Adolescents' experiences of childbirth: Nothing is simple.

Abstract

Thirteen percent of births in the United States are to adolescents, yet our understanding of their experiences of childbirth is limited. Most research about the experience of childbirth has been conducted with homogeneous, economically advantaged adult women. To understand adolescents' experiences of childbirth and its effect on their development, a qualitative investigation was conducted. The specific aims were to: (1) describe how the experience of childbirth differs for adolescents as compared to the literature, (2) identify care practices that promote a positive experience of childbirth, and (3) explore the influence of childbirth on adolescent development. Twenty-five ethnically diverse, low income adolescents between 13--18 years old, were interviewed regarding their first birth experiences. Semi-structured, face to face or phone interviews were conducted one week to 36 months after the births. Extended case methodology was used which included a process of interpretive analysis and comparison of the data to synthesized adult literature. Key findings demonstrated differences between these adolescents and current literature. Differences included the themes that were emphasized, how the birth story was told and specific care practices that were painful. These adolescents were concerned about their relationship with health care providers, which appeared strained by the social context of being young and pregnant. Negative interactions with care providers created experiences of frustration and shame for these adolescents. Analysis of the meaning of the birth experiences revealed themes of regret, resignation, and transformation. In this study, adolescents with negative birth experiences more often narrated stories of regret. Those with positive birth experiences tended to narrate stories of transformation. Differing from the adult literature, adolescents in this study focused on the infant and impending responsibility of parenthood rather than the birth process. Income level may have influenced this finding. Adolescents in this study described becoming adults by giving birth, due to the added responsibility of parenthood. Further research with adolescents and childbirth should focus on defining new relationships with health care providers, implementing positive care practices that promote development, and the influence of income level on birth experiences. Ethnographic methods may enhance understanding potential confounding factors regarding the birth experience.