A hopeful future: a qualitative investigation of positive psychological functioning in young mothers.

AIMS/BACKGROUND: Young mothers have reported facing specific challenges such as stigmatisation and social isolation, which may be exaggerated by the increasing maternal age in industrialised countries. Despite these challenges, some young mothers have been shown to exhibit resilience and confidence during the transition to parenthood. Using strength-based psychological concepts, this study aimed to identify the facilitators of and barriers to the development of positive psychological states in young Australian mothers. DESIGN/METHODS: Using semi-structured interview questions, 11 women who had given birth between 15 and 22 were asked to share their experiences of pregnancy, birth, and motherhood. Their responses were analysed using the Framework method; initially coding the data to a priori themes such as resilience and social support, and then to higher order themes. RESULTS: Five higher order themes were developed from participant responses: 1. Everything is about to change, 2. Disrespected and disempowered, 3. Resilience, 4. It takes a village, and 5. A hopeful future. Across these themes, participants described the mixed emotional experiences of pregnancy and birth, experiences of stigma from various sources, efforts to maintain mental wellbeing, reliance on support networks, and aspirations for themselves and their children. CONCLUSION: Findings from the current study highlight several key strategies for managing the challenges of early motherhood and promoting positive psychological states. Recommendations include fostering self-efficacy, supporting identity development, and establishing strong support networks across social and healthcare contexts. Recognizing and celebrating the strengths of young mothers is essential for effectively supporting them through the complex experience of motherhood.

Determinants of health facility delivery among young mothers aged 15 - 24 years in Nigeria: a multilevel analysis of the 2018 Nigeria demographic and health survey.

BACKGROUND: Young mothers aged 15 to 24 years are particularly at higher risk of adverse health outcomes during childbirth. Delivery in health facilities by skilled birth attendants can help reduce this risk and lower maternal and perinatal morbidity and mortality. This study assessed the determinants of health facility delivery among young Nigerian women. METHODS: A nationally representative population data extracted from the 2018 Nigeria Demographic and Health Survey of 5,399 young women aged 15-24 years who had had their last birth in the five years before the survey was analysed. Data was described using frequencies and proportions. Bivariate and multivariate analyses were carried out using Chi-Square test and multilevel mixed effect binary logistic regression. All the analysis were carried out using STATA software, version 16.0 SE (Stata Corporation, TX, USA).. RESULTS: Of the total sampled women in the 2018 NDHS, 5,399 (12.91%) formed our study population of young women 15 -24 years who had their last birth in the preceding five years of the survey. Only 33.72% of the young mothers utilized health facility for delivery. Women educated beyond the secondary school level had 4.4 times higher odds of delivering at a health facility compared with women with no education (AOR 4.42 95%, CI 1.83 - 10.68). Having fewer children and attending more antenatal visits increased the odds of health facility delivery. With increasing household wealth index, women were more likely to deliver in a health facility. The odds of health facility delivery were higher among women whose partners had higher than secondary level of education. Women who lived in communities with higher levels of female education, skilled prenatal support, and higher levels of transportation support were more likely to deliver their babies in a health facility. CONCLUSION: Strategies to promote institutional delivery among young mothers should include promoting girl child education, reducing financial barriers in access to healthcare, promoting antenatal care, and improving skilled birth attendants and transportation support in disadvantaged communities.

Her strength: Reflections on nurse home-visiting.

The Nurse-Family Partnership is a targeted parenting intervention designed to improve maternal and child health. In Canada it is delivered exclusively by public health nurses who provide complex care to adolescent girls and young women. A process evaluation was conducted to better understand the experiences of public health nurses delivering the Nurse-Family Partnership program in Canada. Although the traditional qualitative data analysis led to the creation of significant findings and clinical implications, it lacked the "heart" of public health nursing practice. Through a reflective process, and to present an evocative account of the multifaceted nursing care provided by the study participants, direct quotes were used to create a poetic display of nurses' experiences. Through the power of found poetry, the complexities of clients' lives, as well as the challenges and joys of home-visitation nursing, were illuminated.

