Adolescent pregnancy: an intervention challenge

Abstract

Even in the best of circumstances, pregnancy is a time of emotional upheaval. This is especially true for pregnant adolescents who are also attempting to adjust to pubertal status and to establish an identity independent from their family. Although research has focused on the etiology of teenage pregnancy, relatively few interventions consider the developmental obstacles encountered when treating pregnant teenagers. In particular, adolescents are cognitively unprepared to predict long-term outcomes, a skill essential for confronting the challenges of pregnancy. One new intervention, known as previewing, seeks to overcome this deficit. Previewing encourages expectant teenage mothers to represent future scenarios with the infant as a means of predicting and rehearsing adaptive outcomes.

PIP: An estimated one million adolescents become pregnant annually in the US. While pregnancy is an emotionally turbulent time for all women, the period is especially so for pregnant adolescents. Adolescents are cognitively unprepared to predict long-term outcomes. This deficiency helps them to become pregnant in the first place and may encourage them to decide to carry the infant to term once the pregnancy is confirmed. The pregnant adolescent will generally be unable to envision the effect which raising a child will have upon her life. An adolescent's inability to envision and evaluate future outcomes may also seriously influence the status of her health if she decides to give birth. For example, she may fail to have regular obstetric visits or not follow instructions regarding diet, smoking, or alcohol consumption. 50% of pregnant teenagers receive no medical care during the first trimester, 10% receive no care during the first and second trimesters, and 2.4% receive no medical care at all during their pregnancy. Previewing, however, is a new intervention which encourages pregnant adolescents to represent future scenarios with the infant as a means of predicting and rehearsing adaptive outcomes. In so doing, this inherent cognitive deficit of adolescence may be partially overcome. Previewing techniques may be integrated with other clinical strategies or stand alone. Built upon a strong therapist-patient relationship, previewing helps adolescents predict the physical and psychological changes which will occur as the pregnancy develops as well as the changes which will transpire with the child after birth. The mother during previewing is highly sensitive to the imminent maturational changes of her infant and develops rehearsal exercises which will introduce the infant to how new skills will result in more sophisticated capacities and affect their relationship.