“While a higher risk of poor birth outcomes such as low birth weight is seen for births to teenage women, this is likely to be related more to the social circumstances of these young women, rather than their age.” (Middleton 2009)
The number of births to adolescent women in Australia has decreased over the last few decades (ABS 2008) but still accounts for around 4 per cent of all births (Laws et al 2010). Around 20 per cent of births to Aboriginal and Torres Strait Islander mothers are to women aged younger than 20 (Laws et al 2010). Women younger than 20 years experience higher rates of fetal and neonatal deaths than Australian women in general (15.7 versus 7.4 total births and 4.0 versus 2.8 per 1,000 live births, respectively)(Laws et al 2010).
Adolescent women are likely to seek confirmation of pregnancy and antenatal care later in pregnancy. For example in NSW an average of only 76% of adolescent women started antenatal care before 20 weeks of pregnancy, compared with 90% of women aged between 30 and 39 years of age (CER 2008).
The high levels of social disadvantage, higher incidence of domestic violence, higher rates of smoking in pregnancy, lack of social supports and lower socioeconomic and education status of these women contribute to poorer outcomes. Young adolescent mothers still have their own developmental needs that should be addressed in addition to the needs related to the pregnancy. Whether the pregnancy is unplanned or unwanted, and the need for reporting of sex in a minor at risk, are also considerations.
Improving perinatal outcomes for adolescent women and their babies
In the context of growing recognition of young people’s need for services that are sensitive to their unique stage of biological, cognitive and psychosocial transition into adulthood (Tylee et al 2007), the World Health Organization identified that youth-friendly services need to be equitable, accessible, acceptable,appropriate, comprehensive, effective and efficient (WHO 2002). Key features of youth-friendly care include (WHO 2002; Tylee et al 2007):
- health professionals and support staff who are non-judgmental and considerate, treat each young person with equal care and respect, are competent, motivated and well supported; and
- health services that have an appealing ambience, convenient working hours, offer privacy and avoid stigma, and aim for short waiting times and (when needed) swift referral.