Contraceptive use among young mothers with repeat births: Evidence from a qualitative study in KwaZulu-Natal, South Africa.

Teenage pregnancy and rapid repeat pregnancies are declining globally, but they continue to be a significant health issue. Many studies have explored contraceptive use by adolescents, but too date there is a lack of literature on the contraceptive use dynamics of young women in repeat births. This study was conducted in Umlazi, a township located in the province of KwaZulu-Natal. A total of 50 interviews with young mothers aged 18-24 years were conducted. The results revealed that contraceptive use among young mothers remains a challenge, resulting in a significant lack of contraceptive use. This study concludes that much more needs to be done to help young women protect themselves from unwanted and unplanned repeat pregnancies, which includes raising contraception awareness as well as educating young women about their own sexual reproductive health.

Assessment of Young Mothers' Oral Hygiene Practices during Pregnancy and Their Knowledge of Children's Oral Health in Northern Greece.

AIM: The aim of the study was to assess maternal knowledge about oral health practices for children along with oral hygiene perceptions of mothers during pregnancy in the city of Thessaloniki, Greece. MATERIALS AND METHODS: This cross-sectional study was conducted among 300 newly delivered mothers who were admitted to the obstetrician/gynecological (OB/GYN) University Clinic in Thessaloniki, Greece, to give birth. A three-part, self-reported, 40-item questionnaire was designed, collecting socioeconomic data, perceptions, and practices regarding maternal oral hygiene during pregnancy and their knowledge in relation to children's oral health. Collected data were recorded, tabulated, and statistically analyzed with SPSS (Version 24.0), and p < 0.05 was accepted as statistically significant. RESULTS: The sample consisted of mainly Greek, married, university alumni mothers less than 35 years of age. Self-reports of oral hygiene practices during gestation were sufficient but an inadequate level of regular dental visits was recorded. Poor knowledge was equally noted, regarding children's oral health, in the domains of fluoride toothpaste usage, the age of the first dental visit, supervised toothbrushing, nighttime breastfeeding, potential hazards of pacifier use, and thumb sucking. All factors were significantly associated with the mothers' education level (p < 0.05). CONCLUSION: Newly-delivered mothers presented with a lack of knowledge regarding mother/caregiver-related risk factors associated with early childhood caries (ECC), the timing of establishing a dental home, and misconceptions about the safety of dental visits during pregnancy. CLINICAL SIGNIFICANCE: Healthcare professionals interacting with pregnant women or young mothers are a vital element to bridge the existing gap in knowledge and assist those socially and educationally deprived.

Mapping the contextual mental health interventions for perinatal adolescent mothers with self-reported common mental symptoms (anxiety and depression) in sub-Saharan African countries: a scoping review.

Introduction: Early preventive interventions may support adolescent mothers' mental health during the perinatal period. However, adolescent maternal mental health interventions have received little empirical research attention. This scoping review maps the evidence on interventions appropriate for adolescent mothers during the perinatal period in Sub-Saharan African countries.Methods: The process was guided by the Joanna Briggs Institute's methodology for scoping reviews. Five databases, MEDLINE, EMBASE, PsycInfo, CINAHL, Google Scholar, and ProQuest, were searched for citations of studies published from 2000. The reporting is according to Preferred Reporting for Systematic Reviews and Meta-analysis (PRISMA).Results: The initial search of databases resulted in 2 757 records. After duplicates were removed, 311 records were screened, and eight records included. Interventions included five key strategies: cognitive behavioural therapy; group problem-solving; psychoeducation; psychosocial group counselling; and integrated mothers and babies course and early childhood development group-based intervention. None of the interventions specifically targeted adolescent mothers, however.Discussion and conclusion: There is limited evidence of interventions specific to adolescent mothers. There is a need for the development, implementation and evaluation of specific interventions relevant to this population group.

