Mother‐role development program and postpartum health‐service utilization by adolescent mothers: A randomized, controlled trial

Abstract

Aim To evaluate the impact of a mother‐role development program on postpartum health‐service utilization by adolescent mothers. Methods A single center, parallel, randomized, controlled, open‐label trial using a computer‐generated sequence was conducted at Siriraj Hospital. In all, 120 teenage mothers who delivered February 2015–December 2016 were randomized into experimental and control groups. The experimental group participated in a 2‐year, mother‐role development program at the Young Family Clinic. The two groups' characteristics, pregnancy outcomes and postpartum follow‐up details over the 2‐year period were compared. The main outcome measure was the utilization of maternal healthcare services (MHS). Results The teenage mothers were randomized into two groups of 60 participants each. Many were progressively lost to follow‐up, leaving only 37 (experimental group, 19; control group, 18) for the intention‐to‐treat analysis. The results demonstrated a higher MHS utilization by the experimental group, but only at the 6‐week postpartum follow‐up. The usage of long‐acting, reversible contraception (birth control implants and intrauterine devices) rose from 53.3% (immediate postpartum) to 95.5% (2 years postpartum). The two groups also had identical repeat pregnancy rates (6.67%; four participants in each), a marked decrease from 20% in a prior study. The breastfeeding rate was consistently higher among the mothers undertaking the mother‐role development program. Conclusion The program increased both MHS utilization during the initial postpartum period and the breastfeeding duration. Access to immediate postpartum contraception and long‐acting, reversible contraception was associated with a reduction in repeat teen pregnancies. Having a multidisciplinary team was key to the health‐service improvements.