclampsia (26.6%). Complications were soft tissue tears (5%), postpartum hemorrhage (2.74%). The maternal mortality rate was two cases out of a total of 655 and the stillbirth rate was 5.6%.

Understanding the socio-demographic and programmatic factors associated with adolescent motherhood and its association with child undernutrition in Bangladesh

BackgroundWorldwide, a significant number of girls become mothers during adolescence. In Bangladesh, adolescent childbirth is highly prevalent and has adverse effects on children’s health and undernutrition. We aimed to identify the relationship between the undernutrition of children and adolescent motherhood, the factors associated with adolescent mothers’ age at first birth, and to examine the programmatic factors and gaps influencing children’s undernutrition in Bangladesh.MethodsWe analysed the ‘Bangladesh Demographic and Health Survey’ BDHS-17-18 data and desk review. To examine the factors associated with adolescent motherhood and its impact on child undernutrition, data from 7,643 mother-child pairs were selected. Child stunting, wasting, and underweight were measured according to the World Health Organisation (WHO) median growth guidelines based on z-scores − 2. Univariate, bivariate, simple, and multiple logistic regressions were used for analyse. We followed the systematic procedures for the literature review.ResultsApproximately, 89% of adolescents aged ≤ 19 years were married and 71% of them gave their first childbirth. Children of adolescent mothers (≤ 19 years) were significantly 1.68 times more wasted (aOR: 1.68; 95% CI: 1.08 to 2.64), 1.37 times more underweight (aOR: 1.37; 95% CI: 1.01 to 1.86) and either form 1.32 times more stunting, wasting or underweight (aOR:1.32; 95% Cl: 1.05 to 1.66) compared to the children of adult mothers (> 19 years) after adjusting potential confounders. The factors associated with mothers’ first childbirth during adolescence were the age gap between husband and wife 5–10 years (aOR: 1.81; 95% Cl: 1.57–2.10) and age gap > 10 years (aOR: 2.41; 95% Cl: 1.96–2.97) compared with the age group < 5 years, and husbands’ education (aOR: 1.29; 95% Cl: 1.04–1.61) compared with the uneducated husbands. In the literature review, we found potential gaps in focusing on the Adolescent Sexual and Reproductive Health (ASRH) program in Bangladesh, from thirty-two programmes only half of them focused on adolescents aged 10–19 years, and eleven programmes focused only on girls.ConclusionChildren of adolescent mothers are at risk of wasting, underweight, and any form of undernutrition. For effective policies and interventions in Bangladesh, it is important to emphasise delaying adolescent pregnancy and prioritising child undernutrition.

A qualitative review of adolescent childbirth experiences, its impact on development and the need for age-specific care

A qualitative review of adolescent childbirth experiences, its impact on development and the need for age-specific care

Muscle strength during pregnancy and postpartum in adolescents and adults.

Adolescent childbirth is associated with worse physical function over the long-term. Differential loss of muscle strength during pregnancy and postpartum for adolescents compared to adults may be one explanation for this, but research examining these differences is lacking. The objective of this study as to assess hand grip strength and hip adduction muscle strength in adolescents and adults during pregnancy and postpartum. A prospective cohort study was carried out with adolescent (13 to 18 years) and adult (23 to 28 years) primigravid women. Assessments were performed at three timepoints: before the 16th gestational week, during the third trimester, and between the fourth and sixth week postpartum. Hand grip strength (continuous and muscle weakness if ≤ 20.67 kgf) and hip adductor measures (continuous and muscle weakness if ≤ 13.8 kgf) were assessed using dynamometry. Generalized estimating equations modelled longitudinal relationships between muscle weakness and age group. More adolescents had hip adductor weakness than adults in the third trimester of pregnancy (62.5% vs. 31.8%, p < 0.005), which was corroborated by the longitudinal analyses. For all women, there were higher odds of hip adductor weakness in the third trimester (OR = 4.35; p< 0.001) and postpartum (OR = 9.45; p < 0.001) compared to the 16th gestational week. No significant difference in HGS was observed between age groups or across the different timepoints. The higher proportion of hip adductor weakness among adolescents may indicate a need for resistance training during and after pregnancy and physical therapy if weakness or injury is noted.