Utilization of antenatal care among adolescent and young mothers in Ghana; analysis of the 2017/2018 multiple indicator cluster survey.

BACKGROUND: Complications during pregnancy and childbirth are the leading cause of death among adolescent girls. In Ghana, the prevalence of adolescent pregnancy remains high. Yet, little is known about ANC utilization among adolescent and young mothers. This study aimed to assess the prevalence of obtaining 4 or more ANC visits and associated factors among adolescent and young mothers. METHODS: We analysed secondary data from the sixth round of the Ghana Multiple Indicator Cluster Survey. A total of 947 adolescent and young mothers were included in this study. Data were analysed using STATA/SE, version 16, employing descriptive statistics and Binary Logistic Regression. RESULTS: It was found that majority of the participants were aged 20-24 years (70%), married/in union (61%) and non-insured (64%). The prevalence of obtaining 4 or more ANC visits was 84%. Adolescent and young mothers with junior high school education, in the second wealth quintile, exposed to the internet, and resided in the Upper East region had a higher likelihood of obtaining 4 or more ANC visits (p < 0.05). CONCLUSIONS: This study demonstrated that optimal ANC utilization among adolescent and young mothers were determined by socio-economic factors. Going forward, maternal healthcare interventions must prioritize adolescent and young mothers from poor socio-economic backgrounds.

Experiences of young Australian mothers with infant feeding.

BACKGROUND: Despite the overwhelming evidence of health and other benefits of breastfeeding and recommendations to breastfeed by peak health bodies, breastfeeding rates are significantly lower than recommended in Australia and globally. Young mothers are identified as being at high risk of not breastfeeding their infants according to infant feeding recommendations. This study aimed to gain an in-depth understanding of young Australian mothers' experiences of infant feeding, and to explore the factors which facilitated or hindered adherence to recommended breastfeeding practices. METHODS: Purposive and snowball sampling were used to recruit young mothers in Australia (n = 17) aged 18-25 years who had given birth to their first child within the last two years. Data were collected through semi-structured interviews via online videoconferencing. Interviews were audio-recorded, transcribed verbatim, coded, and subsequently analysed. Thematic analysis was conducted using Quirkos, a qualitative data management and analysis software. RESULTS: Four major themes were identified: Breastfeeding is challenging; Feeling judged about infant feeding choices; Experiences with breastfeeding support; and Experiences and views on breastfeeding education. Most mothers reported experiencing breastfeeding challenges, particularly those arising from lactation difficulties, yet many were able to overcome these challenges through their determination to breastfeed. Many mothers expressed perceiving judgement from others for breastfeeding in public. Some mothers who were bottle feeding their infants, whether with expressed breast milk or infant formula, felt that they were being judged for using a bottle. Many mothers reported professional, partner, family, and peer support as critical facilitators to the continuation of breastfeeding. Most mothers shared positive experiences of attending breastfeeding education sessions, but indicated the need for community education to reduce judgement toward mothers' infant feeding decisions. CONCLUSIONS: The barriers and enablers to infant feeding experienced by young mothers are similar to those experienced by mothers of all ages. Young mothers experience significant breastfeeding challenges and need support from partner, family, peers, and professionals to continue breastfeeding in line with recommendations. Breastfeeding campaigns to support young mothers should be aimed at the wider community to increase awareness of breastfeeding challenges, reduce stigma associated with breastfeeding in public, and to support mothers in their infant feeding decisions.

Determinants of health facility delivery among young mothers in Ghana; insights from the 2014 Ghana Demographic and Health Survey.

