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BMC Women's Health
Published in: BMC Women's Health 1/2019

Open Access 01-12-2019 | Affective Disorder | Research article

No straight lines – young women’s perceptions of their mental health and wellbeing during and after pregnancy: a systematic review and meta-ethnography

Authors: Grace Lucas, Ellinor K. Olander, Susan Ayers, Debra Salmon

Published in: BMC Women's Health | Issue 1/2019

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Abstract

Background

Young mothers face mental health challenges during and after pregnancy including increased rates of depression compared to older mothers. While the prevention of teenage pregnancy in countries such as the United States and the United Kingdom has been a focus for policy and research in recent decades, the need to understand young women’s own experiences has been highlighted. The aim of this meta-ethnography was to examine young women’s perceptions of their mental health and wellbeing during and after pregnancy to provide new understandings of those experiences.

Methods

A systematic review and meta-ethnographic synthesis of qualitative research was conducted. Seven databases were systematically searched and forward and backward searching conducted. Papers were included if they were from Organisation for Economic Co-operation and Development countries and explored mental health and wellbeing experiences of young mothers (age under 20 in pregnancy; under 25 at time of research) as a primary research question – or where evidence about mental health and wellbeing from participants was foregrounded. Nineteen papers were identified and the Critical Appraisal Skills Programme checklist for qualitative research used to appraise the evidence. Following the seven-step process of meta-ethnography, key constructs were examined within each study and then translated into one another.

Results

Seven translated themes were identified forming a new line of argument wherein mental health and wellbeing was analysed as relating to individual bodily experiences; tied into past and present relationships; underpinned by economic insecurity and entangled with feelings of societal surveillance. There were ‘no straight lines’ in young women’s experiences, which were more complex than dominant narratives around overcoming adversity suggest.

