Negotiating the transition from adolescence to motherhood: Coping with prenatal and parenting stress in teenage mothers in Mulago hospital, Uganda

Makerere University Medical School, Dept. of Obstetrics and Gynecology, P,O, Box 7072, Kampala, Uganda.
BMC Public Health (Impact Factor: 2.26). 02/2008; 8(1):83. DOI: 10.1186/1471-2458-8-83
Source: PubMed


Adolescence is a transitional stage from childhood to adulthood that is characterized by physical, physiological, psychosocial and behavioral changes that are influenced to a large extent by the age, culture and socialization of the individual. To explore what adolescent mothers perceive as their struggles during the period of transition from childhood to parenthood (through motherhood) and to describe strategies employed in coping with stress of pregnancy, motherhood and parenthood.
Longitudinal qualitative study involving twenty two in-depth interviews and six focus group discussions among pregnant adolescents who were followed from pregnant to delivery, from January 2004 to August 2005. Participant were selected by theoretical sampling and data was analyzed using grounded theory.
Overall, young adolescents reported more anxiety, loss of self esteem (when they conceived), difficulty in accessing financial, moral and material support from parents or partners and stigmatization by health workers when they sought care from health facilities. Three strategies by which adolescent mothers cope with parenting and pregnancy stress that were described as utilizing opportunities (thriving), accommodating the challenges (bargaining and surviving), or failure (despairing), and varied in the extent to which they enabled adolescents to cope with the stress.
Adolescents on the transition to motherhood have variable needs and aspirations and utilize different strategies to cope with the stress of pregnancy and parenthood.

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    • "Fetal health Damage to fetus (Pleshette et al., 1956; Andersson et al., 2012) Fetal abnormality (Huizink et al., 2004; Pleshette et al., 1956; Brockington et al., 2006; Kleiverda et al., 1990; Loke and Poon, 2011) Fetal health and well-being in general (Standley et al., 1979; Pleshette et al., 1956; Harpel, 2008; Furber et al., 2009; Mwape et al., 2012; Ohman et al., 2003; Affonso et al., 1988; Light and Fenster, 1974) Loss of fetus Loss of fetus, miscarriage or premature birth (Cote-Arsenault et al., 2006; Ohman et al., 2003; Loke and Poon, 2011) Fear of fetal death (Pleshette et al., 1956; Brockington et al., 2006; Furber et al., 2009; Sjogren, 1997) Childbirth General fear of childbirth (Huizink et al., 2004; Standley et al., 1979; Pleshette et al., 1956; Brockington et al., 2006; Schneider, 2002; Kleiverda et al., 1990; Ohman et al., 2003; MacLellan, 2010) Specific concerns such as pain (Pleshette et al., 1956; Sjogren, 1997; Kleiverda et al., 1990; MacLellan, 2010; Cheyne et al., 2007) Concerns about not having a normal delivery (Furber et al., 2009; Sjogren, 1997; Sawyer et al., 2011) Mother's well-being Serious health situations (Boyacioglu and Turkmen, 2008) Woman's own health (Ohman et al., 2003) Death (Westbrook, 1978; Sjogren, 1997) Postpartum depression (Furber et al., 2009) Mother's own survival or having HIV (Mwape et al., 2012; Stewart et al., 2015) Body image One's appearance (Huizink et al., 2004) Gaining weight (Pleshette et al., 1956) Shame about pregnant appearance (Brockington et al., 2006) Parenting and care for child Inadequacy as a mother (Brockington et al., 2006; Bondas and Eriksson, 2001; Kaye, 2008) Failure to bond (Furber et al., 2009) Maternal role (Sjogren, 1997) Being criticized for mothering skills (Brockington et al., 2006; Furber et al., 2009) Allegations of child abuse and social services as interventions (Brockington et al., 2006; Furber et al., 2009) SIDS or the baby's health and safety (Brockington et al., 2006) Physical demands in caring for the newborn and recovery (Loke and Poon, 2011) or caring for other children (Furber et al., 2009) Health care related Insufficient support or lack of control over important decisions (Sjogren, 1997) Prejudiced reaction as a result of disclosure of their sexuality (Wilton and Kaufmann, 2001) Separation from baby in the hospital or baby switching in the hospital (Furber et al., 2009) Ultrasound (Harpel, 2008) Accessibility of care when needed (Boyacioglu and Turkmen, 2008) Financial Financial responsibilities of raising a child (Sawyer et al., 2011) Employment (Brockington et al., 2006; Ohman et al., 2003) Housing problems (Brockington et al., 2006) Family and social support Insufficient support (Brockington et al., 2006; Mwape et al., 2012) particularly from partner during pregnancy (Sawyer et al., 2011) Becoming isolated (Bondas and Eriksson, 2001) Loss of freedom, family dynamics, the sex of the child, involvement of in-laws (Brockington et al., 2006) "
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    • "This result may be due to the age of participants , who were mostly living with their own family in which adolescent's mother may play a more important role in providing support than the husband/partner (Devereux et al., 2009). Besides, the presence of the infant's father, among adolescent mothers, often increased the mother's distress, accounting for anxiety and depression (Divney et al., 2012; Kaye, 2008). "
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