BACKGROUND: Globally, young women deliver at home, often under unhygienic conditions and without skilled birth attendants. This study identified the determinants of health facility delivery among young mothers in Ghana. METHODS: We analysed secondary data from the 2014 Ghana Demographic and Health Survey, which collected data across the former ten administrative regions of Ghana. This study analysed data from the 'women file' by adjusting for the sample weight. STATA/SE version 16 was employed to analyse the data by computing descriptive statistics, Chi-square, and Binary Logistic Regression. RESULTS: Seven in ten young mothers gave birth in a health facility. Young mothers who had secondary school education were over three-fold more likely to deliver in a health facility (AOR = 3.5, 95% CI: 1.33-9.23) compared with young mothers with no formal education. Young mothers who resided in rural areas had lower odds (73%) of delivering in a health facility (AOR = 0.27; 95% CI: 0.14-0.514) compared with those in urban areas. Young mothers within the richest wealth quintile also had higher odds (8 times) of delivering in a health facility (AOR = 8.24; 95% CI: 0.95-71.77) compared with those within the poorest wealth quintile. Young mothers who obtained four to seven antenatal visits (AOR = 0.53; 95% CI: 0.27-1.03) had lower odds of delivering in a health facility compared with those who obtained eight or more antenatal visits. CONCLUSION: The majority of young mothers in Ghana gave birth in a health facility. The likelihood of delivering in a health facility was influenced by socio-demographic factors, economic factors and utilization of antenatal care services. Therefore, interventions aimed at increasing utilization of skilled delivery among young women should focus on promoting girl child education, economic status and antenatal care visits.

Partner Emotional Support and Child Problem Behaviors: The Indirect Role of Harsh Parenting for Young Mothers and Their Children.

Emotionally supportive partners promote the well-being of teenage mothers and their children as they navigate sensitive developmental periods. Yet, having focused on young parents' relationship dissolution, we know very little about benefits of partner supportiveness for the development of children's psychological adjustment or processes that may explain this association. Using five waves of Fragile Families and Child Well-being Study data (N = 771) and parallel process latent growth curve modeling, this study tested whether trajectories of partner supportiveness (measured by maternal reports of fathers' emotional support) directly mitigated trajectories of children's externalizing and internalizing problem behaviors (measured by maternal reports of problem behaviors) and/or whether such effects were indirectly linked through lower levels of maternal harsh parenting (measured by observational ratings of mother-child interactions). Results suggest that higher levels of partner supportiveness at birth were associated with child externalizing and internalizing trajectories that started at lower levels and demonstrated slower improvements across time. Lower starting levels of maternal harsh parenting when children were three years old partially explained associations between partner supportiveness at birth and lower levels of child externalizing symptoms at age three. Lessons gleaned from this study are discussed in context of young families' strengths and applied to practice-based settings.

Las personas que apoyan emocionalmente a su pareja promueven el bienestar de las madres adolescentes y sus hijos mientras transitan periodos sensibles del desarrollo. Sin embargo, al habernos centrado en la disolución de las relaciones de padres jóvenes, sabemos muy poco acerca de los beneficios que aporta el apoyo de las parejas al desarrollo de la adaptación o de los procesos psicológicos de los niños, y que podrían explicar esta asociación. Utilizando cinco tandas de datos (N = 771) del estudio Familias Frágiles y el Bienestar Infantil (Fragile Families and Child Well-Being Study) y el modelo de la curva de crecimiento latente de proceso paralelo, este estudio evaluó si las trayectorias de apoyo de las parejas (medidas por informes maternos del apoyo emocional de los padres) mitigaron directamente las trayectorias de las conductas problemáticas de exteriorización y de interiorización de los niños (medidas por informes maternos de conductas problemáticas) o si estos efectos estuvieron asociados indirectamente mediante niveles más bajos de crianza materna rigurosa (medida por las calificaciones observacionales de las interacciones entre madre e hijo). Los resultados sugieren que los niveles más altos de apoyo de la pareja en el nacimiento estuvieron asociados con trayectorias de exteriorización y de interiorización del niño que comenzaron a niveles más bajos y demostraron mejoras más lentas con el tiempo. Los niveles iniciales más bajos de crianza materna rigurosa en la tercera tanda explicaron parcialmente las asociaciones entre el apoyo de la pareja en el nacimiento y los niveles más bajos de síntomas de exteriorización de los niños cuando los niños tenían tres años. Se comentan las enseñanzas obtenidas de este estudio en el contexto de los puntos fuertes de las familias jóvenes, y se aplican a entornos de práctica.