Conclusions

The synthesis concludes that health and social care professionals need to reflect on the operation of power and stigma in young women’s lives and its impact on wellbeing. It adds to understanding of young women’s mental health and wellbeing during and after pregnancy as located in physical and structural factors rather than individual capacities alone.
Literature
1.
Kearney MS, Levine PB. Why is the teen birth rate in the United States so high and why does it matter? J Econ Perspect. 2012;26(2):141–66.CrossRefPubMed
2.
Sedgh G, Finer LB, Bankole A, Eilers MA, Singh S. Adolescent pregnancy, birth, and abortion rates across countries: levels and recent trends. J Adolesc Health. 2015;56(2):223–30.CrossRefPubMedPubMedCentral
3.
4.
Hadley A. Teenage pregnancy: strategies for prevention. Obstet Gynaecol Reprod Med. 2018;28(4):99–104.CrossRef
5.
World Health Organization. Adolescent Pregnancy: Issues in Adolescent Health and Development. Geneva: WHO; 2004.
6.
Coyne CA, Långström N, Lichtenstein P, D'Onofrio BM. The association between teenage motherhood and poor offspring outcomes: a national cohort study across 30 years. Twin Res Hum Genet. 2013;16(3):679–89.CrossRefPubMedPubMedCentral
7.
Hodgkinson BL, Southammakosane C, Lewin A. Addressing the mental health needs of pregnant and parenting adolescents. Pediatrics. 2014;133(1):114–22.
8.
SmithBattle L, Freed P. Teen Mothers' mental health. MCN-AM J Matern-Chil. 2016;41(1):31–6.
9.
Hodgkinson SC, Colantuoni E, Roberts D, Berg-Cross L, Belcher HM. Depressive symptoms and birth outcomes among pregnant teenagers. J Pediatr Adolesc Gynecol. 2010;23(1):16–22.CrossRefPubMed
10.
Siegel RS, Brandon AR. Adolescents, pregnancy, and mental health. J Pediatr Adol Gynec. 2014;27(3):138–50.CrossRef
11.
Pearson RM, Carnegie RE, Cree C, Rollings C, Rena-Jones L, Evans J, et al. Prevalence of prenatal depression symptoms among 2 generations of pregnant mothers: the Avon longitudinal study of parents and children. JAMA Netw Open. 2018;1(3):e180725.CrossRefPubMedPubMedCentral
12.
Dinwiddie KJ, Schillerstrom TL, Schillerstrom JE. Postpartum depression in adolescent mothers. J Psychosom Obstet Gynecol. 2018;39(3):168–75.CrossRef
13.
Campbell-Grossman C, Hudson D, Kupzyk K, Brown S, Hanna K, Yates B. Low-income, African American, adolescent Mothers' depressive symptoms, perceived stress, and social support. J Child Fam. 2016;25(7):2306–14.CrossRef
14.
Chase E, Maxwell C, Knight A, Aggleton P. Pregnancy and parenthood among young people in and leaving care: what are the influencing factors, and what makes a difference in providing support? J Adolescence. 2006;29(3):437–51.CrossRef
15.
Mollborn S, Morningstar E. Investigating the relationship between teenage childbearing and psychological distress using longitudinal evidence. J Health Soc Behav. 2009;50(3):310–26.CrossRefPubMedPubMedCentral
16.
Lesser J, Koniak-Griffin D. The impact of physical or sexual abuse on chronic depression in adolescent mothers. J Pediatr Nurs. 2000;15(6):378–87.CrossRefPubMed
17.
Gavin AR, Lindhorst T, Lohr MJ. The prevalence and correlates of depressive symptoms among adolescent mothers: results from a 17-year longitudinal study. Women Health. 2011;51(6):525–45.CrossRefPubMedPubMedCentral
18.
Mitchell SJ, Lewin A, Horn IB, Valentine D, Sanders-Phillips K, Joseph JG. How does violence exposure affect the psychological health and parenting of young African-American mothers? Soc Sci Med. 2010;70(4):526–33.CrossRefPubMed
19.
20.
Hadley A, Ingham R, Chandra-Mouli V. Implementing the United Kingdom's ten-year teenage pregnancy strategy for England (1999-2010): how was this done and what did it achieve? Reprod Health. 2016;13:1–11.CrossRef
21.
22.
Graham H, McDermott E. Qualitative research and the evidence base of policy: insights from studies of teenage mothers in the UK. J Soc Policy. 2006;35(1):21–37.CrossRef
23.
24.
Downe S. Metasynthesis: a guide to knitting smoke. Evidence Based Midwifery. 2008;6(1):4–8.
25.
Finfgeld DL. Metasynthesis: the state of the art so far. Qual Health Res. 2003;13(7):893–904.
26.
27.
Bettany-Saltikov JA. How to do a systematic literature review in nursing: a step-by-step guide. Maidenhead: Open University Press; 2012.
28.
France EF, Cunningham M, Ring N, Uny I, Duncan EAS, Jepson RG, et al. Improving reporting of meta-ethnography: the eMERGe reporting guidance. Psycho-Oncology. 2019;28(3):447–58.CrossRefPubMed
29.
Wilson H, Huntington A. Deviant (M)others: the construction of teenage motherhood in contemporary discourse. J Soc Policy. 2006;35(1):59–76.CrossRef
30.
31.
Dixon-Woods M, Sutton A, Shaw R, Miller T, Smith J, Young B, et al. Appraising qualitative research for inclusion in systematic reviews: a quantitative and qualitative comparison of three methods. J Health Serv Res Po. 2007;12(1):42–7.CrossRef