Factors Influencing Birth in Adolescents in the Province of West Nusa Tenggara

Background: Adolescent childbirth is a global problem, especially in developing countries. Based on data from the 2017 Indonesian Demographic and Health Survey (SDKI), the ASFR 15-19 at the national level is 36 per 1000 women while the NTB Province is 42 per 1000 women, so it is still in a position above the national level. Aims: To know the factors that influence teenage births. Methods: This research is an analytical study using secondary data from the results of the 2017 Indonesian Demographic and Health Survey (IDHS) by using a cross-sectional approach. The population in this study was 1368 respondents. sampling technique using purposive sampling obtained as many as 806 respondents. Data analysis was using univariate, bivariate analysis with chi-square, and multivariate with logistic regression analysis. Results: Based on the results of bivariate analysis, it was found that there was a significant relationship between the factors of education (CI 95% 2.996-16.366), age of first sex (CI 95% 2.271-11.853), use of contraception (CI 95% 0.292-0.846), number of children born (CI 95% 0.378-0.880) to teenagers. Factors of employment status (CI 95% 0.667-1.482) and living area (CI 95% 0.635-1.406) did not have a significant relationship with teenage births, while the results of multivariate analysis showed that the R2 value was 0.603 which means that education, age of first sex, use of contraceptives, and number of children contributed to teenage births of 60.3%, the remaining 39.7% is caused by other variables. Conclusion: Factors of education, age of first sex, use of contraceptives, and the number of children have a significant relationship with teenage births. It is hoped that the BKKBN of West Nusa Tenggara Province will evaluate the programs that have been established to determine the effectiveness of these programs in overcoming the problem of teenage births.

Adolescent Childbearing and Associated Factors in Vietnam

This research examines the factors influencing adolescent girl childbirth in Vietnam by employing data from the 2019 Vietnam Population and Housing Census and socio-ecological theory. The research underscores the substantial impact of environmental systems on adolescent childbirth, encompassing age, marital status, educational level, living area, and ethnicity. Higher adolescent birth rates are observed among older adolescents, ethnic minorities, and those with lower levels of education; this highlights the significance of cultural norms, restricted healthcare access, and poverty in influencing these results. The study emphasizes the importance of education, access to healthcare, and community support in mitigating the occurrence of pregnancies among adolescents. It further advocates for focused interventions that enhance the development of human capital, with a specific focus on rural regions and ethnic minority populations. To lessen the hazards associated with adolescent pregnancy, the study recommends policies that reduce child marriage and early motherhood and enhance education and knowledge on sexual and reproductive health.

The socio-economic factors influencing adolescent childbirth in Indonesia

Adolescent childbirth (ages 15-19) is a global issue that can result in morbidity and mortality among adolescents. The rate of adolescent childbirth is of particular concern to the Indonesian government as it has not yet reached the desired targets. The aim of this research is to analyze the socio-economic factors influencing adolescent childbirth (ages 15-19) in Indonesia based on data from the 2017 Indonesian Demographic and Health Survey (IDHS). This study utilizes secondary data from the 2017 Indonesian Demographic and Health Survey, with a sample size of 7,930 adolescents. Data were analyzed using univariate, bivariate, and multivariate descriptive statistical methods. Adolescent childbirth in Indonesia among ages 15-19 is observed in 416 adolescents (5.2%). Based on multivariate analysis, it was found that variables significantly associated with adolescent childbirth are educational level and economic status. Adolescents with low education are 27 times more likely to experience childbirth (aOR: 27.756; 95% CI: 12.007 - 64.163) compared to those with higher education. Furthermore, adolescents with the lowest economic status have a 2 times higher risk (aOR: 2.644; 95% CI: 2.014 - 3.470) of experiencing adolescent childbirth compared to those with the highest economic status. Adolescent childbirth is a health issue that warrants attention in Indonesia. Enhancing education, empowerment, awareness, and support for adolescent girls, along with policy implementation, is crucial for reducing the adolescent childbirth rate.

