Support Provided by Public Health Nurses to Teen Mothers with Adverse Childhood Experiences (ACEs)

Abstract

We evaluated the support practices provided by public health nurses (PHNs) for pregnant teenagers with adverse childhood experiences (ACEs). Fifty PHNs were surveyed between August and September 2016. The survey was designed to obtain maternal characteristics and support needs from conception to 4 months postpartum. Data were analyzed using a chi-square test and a Fisher's exact test. The significance level was set to 0.05 for all analyses. Forty-seven PHN surveys were completed (response rate 94%) and 110 pregnant teenage mothers were analyzed. Forty-five (40.9%) mothers had one or more ACEs. The ACE mothers were more likely to discontinue high school, have special needs, be < 18 years old, feel anxiety about pregnancy and motherhood, and have unplanned pregnancies. PHNs had a significantly higher contact rate with ACE mothers compared with non-ACE mothers. Contact included personal interviews and visits in early pregnancy; telephone calls, personal interviews and visits during the third trimester; and hospital visits during delivery. There was more contact from ACE mothers before the 4-month postnatal checkup. ACEs impacted schooling during pregnancy and after birth. Thus, it is important to determine the ACE status of teenage mothers and to provide specialized support throughout pregnancy and the postpartum period. Our results imply that PHNs play an important role in connecting mothers to activities that emphasize maternal and child health.