32.
Dheensa S, Metcalfe A, Williams RA. Men's experiences of antenatal screening: a metasynthesis of the qualitative research. Int J Nurs Stud. 2013;50(1):121–33.CrossRefPubMed
33.
34.
35.
Lawrence V, Fossey J, Ballard C, Moniz-Cook E, Murray J. Improving quality of life for people with dementia in care homes: making psychosocial interventions work. Brit J Psychiat. 2012;201(5):344–51.CrossRefPubMed
36.
37.
Malpass A, Shaw A, Sharp D, Walter F, Feder G, Ridd M, et al. "medication career" or "moral career"? The two sides of managing antidepressants: a meta-ethnography of patients' experience of antidepressants. Soc Sci Med. 2009;68(1):154–68.CrossRefPubMed
38.
Britten N, Campbell R, Pope C, Donovan J, Morgan M, Pill R. Using meta ethnography to synthesise qualitative research: a worked example. J Health Serv Res Po. 2002;7(4):209–15.CrossRef
39.
40.
Lesser J, Koniak-Griffin D, Anderson NL. Depressed adolescent mothers' perceptions of their own maternal role. Issues Ment Health N. 1999;20(2):131–49.CrossRef
41.
Clemmens DA. Adolescent mothers' depression after the birth of their babies: weathering the storm. Adolescence. 2002;37(147):551–65.PubMed
42.
Renker PR. "Keep a blank face. I need to tell you what has been happening to me." Teens' stories of abuse and violence before and during pregnancy. MCN-AM J Matern-Chil. 2002;27(2):109–16.
43.
Kennedy AC. Resilience among urban adolescent mothers living with violence: listening to their stories. Violence Against Wom. 2005;11(12):1490–514.CrossRef
44.
Stevens CA. Being healthy: voices of adolescent women who are parenting. J Spec Pediatr Nurs. 2006;11(1):28–40.CrossRefPubMed
45.
Shanok AF, Miller L. Depression and treatment with inner city pregnant and parenting teens. Arch Women Ment Hlth. 2007;10(5):199–210.CrossRef
46.
Erdmans MP, Black T. What they tell you to forget: from child sexual abuse to adolescent motherhood. Qual Health Res. 2008;18(1):77–89.CrossRefPubMed
47.
Meadows-Oliver M. Adolescent Mothers' experiences of caring for their children while homeless. J Pediatr Nurs. 2009;24(6):458–67.CrossRefPubMed
48.
Kulkarni SJ. The relational consequences of interpersonal violence (IPV) for adolescent mothers. Youth Soc. 2009;41(1):100–23.CrossRef
49.
Brown G, Brady G, Letherby G. Young Mothers' experiences of power, control and violence within intimate and familial relationships. Child Care Pract. 2011;17(4):359–74.CrossRef
50.
Smith D, Roberts R. Young parents: the role of housing in understanding social inequality. J Fam Health Care. 2011;21(1):20–2.PubMed
51.
Crawford DM, Trotter EC, Hartshorn KJS, Whitbeck LB. Pregnancy and mental health of Young homeless women. Am J Orthop. 2011;81(2):173–83.CrossRef
52.
Boath EH, Henshaw C, Bradley E. Meeting the challenges of teenage mothers with postpartum depression: overcoming stigma through support. J Reprod and Infant Psych. 2013;31(4):352–69.CrossRef
53.
Herrman JW. How teen mothers describe dating violence. J Obstet Gynecol Neonatal Nurs. 2013;42(4):462–70.CrossRefPubMed
54.
Aparicio E, Pecukonis EV, O'Neale S. "the love that I was missing": exploring the lived experience of motherhood among teen mothers in foster care. Child Youth Serv Rev. 2015;51:44–54.CrossRef
55.
Kinser P, Masho S. 'I just start crying for no reason': the experience of stress and depression in pregnant, urban, African-American adolescents and their perception of yoga as a management strategy. Womens Health Issues. 2015;25(2):142–8.CrossRefPubMedPubMedCentral
56.
Leese M. The bumpy road to ‘becoming’: capturing the stories that teenage mothers told about their journey into motherhood. Child Fam Soc Work. 2016;21(4):521–9.CrossRef
57.
Fortier E, Foster AM. "It was kind of like if it happens it happens. It wasn't planned, it wasn't intentional": Young mothers' experiences with subsequent pregnancy in Ottawa, Canada. Facets. 2017;2:859–71.
58.
Bledsoe SE, Rizo CF, Wike TL, Killian-Farrell C, Wessel J, Bellows A-MO, et al. Pregnant adolescent women’s perceptions of depression and psychiatric services in the United States. Women Birth. 2017;30(5):e248–e57.CrossRefPubMedPubMedCentral
59.
Goffman E. The presentation of self in everyday life: Anchor Books; 1959.
60.
Rose N, Abi-Rached JM. Neuro: the new brain sciences and the management of the mind. Princeton: Princeton University press; 2013.
61.
Breheny M, Stephens C. Strengthening social support: health professionals' views of the health care needs of adolescent mothers. Aust J Rehabil Couns. 2006;12(2):63–72.
62.
Reid V, Meadows-Oliver M. Postpartum depression in adolescent mothers: an integrative review of the literature. J Pediatr Health Car. 2007;21(5):289–98.CrossRef