Adolescent Childbirth: Epidemiological and Clinic Aspects, Maternal and Perinatal Prognosis in Tengandogo Teaching Hospital, Burkina Faso

Background/Aim: Adolescent pregnancy is considered as a public health issue. This study aims at describing the epidemiological and clinical aspects, as well as the maternal and perinatal prognosis of adolescent childbirth. Materials and Methods: This was a descriptive and analytical study. Data were collected prospectively. The study population included all women admitted for delivery. Adolescents were sampled exhaustively. In order to identify factors associated with adolescent childbirth, we selected a control group of women aged between 20 and 39. Results: Adolescent deliveries accounted for 12.6% of all deliveries. The average age was estimated at 18.2 years. Patients aged 19 accounted for 55.1% of cases. Upon admission, 88.9% of adolescent girls were nulliparous. Adolescents were referred in 93.5% of cases. As for admission reasons, abdominopelvic pain with uterine contractions accounted for 39.81% of cases. In 21.3% of cases the gestational age as below 37 weeks of amenorrhea. Fetal breech presentation was observed in 8.3% of cases. Caesarean section was the mode of delivery in 60.2%. In our series, two adolescent girls presented a hemorrhage of deliverance. One case of maternal death was recorded. The prematurity birth rate was estimated at 20.4% and neonatal resuscitation concerned 24.9% of newborns. The perinatal mortality rate is estimated at 11.2% corresponding 112 deaths per thousand births. Conclusion: Adolescent childbirth, compared to that of adult women is still associated with a poor prognosis. There is the need to enhance appropriate measures in education, contraception, prenatal care and the fight against early marriage need to reduce the rates of early pregnancy and obstetric complications in this high-risk population.

Adolescent childbirth and mobility disability among women ages 15–49: an analysis of population health surveys from 14 low-income and middle-income countries

ObjectivesAdolescent childbirth is associated with older adult adverse health outcomes that negatively affect mobility function, but these associations have not been studied globally in large samples of reproductive-age women. This...

Adolescent pregnancy in Sao Tome and Principe: are there different obstetric and perinatal outcomes?

BackgroundAdolescent childbirth is a major public health problem in Sao Tome and Principe (STP). Adolescent pregnancy and childbirth can carry a risk of morbidity associated with the physiological and sociological characteristics of teenage girls. This study aims to identify the main adverse obstetric and perinatal outcomes for adolescent pregnancies in the Hospital Dr. Ayres de Menezes (HAM), the only hospital in STP.MethodsAn institution-based cross-sectional study. Pregnant women ≤ 19 years of age (n = 104) were compared to non-adolescent women (n = 414). The obstetric and perinatal outcomes were compared between groups using the t test. Odds ratio (OR) were calculated through Cochran’s and Mantel–Haenszel statistics test for odds ratio equal to 1, 95% confidence intervals (CI) and p values (p < 0.05) were considered significant.ResultsThe adverse perinatal outcomes imputable to adolescent births were foetal distress with low first minute Apgar score < 7 (OR 1.94, 95% CI 1.18–3.18, p = 0.009) and performance of neonatal resuscitation manoeuvres (OR 2.4, 95% CI 1.07–5.38, p = 0.032). Compared to older mothers, teenage girls were likely to have a non-statistically significant threefold higher risk of having an obstructed labour (OR 3.40, 95% CI 0.89–12.94, p = 0.07). Other perinatal outcomes as neonatal asphyxia, risk for cerebral palsy, premature birth, early neonatal infection, and neonatal death were identical between groups as well as maternal anaemia, mode of delivery or other obstetrical outcomes.ConclusionAdolescent pregnancies were associated with worse perinatal outcomes as foetal distress and higher need for neonatal resuscitation manoeuvres. This study may support STP health authorities in their efforts to make Sustainable Development Goals 3 (good health and wellbeing), 4 (quality education) and 5 (gender equality) a reality by 2030, since it identifies specific problems that need to be addressed to improve maternal adolescent health.

