Perceptions of pregnant teenagers with regard to the antenatal care clinic environment

Abstract

Pregnancy in teenagers seems to be a challenge that might contribute to a struggle to fulfil the objectives of the Millennium Development Goals directly related to women's reproductive health and neonatal care. The challenge becomes worse as midwives and nurses find it difficult to fully supervise all these pregnancies, because teenagers stay away or default from clinic attendance. The purpose of the study was to explore and describe the perceptions of pregnant teenagers of the antenatal care (ANC) clinic environment and to recommend guidelines to midwifery operational managers for strategies to create teenager-friendly ANC clinic environments. The study applied a qualitative research design with explorative, descriptive and contextual research approaches. The ethical principles that guided this study were respect for the person, beneficence and justice. Semi-structured interviews utilising a predetermined interview schedule with a central open-ended question to address the study objectives were used. Data were collected from pregnant teenagers attending ANC clinics in Nelson Mandela Metropolitan Municipality. Participants were unanimous in that they perceived the clinic environment as causing discomfort to them. Different reasons attributed to this experience were related to their young age. The age difference between themselves and other women attending the clinic made participants perceive themselves as inferior and as being treated as such at the clinic. They found this embarrassing and recommended having their own waiting area and additional midwives at the clinic so that they would not be subjected to humiliating scrutiny and disapproval from older pregnant women. Pregnant teenagers' recall of their experiences of the ANC clinic environment suggests that they perceive themselves as not being adequately cared for, as judged, and as forced to be in an environment that is insensitive to their needs. As a result some of their peers stayed away from the clinic and at times they contemplated the same action. A well-managed ANC clinic environment which has midwives who are empowered with the necessary skills in terms of dealing with the needs of youth has been requested by the pregnant teenagers.

Antenatal services for pregnant teenagers in Mbarara Municipality, Southwestern Uganda: health workers and community leaders’ views

“…This could be due to lack of specific training in how to deal with adolescents. This finding concurs with other studies which indicated that teenagers tend to stay away from the service or default from clinic attendance [ 24 ]. The environment in which the teenagers are expected to seek service is not conducive.…”

How optimal caseload midwifery can modify predictors for preterm birth in young women: Integrated findings from a mixed methods study

“…Most young women liked having their check-up take place on a yoga mat on the floor, rather than an examination table, because it felt "less medical" (Allen et al, 2015b). Informal environments appear to afford protection against the shame adolescents can feel when sitting in a waiting room with older pregnant women (Arthur, 2007;James et al, 2012). Venues where they can just 'hang-out' and talk with their peers are valued by this age group (Arthur, 2007).…”

Obstetric outcomes and antenatal access among adolescent pregnancies in KwaZulu-Natal, South Africa

“…All pregnant women of different ages access care in the same facilities at the same time. 6 In this study, ANC booking initiated above 20 weeks was considered as late booking. The earliest ANC booking was initiated at five weeks (year 2011), while the latest booking was at 37 weeks (2012 and 2013).…”

“…This programme enables women to be screened to allow the accurate categorisation of patients as high-risk or low-risk during pregnancy. 5,6 Early booking and effective utilisation of ANC services form key strategies in reducing maternal and child mortality. Health promotion as part of the ANC package of services empowers women and promotes health during pregnancy, leading to positive pregnancy and birth outcomes.…”