Engaging in antenatal care: an interview study of teenage women.

Abstract

Background: Teenage pregnancy is associated with a large societal and personal burden, worldwide. The rate of teenage pregnancy at Ballarat Health Services (14.2/1000 births) was higher than the Victorian average of 10/1000 births. Attendance for pregnancy care is associated with improved outcomes. This study aimed to explore the barriers and facilitators to engagement with pregnancy care providers experienced by teenage women. Method: Semi structured interviews were conducted with women who were pregnant aged ≤ 19 yrs from Ballarat, Ararat and Maryborough health services between Feb-Jun 2017. Interviews were audio taped and professionally transcribed. Data was analysed by two researchers independently using thematic analysis guided by Braun and Clarke’s approach. Findings: Transcripts of interviews with 16 women were analysed and four themes identified: Valuing pregnancy care, Interactions with maternity service, Women-centred care, and Support systems. Young women were motivated to attend to ensure the wellbeing of their baby and lack of engagement occurred when the importance of care was not understood. Flexibility of appointments and a central location was important; most participants were highly reliant on others for transport. Continuity of care and carer were valued and the interpersonal skills of staff strongly influenced engagement. Many women had fractured families and pregnancy led to a contraction of their social world. Conclusions: This study has provided an understanding of the motivating reasons and external influences affecting engagement in antenatal care for teenage women in rural and regional areas. These findings have informed the development of best practice guideline for teenage pregnancy care.