Early age at first childbirth and skilled birth attendance during delivery among young women in sub-Saharan Africa

BackgroundDespite the numerous policy interventions targeted at preventing early age at first childbirth globally, the prevalence of adolescent childbirth remains high. Meanwhile, skilled birth attendance is considered essential in preventing childbirth-related complications and deaths among adolescent mothers. Therefore, we estimated the prevalence of early age at first childbirth and skilled birth attendance among young women in sub-Saharan Africa and investigated the association between them.MethodsDemographic and Health Survey data of 29 sub-Saharan African countries was utilized. Skilled birth attendance and age at first birth were the outcome and the key explanatory variables in this study respectively. Overall, a total of 52,875 young women aged 20-24 years were included in our study. A multilevel binary logistic regression analysis was performed and the results presented as crude and adjusted odds ratios at 95% confidence interval.ResultsApproximately 73% of young women had their first birth when they were less than 20 years with Chad having the highest proportion (85.7%) and Rwanda recording the lowest (43.3%). The average proportion of those who had skilled assistance during delivery in the 29 sub-Saharan African countries was 75.3% and this ranged from 38.4% in Chad to 93.7% in Rwanda. Young women who had their first birth at the age of 20-24 were more likely to have skilled birth attendance during delivery (aOR = 2.4, CI = 2.24-2.53) than those who had their first birth before 20 years.ConclusionEarly age at first childbirth has been found to be associated with low skilled assistance during delivery. These findings re-emphasize the need for sub-Saharan African countries to implement programs that will sensitize and encourage the patronage of skilled birth attendance among young women in order to reduce complications and maternal mortalities. The lower likelihood of skilled birth attendance among young women who had their first birth when they were adolescents could mean that this cohort of young women face some barriers in accessing maternal healthcare services.

Adolescent Childbirth and Mobility Disability Among Women Ages 15-49: An Analysis of Population Health Surveys from 14 Low- and Middle-Income Countries

Background: Adolescent childbirth is associated with older adult adverse health outcomes that negatively affect mobility function, but these associations have not been studied globally in large samples of reproductive-age women. This study examines the association between age at first childbirth and mobility disability in national surveys from low- and middle-income countries. Methods: Population health surveys from 2013-2018 containing mobility disability measures among ever-pregnant women ages 15-49 were analyzed (14 countries). Covariates included current age, urban/rural residence, education, and household wealth. Poisson regression models were used to estimate prevalence ratios (PR) of mobility disability among women who first gave birth during adolescence (19 years or younger) and in adult life (ages 20 to 45 years) in each country and across the whole sample. Countries were also analyzed according to the use of standard and non-standard mobility disability measures. Findings: Prevalence of adolescent childbirth (17·5%-66·2%) and mobility disability (0·32%-21·45%) varied widely across countries. Adolescent childbirth was significantly (p<0·05) associated with greater mobility disability in 6 of 8 countries utilizing standard disability measures. Among the 6 countries that did not use standard disability measures, none showed a statistically significant association between adolescent childbirth and mobility disability. Considering the whole sample and adjusting for all covariates, women who gave birth during adolescence had greater prevalence of mobility disability (Pooled PR 1·19, 95%CI 1·06-1·31). Interpretation: This analysis suggests a moderate and consistent association of adolescent childbearing with subsequent mobility disability. Adolescent childbearing appears to contribute to lasting negative effects on women’s mobility. Funding: Fogarty International Center: 5R21TW010466-02 Declaration of Interest: None to declare. Ethical Approval: Ethical approval statement: For this study, we conducted secondary data analysis of fully de-identified public use data sets. As such, our research does not fall within the regulatory definition of research involving human subjects and does not require ethical approval.

