Pregnancy care for the adolescent [letter]

In Michigan nurse researchers compared data on pregnant teens whose prenatal care involved a nurse practitioner-managed peer support group with data on pregnant teens who received only routine prenatal care in the clinic. All cases and controls were low income black teens. After receiving instruction in how to perform health care activities the cases measured blood pressure weight fundal height fetal heart tones and fetal position of their partner. They pressured their partner to attend prenatal care. Prenatal education topics were nutrition discomforts of pregnancy preterm labor danger signs post pregnancy care baby care and feeding and working within the health care setting. Teens kept their own personal records. Cases attended more prenatal care sessions than did the controls (11 vs. 6). The gestational age of the newborns was greater than that of the controls (39 vs. 37 weeks). Overall less than 14% of all pregnant teens experienced preterm labor. None of the teens in the intervention group had a repeat pregnancy in the 6 months after the index pregnancy compared to 20.5% of the controls. Within 2 years the repeat pregnancy rate was still lower among cases than controls (12% vs. 37%). Teens in the intervention group had a significantly lower self-criticism score than did those in the control group indicating that they had a more positive self-concept and a lower sense of conflict. They were comfortable making their own decisions about their care and asking the health care providers questions about their care. Based on mastery scales delivery and labor/delivery were less traumatic for cases than controls (p = 0.045 and 0.008 respectively). These findings suggest that pregnant teens in a nurse practitioner-managed peer support program are more comfortable and at ease in dealing with health care providers and are more likely to improve their personal responsibility for health care.