Date of Award

2015

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Doctor of Philosophy

School

School of Nursing and Midwifery

Faculty

Faculty of Health, Engineering and Science

First Supervisor

Dr Joyce Hendricks

Second Supervisor

Dr Judith Pugh

Abstract

Aim: This research aims to explore the motivating reasons and external influences that affect pregnant adolescents’ reasons for attending an antenatal clinic. Background: Pregnancy during adolescence has been researched from perceived ‘poor’ decision making during pregnancy and postnatal perspectives involving high-risk outcomes for mother and baby. Antenatal clinic attendance by pregnant adolescents is often characterised by late and infrequent attendance, limiting midwifery contact with this inexperienced group. Gaps in the literature exist where the real-time voices of pregnant adolescents offer their current experiences of antenatal clinic as a relevant means to inform midwifery practice.

Research design: Using ethnographic methods, this research positioned a midwife to observe pregnant adolescents for a period of nine months while they attended a public antenatal clinic in Western Australia.

Data collection and analysis: Data from participant observation was supplemented by in-depth key informant interviews. Analysis of the data was concurrent with data collection and guided by Spradley’s Developmental Research Sequence (1980). Findings: Findings revealed four themes influencing attendance for antenatal care during pregnancy: a) connecting with midwives b) the importance of the maternal mother c) supportive relationships and d) engaging with pregnancy. Themes highlighted maternal mothers are pivotal to antenatal clinic attendance; they provide guidance and antenatal advice that pregnant adolescents accept in preference to that of midwives. Adolescents are influenced to attend antenatal clinic by different milestones than those represented in midwifery care; this may provide opportunity for midwives to align themselves alongside adolescents to provide pregnancy education at moments most relevant to them.

Conclusion: Information discovered will increase midwifery knowledge of what factors bring pregnant adolescents to antenatal clinic, aiding midwives to influence regular attendance in this group. To increase pregnant adolescents’ comfort and perceptions of value, midwives may need to reconsider the traditional environment of the antenatal clinic to make better use of waiting times and become more inclusive of adolescents’ supportive relationships. Embracing web-based technology is a pathway, which may effectively assist in the successful provision of antenatal education to this age group. Non-judgemental midwives offering a caring approach to antenatal care, verifying pregnant adolescents’ individual understanding, is identified as essential to engagement with this group.

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