Under-5 mortality in sub-Saharan Africa: is maternal age at first childbirth below 20 years a risk factor?

ObjectivesThis study aimed at examining the association between young maternal age at first childbirth and under-5 mortality in sub-Saharan Africa (SSA).Design and settingThis cross-sectional study pooled nationally-representative data from the...

Maternal age at first childbirth and under-five morbidity in sub-Saharan Africa: analysis of cross-sectional data of 32 countries

BackgroundThe prevalence of childhood morbidity remains high in low-and middle-income countries, including sub-Saharan Africa (SSA). In this study, the association between maternal age at first childbirth and under-five morbidity in SSA was examined.MethodsThis was a cross-sectional study involving nationally-representative data from the most recent Demographic and Health Surveys conducted in 32 countries in SSA from 2010 to 2019. A sample size of 311,603 mothers of children under-five was considered. The outcome variable for this study was under-five morbidity. This variable was derived from the experience of fever, cough, and diarrhoea among children under-five. Both multilevel and binary logistic regression models were used to test the hypothesis that adolescent childbirth is associated with under-five morbidity. The results were presented as crude odds ratios (cORs) and adjusted odds ratios (aORs), with 95 % confidence intervals (CIs).ResultsChildren born to mothers whose first childbirth occurred at < 20 years were 16 % times more likely to suffer from under-five morbidity, compared to those whose mothers’ first childbirth occurred at age ≥ 20 years [cOR = 1.16; CI = 1.13–1.19], and this persisted but with reduced odds after controlling for covariates [aOR = 1.10; CI = 1.07–1.12]. At the country level, children born to mothers whose first childbirth occurred at < 20 years were more likely to suffer from under-five morbidity, compared to those whose mothers’ first childbirth occurred at age ≥ 20 years in Angola, Burundi, Congo DR, Guinea, Kenya, and Uganda.ConclusionsIn this study, an association between adolescent childbirth and morbidity in children under five in SSA has been established. The study concludes that under-five morbidity is higher among children born to mothers whose first childbirth occurred before 20 years compared to those whose mothers’ first childbirth occurred at 20 years and above. The findings indicate that in order to reduce under-five morbidity, there is the need to deal with adolescent childbearing through cultural and social change, coupled with engagement of adolescents and stakeholders in adolescent sexual and reproductive health programmes.

Hypertension in women: the role of adolescent childbearing

BackgroundAdolescent childbearing is associated with various health risks to the mother and child, and potentially with adverse socioeconomic outcomes. However, little is known about the role of adolescent childbearing in maternal health outcomes in adulthood. This study investigates the link between childbirth in adolescence and later-life risk of hypertension among women in India.MethodsWe obtained nationally representative data on demographic and health outcomes for 442,845 women aged 25 to 49 from the India National Family Health Survey (NFHS) 2015-16. We assessed the difference in hypertension prevalence between women who gave birth in adolescence (age 10 to 19) and those who did not, for the full sample and various sub-samples, using linear probability models with controls for individual characteristics, hypertension risk factors, and geographic fixed effects.ResultsNearly 40% of the women in the sample gave birth in adolescence. The adjusted probability of being hypertensive in adulthood was 2.3 percentage points higher for this group compared to women who did not give childbirth in adolescence. This added probability was larger for women who gave birth earlier in adolescence (4.8 percentage points) and for women who gave birth more than once in adolescence (3.4 percentage points).ConclusionsAdolescent childbearing was strongly associated with a higher probability of adult female hypertension in India. This finding illustrates the intertemporal relationship between health risk factors during the life cycle, informing the importance of addressing adverse early life events (e.g. child marriage and adolescent childbirth) for hypertension outcomes among women in India.