Preliminary Effectiveness of Group Interpersonal Psychotherapy for Young Kenyan Mothers With HIV and Depression: A Pilot Trial.

OBJECTIVE: The authors adopted a task-sharing strategy in which lay health workers delivered group interpersonal psychotherapy (IPT-G) in primary care clinics in Nairobi, Kenya, to young mothers with HIV and depression. The study examined the acceptability, feasibility, and effectiveness of IPT-G in improving depression and antiretroviral therapy adherence. METHODS: Twenty-four mothers (ages 18-24 years and 6-12 weeks postpartum) participated. The women were randomly assigned to IPT-G or to a waitlist. Eight lay providers administered the IPT-G sessions across 8 weeks. The primary outcome was pre- to postintervention change in depression scores as measured on the Edinburgh Postnatal Depression Scale. The secondary outcome was antiretroviral therapy adherence. All waitlist participants subsequently received the intervention, and a secondary outcome, within-group analysis, was conducted and included those participants. RESULTS: Participants' median age was 23.0 years, 17 (71%) lived with a partner, and 19 (79%) had fewer than two children. The intervention group had a mean±SD depression score of 15.9±4.3 at baseline and 6.8±7.0 postintervention. For the waitlist control group, the mean score was 17.3±5.9 at baseline and 13.2±6.6 at the first follow-up. Waitlist participants had significantly greater mean depression scores than did intervention group participants at the first follow-up (after the intervention group's 8-week IPT-G) (ß=6.42, 95% confidence interval=1.17 to 11.66, p=0.017). No difference was observed between groups in antiretroviral therapy adherence. CONCLUSIONS: This study provides preliminary evidence that IPT-G led by community health workers may have benefits for postpartum depression among young mothers with HIV.

Building Healthy Children: A preventive intervention for high-risk young families.

The Building Healthy Children (BHC) home-visiting preventive intervention was designed to provide concrete support and evidence-based intervention to young mothers and their infants who were at heightened risk for child maltreatment and poor developmental outcomes. This paper presents two studies examining the short- and long-term effectiveness of this program at promoting positive parenting and maternal mental health, while preventing child maltreatment and harsh parenting. It also examines the intervention's sustained effect on child symptomatology and self-regulation. At baseline, young mothers and their infants were randomly assigned to receive BHC or Enhanced Community Standard. Families were assessed longitudinally across four time points. Data were also collected from the child's teacher at follow-up. Mothers who received BHC evidenced significant reductions in depressive symptoms at mid-intervention, which was associated with improvements in parenting self-efficacy and stress as well as decreased child internalizing and externalizing symptoms at postintervention. The follow-up study found that BHC mothers exhibited less harsh and inconsistent parenting, and marginally less psychological aggression. BHC children also exhibited less externalizing behavior and self-regulatory difficulties across parent and teacher report. Following the impactful legacy of Dr. Edward Zigler, these findings underline the importance of early, evidence-based prevention to promote well-being in high-risk children and families.

Informative title: Effects of social support, parenting stress and self-efficacy on postpartum depression among adolescent mothers in Jordan.

