CT’s situation although unique, is a common occurrence in the United States, seen though all geographic, racial, ethnic, and socioeconomic groups (Hodgkinson et al., 2014). Many pre disposing risk factors or social determinants such as ethnicity, growing up in a single parent household, economic status, place CT at a disadvantage for risky behavior. Risky behavior includes unprotected sexual encounters leading to exposure to sexually transmitted diseases and early pregnancy. CT’s mother giving birth to her also at a young age, may have added to the stress of raising CT alone, while working two jobs, to provide for herself and her family. Such stressors may contribute to a range of mental health problems that can affect the parenting behavior of teenage mothers leading to an increased risk of behavioral problems in their offspring (Hodgkinson et al., 2014). As a 14-year-old freshman in high school, CT is still learning about the world, and at that age considered a child herself. Having a child this early in life forces one to grow up at an early age which may be earlier than most adolescents her age. Adolescent parenthood is associated with mental health issues such as depression, substance abuse, and post-traumatic stress disorder (Hodgkinson et al., 2014). Teen mothers are more than likely to be in poverty and reside in families or communities that are also at a social and economical disadvantage (Hodgkinson at al., 2014). Birth rates among adolescents who are black, Hispanic, and American Indian are still more than double the rates of non-Hispanic whites (Yee et al., 2019). Teen mothers are two and half times more likely to have low English proficiency and literacy compared to adolescents of the same age (Yee et al., 2019). They are also 50% more likely to graduate high school at a later age of 22 years old (Yee et al., 2019). With all this in mind, as future providers, it is important to understand the vulnerability of this population, respect in their decisions whether to terminate or keep a pregnancy, and provide support to necessary resources. It is also important to provide all the necessary options and education for CT moving forward in her pregnancy. Lack of access to healthcare and lack of education for a healthy pregnancy can lead to low infant birth rates, preterm labor, and neonatal mortality (Yee et al., 2019). Provide acceptance and avoid judgement for her coming forward in her pregnancy. Young mothers < 20 years of age have more hospital admissions and unplanned ER visits (Harron et al., 2020). With CT’s decision, secondary prevention to promote a healthy pregnancy include reducing stress, reducing social stigmatization, and reducing adverse domestic and environmental factors for mother and baby (Harron et al., 2020). Education on avoiding alcohol and smoking, as well as adequate nutrition on diet and vitamin supplementation. Education on primary prevention which would have included access to contraceptives can also be addressed to prevent a future second pregnancy. Although CT does state that she has support of other family members, as a teen, her mother, and her unborn child’s father all play an important role as protective factors for needed support. As providers, we can facilitate communication and foster anticipatory guidance for a positive and supportive relationship between the teen, her mother, and the child’s father (Hodgkinson et al., 2014). This provides the sensitive and responsive parenting necessary for a healthy secure attachment with the future newborn baby. Mental health resources at schools can provide a benefit for teen mothers’ access to a social worker and peer groups (Hodgkinson et al., 2014). Bridging CT to welfare and public health programs that augment reproductive choice to promote pregnancy and post-partum health (Harron et al., 2020).
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