Summary measures of socioeconomic and area-based inequalities in fertility rates among adolescents: evidence from Ethiopian demographic and health surveys 2000\u20132016

BackgroundOne of the highest rates of adolescent pregnancies in the world is in sub-Saharan Africa. Most adolescent pregnancies in the region are unintended or unwanted, due to poor access to information and services on sexual and reproductive health for adolescents. Ethiopia has high adolescent fertility rates (AFR) with disparities across socioeconomic subgroups and regions. This study assessed the magnitude and trends of socioeconomic and area-based AFR inequalities in Ethiopia.MethodsThe 2000 and 2016 Ethiopia Demographic and Health surveys (EDHS) was analyzed using the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software. Adolescent fertility rates were disaggregated using three equity stratifiers (economic status, education and residence) and analyzed through four summary measures (Difference (D), Population Attributable Risk (PAR), Ratio (R) and Population Attributable Fraction (PAF)) to assess inequality. To measure statistical significance, point estimates were constructed using a 95% Uncertainty Interval (UI).ResultsLarge socio-economic and urban-rural inequalities were observed within the 16-year period. Adolescents in less well-off socio-economic groups (PAF: -62.9 [95% UI; − 64.3, − 61.4], D: 96.4 [95% UI; 47.7, 145.1]), uneducated (R: 8.5 [95% UI; 4.8, 12.2], PAR: -76.4 [95% UI;-77.7, − 75.0]) and those from rural areas (D: 81.2 [95% UI; 67.9, 94.6], PAF: -74.2 [95% UI, − 75.7, − 72.7]) had a higher chance of pregnancy and more births than their counterparts.ConclusionsSocioeconomic (education and economic status) and place of residence determine adolescents’ pregnancy and childbearing. Policies and programs should be directed at preventing child marriage and early fertility so that adolescents continue to access education, sexual and reproductive health care as well as access employment opportunities. More emphasis should be placed on subpopulations with disproportionately higher adolescent pregnancy and childbirth.

Inequality in fertility rate among adolescents: evidence from Timor-Leste demographic and health surveys 2009\u20132016

BackgroundDespite a decline in global adolescent birth rate, many countries in South East Asia still experience a slower pace decline in adolescent birth rates. Timor-Leste is one of the countries in the region with the highest adolescent birth rate and huge disparities between socio-economic subgroups. Hence, this study assessed the magnitude and trends in adolescent fertility rates within different socio-demographic subgroups in Timor-Leste.MethodsUsing the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software, data from the Timor-Leste Demographic and Health surveys (TLDHS) were analyzed between 2009 and 2016. We approached the inequality analysis in two steps. First, we disaggregated adolescent fertility rates by four equity stratifiers: wealth index, education, residence and region. Second, we measured the inequality through summary measures, namely Difference, Population Attributable Risk, Ratio and Population Attributable Fraction. A 95% confidence interval was constructed for point estimates to measure statistical significance.ResultsWe found large socio-economic and area-based inequalities over the last 7 years. Adolescent girls who were poor (Population Attributable Fraction: -54.87, 95% CI; − 57.73, − 52.02; Population Attributable Risk: -24.25, 95% CI; − 25.51, − 22.99), uneducated (Difference: 58.69, 95% CI; 31.19, 86.18; Population Attributable Fraction: -25.83, 95% CI; − 26.93, − 24.74), from rural areas (Ratio: 2.76, 95% CI; 1.91, 3.60; Population Attributable Risk: -23.10, 95% CI; − 24.12, − 22.09) and from the Oecussi region (Population Attributable Fraction: -53.37, 95% CI; − 56.07, − 50.67; Difference: 60.49, 95% CI; 29.57, 91.41) had higher chance of having more births than those who were rich, educated, urban residents and from the Dili region, respectively.ConclusionsThis study identified disproportionately higher burden of teenage birth among disadvantaged adolescents who are, poor, uneducated, rural residents and those living in regions such as Oecussi, Liquica and Manufahi, respectively. Policymakers should work to prevent child marriage and early fertility to ensure continuous education, reproductive health care and livelihood opportunities for adolescent girls. Specialized interventions should also be drawn to the subpopulation that had disproportionately higher adolescent childbirth.