AIM AND OBJECTIVE: This study investigated the effects of social support, parenting stress and maternal self-efficacy on postpartum depression among adolescent mothers in Jordan. BACKGROUND: Adolescent pregnancy may have serious health, social and economic consequences for young women, families and communities. In Jordan, the incidence of adolescent pregnancy has increased from 5% in 2012 to 15% in 2018. Little attention has been given to postpartum depression among adolescent mothers in Arab and Middle Eastern countries. METHOD: In a cross-sectional design using convenience sampling, 200 women aged less than 20 years, six to eight weeks postpartum and who could speak and read Arabic were interviewed in a participating health clinic. The interview occurred before or after a woman's scheduled clinic appointment and included socio-demographic data, Edinburgh Postnatal Depression Scale (EPDS), Maternity Social Support Scale (MSSS), Parenting Stress Scale (PSS) and Perceived Self-efficacy Scale (PSES). Data collection took place between December of 2018 and April of 2019. Reporting followed the STROBE guidelines. RESULTS: Results revealed that 28.5% of adolescent mothers had probable postpartum depression. Mothers who reported high social support, high parenting stress, low self-efficacy, financial stress and marital conflict had significantly higher EPDS scores than those who did not report these stressors. CONCLUSION: Prevalence of postpartum depression reported in this study warrants immediate action on early assessment, detection and intervention. High levels of social support may feel overwhelming for young mothers and contribute to high parenting stress, low maternal self-efficacy and marital conflict. RELEVANCE TO CLINICAL PRACTICE: Adolescent mothers are at increased risk of PPD compared to mothers over 20 years of age. Perceived quality rather than availability of social support needs to be considered. Young mothers require education and early intervention prevention strategies to better prepared them for motherhood and manage stressors associated with their changing social role.

Alcohol Use Trajectories Before and After Pregnancy Among Adolescent and Young Adult Mothers.

BACKGROUND: Moderate to heavy alcohol use during pregnancy (≥3 drinks/occasion) is linked to a range of adverse offspring outcomes. Prior studies suggest that adolescent and young adult mothers may be particularly vulnerable to these risky drinking behaviors during and after pregnancy. This study used latent class growth analysis (LCGA) to examine changes in risky drinking from prepregnancy to postpregnancy and identified prepregnancy predictors representing cognitive and social factors to inform prevention. METHODS: Participants included 432 adolescent and young adult mothers (aged 13 to 24; 78% Black) assessed annually since childhood in the Pittsburgh Girls Study. Participants prospectively reported frequency of risky drinking (≥3 drinks/occasion) in the year of pregnancy and 2 years before and after pregnancy, as well as social-cognitive risk factors for drinking (alcohol expectancies, drinking motives, caregiver, and peer alcohol use). RESULTS: Approximately 11% of young mothers in this community-based sample engaged in risky drinking at least once a month during the year of pregnancy, with greater frequency observed for young adult (vs. adolescent) mothers. LCGA revealed 4 risky drinking trajectories across the perinatal period, including 3 relatively stable trajectories (low, moderate, and high frequency) and 1 distinct trajectory ("postpartum initiators") characterized by increased risky drinking post-childbirth. Peer alcohol use during and after pregnancy distinguished higher risk from lower risk trajectories, controlling for age, race, and age of drinking onset. Exposure to caregiver alcohol use and prepregnancy coping motives for drinking also elevated risk, but only for mothers who became pregnant in early adulthood (vs. adolescence). CONCLUSIONS: Adolescent and young adult mothers show heterogeneous risky drinking trajectories from prepregnancy to postpregnancy. Pregnant women in the transitional age of early adulthood who report exposure to caregiver alcohol use, more friends who drink, and coping motives for drinking may have elevated risk for moderate-heavy drinking during the perinatal period and may benefit from targeted intervention.

Identification of motives and barriers to physical activity of polish young mothers.

