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Exploring perceptions of maternity services for pregnant adolescents in Indonesia: a qualitative study

02 November 2024
Volume 32 · Issue 11

Abstract

Background/Aims

Adolescent pregnancies are prevalent in Indonesia. This study aimed to explore perceptions from healthcare workers and pregnant adolescents of maternity services for pregnant adolescents.

Methods

This qualitative exploratory study involved two policymakers, 10 midwives, five doctors, and 10 pregnant adolescents. Data were collected through structured interviews in public health centre consultation rooms. The data were analysed thematically to explore factors that promoted or hindered use of maternity services for pregnant adolescents.

Results

The identified barriers included a lack of tailored directives, challenges in engaging adolescents, insufficient numbers of skilled healthcare professionals, adolescents' fears and compromised confidentiality. Opportunities for improvement included enhancing service quality through strategic planning and specialised training for midwives and psychologists.

Conclusions

The study underscores the need to improve maternity services offered for pregnant adolescents by creating a conducive working environment and sensitising healthcare workers and the community to adolescent mothers' needs.

Implications for practice

There is a need for guidelines in Indonesia specifically on providing care for pregnant adolescents. Healthcare professionals require specialised training and facilities should be made adolescent friendly.

There are approximately 21 million adolescent pregnancies per year, 50% of which are unintended and result in an estimated 12 million births around the world (World Health Organization (WHO), 2019). In Indonesia, the age-specific fertility rate of female adolescents aged 15–19 years is 26.6 per 1000 women of childbearing age (National Family Planning Coordinating Board, 2024). Data from the Indonesian demographic health survey show that 93% of mothers received adequate antenatal care, 84% gave birth at a healthcare facility and 71% received postnatal care (Kemenkes, 2018). However, looking specifically at adolescents, it has been reported that 25% of pregnant adolescents attend less than four antenatal care visits and one-third choose to give birth accompanied by traditional birth attendants (Gayatri et al, 2023).

Pregnant adolescents aged 10–19 years face higher risks of eclampsia, puerperal endometritis and systemic infections than women aged 20–24 years, and babies of adolescent mothers are at greater risk of low birth weight, preterm birth and severe neonatal conditions (WHO, 2024). There are also negative psychosocial outcomes associated with adolescent pregnancy and motherhood (Bostancı Ergen et al, 2017), including perinatal distress (Hipwell et al, 2016), financial difficulties and school dropout (Astuti et al, 2020).

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