References
Is the introduction of a named midwife for teenagers associated with improved outcomes? A service development project
Abstract
Background:
The role of named midwife for teenagers was implemented in Royal Surrey County Hospital NHS Foundation Trust in order to improve outcomes for teenage mothers and their babies. The role comprised a dedicated midwife-led teenage antenatal clinic, antenatal and postnatal home visits and tailored antenatal education.
Aims:
This project monitored the outcomes of teenage mothers following implementation of the role, to assess improvements in outcomes.
Methods:
During this service development project, 31 teenage mothers aged ≤ 19 years received midwifery care and their obstetric outcomes were monitored. These outcomes were compared with 52 teenage mothers who had previously given birth.
Findings:
Comparing teenagers who gave birth in February–August 2014 with those who gave birth in the same period in 2013, there was an increase in the rate of spontaneous vaginal deliveries, a decrease in instrumental deliveries and increase in induction of labour; however, induction of labour for intrauterine growth restriction decreased. The rate of caesarean section increased but remained lower than in the general population. An increase in birth weight and intention to breastfeed were also observed.
Conclusions:
This project indicates that the role of a dedicated midwife for teenagers has a place in the care of teenage mothers.
Teenage mothers are a vulnerable group in maternity services, owing to factors including poor health and social exclusion (Department for Education and Skills, 2006). They often have poorer obstetric outcomes than older women, and are more likely to give birth prematurely or have low birth-weight babies (Gupta et al, 2008). Teenage mothers are known to be more likely to smoke, may have a poor diet, develop postnatal depression and have repeated unplanned pregnancies (Public Health England (PHE) et al, 2015). Their access to maternity services is often poorer than older women's, their pregnancies are associated with increased adverse outcomes and poorer long-term health, and they are more likely to be socially excluded (Whitworth and Cockerill, 2014). In addition, many teenage mothers tend to have low prior educational attainment (Crawford et al, 2013).
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