BACKGROUND: The purpose of the study was to determine the level of physical activity of young mothers living in rural and urban areas and their free time budget. The article also aims to indicate motivating factors and barriers encountered during physical activity. METHODS: A diagnostic survey method, including two survey IPAQ questionnaires - the long version and author's questionnaire, has been applied in the study. A representative sample consisted of 1064 young mothers who gave birth in 2017. Student T test and discriminate function analysis have been used in statistical analysis. RESULTS: No significant difference appeared between young mothers from rural areas and urban areas in the level of physical activity. At the same time, the authors of the study identified several smaller differences when analyzing particular aspects of physical activity. Young mothers from rural areas more often declared their participation in physical activity to improve their physical condition and reduce pain complaints. On the other hand, young mothers from urban areas emphasized that physical activity helps them to strengthen self-confidence and improve their position in the family. In case of the main barriers to physical activity, both group of respondents pointed to the lack of money and interest in occasional events. CONCLUSIONS: The main conclusion is that more efforts are needed is to strengthen family support and material status of young families. It is also important to eliminate infrastructure barriers, mostly in rural areas and raise awareness on the importance of health education.

Mental health in young mothers, single mothers and their children.

BACKGROUND: Parenthood is a life transition that can be especially demanding for vulnerable individuals. Young maternal age and maternal single status have been reported to increase the risk for adverse outcomes for both mother and child. The aim of this study was to investigate the effect of young maternal age and maternal single status on maternal and child mental health and child development at age 3. METHODS: A birth-cohort of 1723 mothers and their children were followed from birth to age 3. Sixty-one mothers (3.5%) were age 20 or younger, and 65 (4.0%) reported single status at childbirth. The mothers filled out standardized instruments and medical information was retrieved from the standardized clinical assessment of the children at Child Welfare Centers, (CWC). RESULTS: Young maternal age was associated with symptoms of postpartum depression whereas single status was not. Young mothers were more prone to report internalizing and externalizing problems in their children, while there was no association between single status and child behavioral problems. No differences were seen on child development (CWC scores). School drop-out was, however, a more influential factor on depressive symptoms postpartum than maternal age. CONCLUSION: Young mothers are at increased risk for symptoms of postpartum depression which indicates the need for attention in pre- and postnatal health care programs. Single mothers and their children were not found to be at increased risk for adverse outcomes. The importance of schooling was demonstrated, indicating the need for societal support to encourage adolescents to remain in school.

No straight lines - young women's perceptions of their mental health and wellbeing during and after pregnancy: a systematic review and meta-ethnography.

BACKGROUND: Young mothers face mental health challenges during and after pregnancy including increased rates of depression compared to older mothers. While the prevention of teenage pregnancy in countries such as the United States and the United Kingdom has been a focus for policy and research in recent decades, the need to understand young women's own experiences has been highlighted. The aim of this meta-ethnography was to examine young women's perceptions of their mental health and wellbeing during and after pregnancy to provide new understandings of those experiences. METHODS: A systematic review and meta-ethnographic synthesis of qualitative research was conducted. Seven databases were systematically searched and forward and backward searching conducted. Papers were included if they were from Organisation for Economic Co-operation and Development countries and explored mental health and wellbeing experiences of young mothers (age under 20 in pregnancy; under 25 at time of research) as a primary research question - or where evidence about mental health and wellbeing from participants was foregrounded. Nineteen papers were identified and the Critical Appraisal Skills Programme checklist for qualitative research used to appraise the evidence. Following the seven-step process of meta-ethnography, key constructs were examined within each study and then translated into one another. RESULTS: Seven translated themes were identified forming a new line of argument wherein mental health and wellbeing was analysed as relating to individual bodily experiences; tied into past and present relationships; underpinned by economic insecurity and entangled with feelings of societal surveillance. There were 'no straight lines' in young women's experiences, which were more complex than dominant narratives around overcoming adversity suggest. CONCLUSIONS: The synthesis concludes that health and social care professionals need to reflect on the operation of power and stigma in young women's lives and its impact on wellbeing. It adds to understanding of young women's mental health and wellbeing during and after pregnancy as located in physical and structural factors rather than individual capacities alone.

"They say that I have lost my integrity by breaking my virginity": experiences of teen school going mothers in two schools in Lusaka Zambia.