Case-control study of risk factors for adolescent fertility and premature birth in Bulgaria

Abstract The significant positive correlation between share of Roma population and adolescent live birth in EU member states (r = 0.804, with 2-tailed significance p = 0.000) was found. The highest level of proportion of live births to mothers aged less than 20 years was found in Romania (9.8%) and Bulgaria (9.5%). At the same tame proportion of Roma population in those countries is highest: Bulgaria (4.7%) and Romania (2.5%). The study found that two thirds (66%) of children born to mothers under the age of 19 are born prematurely OR = 2.10 95% CI (1.13-3.91). Among the newborns studied, the proportion of prematurely born children living in rural areas is significantly higher than those living in the city (p = 0.0001; r = 0.26). Later registration (after the first trimester) and monitoring of pregnancy is a significant risk factor and increases more than four times the risk of having a premature baby OR = 4.23 95% CI (1.41-12.69). A holistic approach is needed in which socio-economic development and education of Roma girls leads to further reduction of adolescent childbirth and premature delivery in Bulgaria.

‘Please treat me like a person’—respectful care during adolescent childbirth

Background This study explored the lived childbirth experiences of ‘middle adolescent’ mothers between 14–16 years of age. Study design A qualitative design was followed with a Husserlian phenomenological approach and Colaizzi's seven steps to unravelling information. Using semi-structured conversations, information was gathered from six middle-adolescent mothers who had normal vaginal births of healthy term infants in two public hospitals in South Africa. Findings An overarching theme of preservation of personhood was identified. Three themes emerged i) unpreparedness for childbirth, ii) an unsettled state of mind during childbirth and iii) feeling overwhelmed by the experience. Conclusion More positive birth experiences were associated with respectful, non-judgmental midwife care and having their mothers as birth companions while humiliation, victimisation and rudeness were associated with negative birth experiences. Recommendations More focus is needed on adolescent-friendly healthcare services and age-appropriate education; continuous labour support; pain management and respectful care during childbirth.

Social normative and social network factors associated with adolescent pregnancy: a cross-sectional study of 176 villages in rural Honduras.

BackgroundAdolescent pregnancy and childbirth are common throughout Central America. While gendered beliefs promoting motherhood are a known risk factor, their association with adolescent childbirth within the social networks of Central American communities is unknown.MethodsThis was a cross-sectional study looking at adolescent childbirth amongst women ages 15-20 years (N = 2990) in rural Honduras, using reproductive health data on all individuals ≥15 years of age (N = 24 937 of 31 300 population) including social network contacts, all of whom were interviewed as part of the study. The outcome, adolescent childbirth, was defined as having had a child < age 20 years. Predictors included whether a woman’s social contact had an adolescent childbirth and the social contact’s reported perception of community support for adolescent childbirth.ResultsWhile girls who identified a father in the village as a social contact had a lower likelihood of adolescent childbirth regardless of whether or not they reported being in a partnership, this finding did not hold for girls who identified mothers. There was an association between a social contact’s report of norms supporting adolescent childbirth and a girl’s risk of adolescent childbirth; however, village-level aggregate norms attenuated that relationship. Independent significant associations were found between a girl’s risk of adolescent childbirth and both a social contact’s adolescent childbirth and the village proportion of women who had had an adolescent childbirth. The association between social contacts’ adolescent childbirth and a girl’s risk of adolescent childbirth across relationships was more robust for stronger relationships and when the social contact was closer in age to the girl.ConclusionsIf, as this evidence suggests, a strong driver of adolescent childbirth is the frequency of the occurrence of adolescent childbirth both within the greater community and within a girl’s proximal social network, the challenge for intervention strategies is to encourage norms that prevent adolescent childbirth without stigmatising those who have had an adolescent childbirth. Programmatic efforts to counter prevailing norms that limit a woman’s role to motherhood, and that support and encourage strong norms for girls’ education may play an important role in addressing this situation.