Meanings of pregnancy and motherhood among out-of-home pregnant adolescents

Abstract

<p>The purpose of this study was to explore influential life experiences, environmental contexts, and meanings attributed to pregnancy and motherhood by a purposive sample of out-of-home pregnant adolescent women in Seattle during pregnancy and early postpartum. The study used methods adapted from feminist anthropology, including ethnographic interviewing and participant observation. The sample (N = 8) included 5 white, 1 American Indian, and 2 African-American young women, 17 to 19 years of age, who were not living at home at entry to the study. All participants were pregnant at initial contact, and 3 reported prior pregnancies; 3 participants were also interviewed after delivery.</p> <p>Several patterns emerged in life experiences and current environments among participants; conflict-laden family relationships, frequent experiences of violence and sexual abuse in childhood and in sexual relationships in adolescence, mental health and substance abuse problems for themselves or parents, and life-long patterns of housing instability were common circumstances.</p> <p>Pregnancy occurred in the context of a history of violence and often powerless sexual relationships. For some, choosing to become pregnant or continue an unexpected pregnancy meant a self-assertion of control and choice in a life with few choices. For others, pregnancy was seen as the natural culmination of their committed romantic relationship with the father of their baby. For all, the pregnancy was perceived as a positive event, and appeared to &ldquo;work&rdquo; in a variety of ways to improve their situations and life trajectories. It allowed them to step away from risky behaviors, demonstrated maturation or &ldquo;settling down,&rdquo; reconnected them with estranged family, met needs for love and attachment or prevented further abandonment, provided access to services seldom available to non-pregnant homeless adolescents, and opportunity to return to school. For many, the pregnancy was a declaration of hope for the future, a &ldquo;reason to keep on living.&rdquo; Motherhood offered a major, positive change in status.</p> <p>By better understanding of the motivations, beliefs, and environments of homeless adolescent mothers, nurses and other health care providers can develop better models of care to engage the pregnant homeless teen, to prevent complications of pregnancy and childbirth, and to enhance maternal and infant well-being.</p>