Authors

Uman Gahlot

Document Type

Honors Thesis

Abstract

Background: Adolescent pregnancy is a current social problem, and despite a recent decline it continues to be a societal issue. At-risk behaviors potentially culminating in unintended pregnancies have been noted to be frequent among African American (AA) adolescents and are often related to a history of abuse and/or depression. Adverse outcomes such as preterm births also are high among AA adolescents. Abuse, depression, and infant outcome have been recognized to impact the birth experience for adults. Yet, little research has been conducted examining the AA adolescent’s experience with birth and the potential for birth trauma when disclosing a history of abuse and/or depression, or preterm birth. Methods: Using a descriptive, correlation design, this study consisted of a convenient sample of 70 AA adolescents between 13 and 19 years of age. Adolescents above the age of 17 consented for themselves; adolescents below the age of 18 assented with written consent from parent/guardian. After 24-72 hours of birthing, AA adolescents were administered surveys at a large, public healthcare facility called John Peter Smith Hospital. To measure birth trauma, subjective and objective indicators were used: a researcher-developed birth appraisal rating scale and the Impact of Event Scale (IES). One question determined the adolescent’s current and history of abuse, with an optional request to state who was the perpetrator: family, friends, and/or a partner. Depressive symptoms were assessed via the Edinburgh Postnatal Depression Scale (EPDS) screening tool. Demographics including gestational age of infant were also collected. Descriptive statistics described the sample and provided means/medians of the birth appraisal, IES, and EPDS scores as appropriate. Due to skewness of the IES outcome variable, correlations between study variables were determined using Spearman’s rho. Chi squares were used to determine associations between categorical variables including demographics and birth trauma. Results: Findings revealed that AA adolescents experienced a mildly traumatic experience with birth. Furthermore, over one-third of adolescents experienced minor or major depressive symptoms. Preterm birth rates exceeded the national average. Correlations between study variables were not significant except for the IES and EPDS scores, rs = .545; p=.000. Demographics did not significantly influence the outcome. A lack of power may have been a partial reason for some of the unexpected findings. Conclusion: This research described the birth experience among AA adolescents and explored the correlations between reports of abuse, depressive symptoms (EPDS), infant outcome, and outcome measures of birth trauma including birth appraisal and IES scores. Study findings offer information related to an overlooked area of research in a seldom examined population. High rates of depression and preterm birth suggested needed follow-up and expanded routine care with healthcare providers. The noted correlation between EPDS and birth trauma (IES scores) suggests direction for expanded prenatal and labor and delivery assessments leading to nursing care aimed at prevention or reduction of symptoms among psychosocially high risk childbearing adolescents. Continued research can more clearly define connections between abuse, depressive symptoms, infant outcomes, and birth trauma.

Publication Date

12-1-2015

Language

English

License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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