New Zealand’s rates of teenage pregnancy are high by OECD standards and the children of teenage parents have been identified as some of the most at risk in our community. The provision of services which support teenage parents has therefore been prioritised in Plunket’s business plan.
Evidence shows teenage mothers often struggle to cope with the demands of caring for a baby while trying to make the transition from adolescence to adulthood. Additional support is required if they are to achieve positive health and life outcomes.
A specialist teenage well child service is being piloted by Plunket in the Hawke’s Bay which provides early engagement in the lives of teenage mothers and their families. It is aimed to help address health targets with a focus on increasing immunization rates, smoking cessation, encouraging breastfeeding, family planning and reducing family violence.
The development of the pilot was informed by evidence from research conducted in 2010 by Plunket Clinical Leader Nicky Skerman that asked teenage mothers what they wanted from the Well Child/Tamariki Ora service.
The research found that teenage mothers did not engage well with the Well Child/Tamariki Ora service for a number of reasons - one of the main reasons being the strength of the relationship between the teenage mother and her Well Child/Tamariki Ora nurse. Continuity of care was identified as being critical to the success of the service.
A lack of referral was another reason that was identified. This resulted in teenage mothers slipping through the cracks during the transition from maternity to Well Child/Tamariki Ora services, often with no support.
The pilot due to be completed by the end of 2011 is trialling a system whereby nurses receive referrals from Lead Maternity Carers. Three extra visits are then delivered, two prenatal visits at weeks 36 and 38 of the pregnancy, and then a postnatal visit before baby is two weeks old.
The additional visits aim to develop a trusting relationship between the mother and whānau and their Well Child/Tamariki Ora nurse, and to ensure ongoing services are provided to those most in need.
The combination of parenting education for teens and mentoring, alongside Well Child/Tamariki Ora service delivery, is also proving to be a successful way of supporting teen mothers. Plunket in the Hawke’s Bay have started training some teens to be breastfeeding mentors for other mothers.
An evaluation is in progress and funding is currently being sought to continue and extend the specialist teenage well child service.