Post on 25-Jan-2015
description
Teenage Pregnancy
Angela Steele
Sexual Behaviour
• Australian Research Centre in Sex, Health & Society
National survey of Australian Secondary students and
sexual health 2013-2,000 students surveyed
• 69% of students have experienced sexual activity
• 34% of students had experienced sexual intercourse
• 59% of sexually active students who experienced sexual
intercourse used a condom
Data
• According to the latest figures available from the
Australian Bureau of Statistics (ABS) released in 2012,
the number of young women that gave birth in Australia
at 19 years-of-age and under was 11,344.
• This was out of a total of 301,697 Australian births so
approximately 3.7 % of the total births.
Data
• At the national level, the teenage fertility rate in 2010
was 16 babies per 1,000 women aged 15-19 years
however the rate differs amongst the states and
territories.
• In 2010, Victoria and the Australian Capital Territory
recorded the lowest teenage fertility rates in Australia
(both 9 babies per 1,000 women), while the Northern
Territory recorded the highest (48 babies per 1,000
women).
Data
Data-age
• The majority of births to teenage mothers in Australia in 2010 were to women aged 18 and 19 years (28% and 44% respectively), which is reflected in the fertility rates for women at these ages.
• In 2010, the fertility rates for women aged 18 and 19 years were 21 babies per 1,000 women and 33 babies per 1,000 women respectively.
• In comparison, only 4% of births to teenage mothers were to women aged 15 years or younger, resulting in a fertility rate of 3 babies per 1,000 women aged 15 years.
Data-Age
Age Number
15 & Under 392
16 932
17 1,917
18 3,190
19 4,913
Data-International Comparison
Country Year Number per 1,000 births
US 2009 39.1
NZ 2011 26.0
Canada 2008 13.0
Australia 2008 8.9
France 2008 7.0
Italy 2008 7.0
Japan 2008 5.0
Diversity
Diversity
• Adolescent mothers and their infants are a diverse group
with diverse outcomes
• The complexity is aligned with social disadvantage and
mental health issues
• Young women with pre-existing psychopathology
particularly depression and conduct disorders are more
likely to become pregnant
Teenage Pregnancy
• 15% of teenagers plan their pregnancy
• Pluralistic society
• Most are aware of contraceptive options
• 40% unintended
• 45% failed contraception
• Poor access
• Medicare
Teenage Pregnancy-Clinic Profile
• Over 40% of women that choose to parent young will
experience the following risk factors;
• Mental illness
• Homelessness
• Domestic Violence
• Drug and Alcohol use
• Single
• Social isolation
• Poor education outcomes
Social Isolation
Teenage Pregnancy
• According to The Australian Institute of Health and
Welfare (2008) identifies that there have been an
increase in the number of adolescent mothers in the
most vulnerable groups particularly Aboriginal and Torres
Strait Islander people
• Poor socio-demographic groups
• Less likely to be engaged in Education
Teenage Pregnancy
• Assessment of risk factors and protective factors
• HEADS assessment
• Social assessment
• ANC local hospital
• Tertiary care depends on complexity
• Community supports
• Age specific services
Mental Health
• Study 1: Found that young women tend to partner with
young men with similar risk issues such as mental illness (Quinlivan, et al 2004)
• Study 2: Antenatal maternal-fetal attachment
(Rowe, et al, 2005)
• Study 3: Development of a mental health screening tool (Judd, et al, 2009)
• Study 4: Maternal-infant attachment (Nicolson, 2013)
Birth Outcomes
• Hospital Data from The Women’s Hospital (2011) found
that young women were more likely to have;
• Preterm birth
• Low birth weight babies
• Low BMI
• Smoke
• Bottle feed
• Have a baby that is admitted to NICU
Birth Outcomes
• Environmental issues
• Not directly related to adolescence
• Smoking
• Poor ANC
• Poor access to services
• Circumstances of poverty
• Poor nutrition
Teenage Pregnancy
Case Study 1
• Presented pregnant at 15 years, birthed at 16
• Family issues, single
• Good antenatal attendance and birth outcome
• Supportive mother
• Linking into Education
• Peer Support worker
• Nursing Degree
Case Study 2
• Access to health workers
• Adoption
• Antenatal care
• Supportive partner
• Good birth outcome
• Ongoing social support and follow up
Case Study 3
• Child protection
• Sex industry from age 12
• Heroin use age 14
• Pregnant-stable on methadone
• Psychiatric symptomology
• Psychosocial support
• Good antenatal attendance
• Good birth outcome
Case study 3 continued
• 2nd pregnancy
• Stable on methadone
• Good antenatal care
• Paediatric follow up
• Attachment issues
• Birth outcome good
• Follow up
• Collaborative post birth care and support
• LARC
Health Services
• Age specific
• Child birth education
• Consistent workers
• Access
• Support
• Non-judgmental
• Ongoing community supports linked in antenatal period
• Ongoing postnatal supports
• Mental Health services
COSMOS
• Review of Teenage Pregnancy Services at The Women’s
Hospital
• Feedback from consumers
• Continuity of care and carer
• 1:1 midwife support
• 24 hour access to midwife
• Evaluation ongoing
• Breast feeding rates increased
Maternal Attachment
• Antenatal attachment
• CBE
• Mental health
• Ongoing assessments
• Ongoing supports
• GP
• MCHN
• Age specific support groups
Teenage Pregnancy
• Prevent 2nd pregnancy
• Education
• Contraception antenatal period
• Postnatal LARC
• Follow up
• FPV
Teenage Pregnancy
• Diversity
• Case by case assessment
• Ongoing community supports
• Mental health services
• Non-judgmental
• Child raising independently
• On-line information
Education
Questions?