63.
Recto P, Champion JD. Psychosocial risk factors for perinatal depression among female adolescents: a systematic review. Issues Ment Health N. 2017;38(8):633–42.CrossRef
64.
Gee CB, Rhodes JE. Adolescent mothers' relationship with their children's biological fathers: social support, social strain and relationship continuity. J Fam Psychol. 2003;17(3):370–83.CrossRefPubMed
65.
Easterbrooks MA, Kotake C, Raskin M, Bumgarner E. Patterns of depression among adolescent mothers: resilience related to father support and home visiting program. Am J Orthop. 2016;86(1):61–8.CrossRef
66.
Fagan J, Lee Y. Perceptions and satisfaction with father involvement and adolescent mothers' postpartum depressive symptoms. J Youth Adolescence. 2010;39(9):1109–21.CrossRef
67.
Coşkun LZ. Housing insecurity among teenage mothers. In: Dissertation. USA: ProQuest Information & Learning; 2018.
68.
Stevens CA. Exploring food insecurity among young mothers (15–24 years). J Spec in Pediatr Nurs. 2010;15(2):163–71.CrossRef
69.
Xavier C, Benoit A, Brown HK. Teenage pregnancy and mental health beyond the postpartum period: a systematic review. J Epidemiol Commun H. 2018;72(6):451–7.CrossRef
70.
Williams O, Annandale E. Obesity, stigma and reflexive embodiment: feeling the 'weight' of expectation. Health. 2018:1363459318812007. [Epub ahead of print]
71.
Birkeland R, Thompson JK, Phares V. Adolescent motherhood and postpartum depression. J Clin Child Adolesc. 2005;34(2):292–300.CrossRef
72.
Whitley R, Kirmayer LJ. Perceived stigmatisation of young mothers: an exploratory study of psychological and social experience. Soc Sci Med. 2008;66(2):339–48.CrossRefPubMed
73.
Bronfenbrenner U. The ecology of human development. Harvard: Harvard University Press; 1979.
74.
Flynn D. Narratives of melancholy: a humanities approach to depression. Med Humanit. 2010;36(1):36–9.CrossRefPubMed
75.
Blackman L. Psychiatric culture and bodies of resistance. Body Soc. 2007;13(2):1–23.CrossRef
76.
Frank AW. The wounded storyteller: body, illness, and ethics. Chicago: University of Chicago Press; 1997.
77.
Anastas JW. What’s the story? Views of pregnant teens in qualitative research. Affilia. 2017;32(2):133–70.CrossRef
78.
Brand G, Morrison P, Down B. “You don’t know half the story”: deepening the dialogue with young mothers in Australia. J Res Nurs. 2015;20(5):353–69.CrossRef
79.
Shea R, Bryant L, Wendt S. ‘Nappy bags instead of handbags’: Young motherhood and self-identity. J Sociol. 2015;52(4):840–55.CrossRef
80.
Linders A, Bogard C. Teenage pregnancy as a social problem: a comparison of Sweden and the United States. In Cherry AL, Dillon ME., editors. International Handbook of Adolescent Pregnancy. New York: Springer; 2014.
81.
82.
Middleton S. ‘I Wouldn’t Change Having the Children—Not at All.’ Young Women’s Narratives of Maternal Timing: What the UK’s Teenage Pregnancy Strategy Hasn’t Heard. Sex Res Soc Policy. 2011;8(3):227.CrossRef
83.
Harrison ME, Clarkin C, Rohde K, Worth K, Fleming N. Treat me but Don't judge me: a qualitative examination of health care experiences of pregnant and parenting youth. J Pediatr Adol Gynec. 2017;30(2):209–14.CrossRef
84.
Harrison M, Worth K, Rohde K, Clarkin C. But we're not like the people on TV: A qualitative examination of the influence of media messages on the lives, beliefs, and health behaviours of pregnant and parenting adolescents. J Paediatr Child Health. 2014;19(6):e79.CrossRef
85.
Kamp A. McSharry M. Re/Assembling the Pregnant and Parenting Teenager - Narratives from the Field. Bern: Peter Lang; 2018.
86.
Barcelos C, Gubrium A. Bodies That Tell: Embodying Teen Pregnancy through Digital Storytelling. J Women Culture Soc. 2018;43(4):905–27.CrossRef
87.
Gubrium AC, Fiddian-Green A, Jernigan K, Krause EL. Bodies as evidence: mapping new terrain for teen pregnancy and parenting. Glob Public Health. 2016;11(5–6):618–35.CrossRefPubMed
88.
McSharry M. What’s Happening to My Body? The Growing, Glowing and Grotesque Teenage Belly. In Kamp A, McSharry M., editors. Re/Assembling the Pregnant and Parenting Teenager. Bern: Peter Lang; 2018. p. 51–74.
89.
Vinson J. Embodying the problem: the persuasive power of the teenage mother. New Brunswick: Rutgers University Press; 2017.
Metadata
Title
No straight lines – young women’s perceptions of their mental health and wellbeing during and after pregnancy: a systematic review and meta-ethnography
Authors
Grace Lucas
Ellinor K. Olander
Susan Ayers
Debra Salmon
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2019
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-019-0848-5

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