BACKGROUND: Adolescent school-going mothers return to school in the rekindled hope of obtaining an education. However, their re-introduction into the school environment requires adequate support from teachers, fellow pupils, and the community. The purpose of this study was to explore the experiences of school-going mothers in Lusaka to understand their coping mechanism in the process of re-integration. METHOD: This is a qualitative case study. We conducted in-depth interviews with 24 school going mothers between the ages of 16-19, purposively selected from 2 schools in Lusaka district. Audio-recorded interviews were transcribed, coded using Nvivo 10 software and analysed using thematic analysis. RESULTS: The girls reported experiencing stigmatization, discrimination, mockery and abuse from their teachers. Some community members labelled, humiliated, gossiped about and isolated the girls from their friends and classmates because of fear of 'contamination'. Families forced some girls into early marriages making them feel rejected. These experiences resulted in low self-esteem, inferiority complex, poor performance in their academic work and identity crises in the young mothers. Therefore, because of the experiences the girls faced, they developed certain behaviours such as beer drinking, truancy and running away from home. They found it difficult to adjust to motherhood while doing their schoolwork. CONCLUSION: There is a need for the teachers to undergo training on how to handle young mothers and have a flexible time-table to accommodate adolescent school going mothers when they miss lessons to attend to their babies. Non-parenting school girls should be counseled so that they do not stigmatize adolescent mothers. Parents need to be educated on how to deal with adolescent mothers in the community. The guidance office should have a qualified psychosocial counselor to help create a conducive learning environment for adolescent mothers, by helping them with missed lessons and seeing to it that they are not stigmatized.

Ethics, effectiveness and population health information interventions: a Canadian analysis.

Population health information interventions (PHIIs) use information in efforts to promote health. PHIIs may push information to a target audience (communication), pull information from the public (surveillance), or combine both in a bidirectional intervention. Although PHIIs have often been framed as non-invasive and ethically innocuous, in reality they may be intrusive into people's lives, affecting not only their health but their senses of security, respect, and self-determination. Ethical acceptability of PHIIs may have impacts on intervention effectiveness, potentially giving rise to unintended consequences. This article examines push, pull, and bidirectional PHIIs using empirical data from an ethnographic study of young mothers in Greater Vancouver, Canada. Data were collected from October 2013 to December 2014 via naturalistic observation and individual interviews with 37 young mothers ages 16-22. Transcribed interviews and field notes were analyzed using inductive qualitative thematic analysis. Both push and pull interventions were experienced as non-neutral by the target population, and implementation factors on a structural and individual scale affected intervention ethics and effectiveness. Based on our findings, we suggest that careful ethical consideration be applied to use of PHIIs as health promotion tools. Advancing the 'ethics of PHIIs' will benefit from empirical data that is informed by information and computer science theory and methods. Information technologies, digital health promotion services, and integrated surveillance programs reflect important areas for investigation in terms of their effects and ethics. Health promotion researchers, practitioners, and ethicists should explore these across contexts and populations.

Becoming a mother: perspectives and experiences of young women in a South African Township.

There has been growing interest in the high levels of pregnancy among young women in South Africa. This study aimed to explore a range of perspectives and experiences of early motherhood among young women in a township in KwaZulu-Natal, South Africa. This was done using in-depth interviews from a small sample of young mothers aged 18-24 years. All the young mothers reported that they had had their first child while still at school. None of them had intended or planned to have a child, and were therefore not ready for motherhood. Limited information on pregnancy prevention methods plays a key role in influencing early childbearing. Young mothers in the study wanted to assume financial responsibility for their children but they were finding it difficult to do so. Many faced numerous obstacles as they were no longer in a relationship with the father of their child and depended on their own parents for support. Participants described how the difficulties they faced in their daily lives and their new roles as mothers impacted negatively on their education and career aspirations. The study recommends greater involvement of schools and community in addressing the challenges of early childbearing.