Unmet Birth Expectations and Birth Trauma among Adolescents

Area of Science:

• Reproductive Health
• Adolescent Psychology
• Perinatal Mental Health

Background:

• Adolescents have unique perceptions and expectations surrounding childbirth.
• Understanding these expectations is crucial for perinatal care and mental health outcomes.
• Previous research has explored adolescents' birth perceptions, necessitating further analysis of expectations and their impact.

Purpose of the Study:

• To compare birth expectations between younger (13-17) and older (18-19) adolescent age groups.
• To investigate whether unmet birth expectations predict psychological birth trauma (PBT).

Main Methods:

• Secondary analysis of a mixed-methods study involving 303 adolescents.
• Focus on 116 usable written narrations assessing birth expectations as met or unmet by three reviewers.
• Comparison of younger versus older adolescents' responses regarding unmet expectations and PBT.

Main Results:

• Birth expectations were more frequently unmet than met across both adolescent age groups.
• No significant difference was found between younger and older adolescents regarding unmet birth expectations (p = .16).
• Unmet expectations primarily concerned pain management; younger adolescents expressed greater fear of dying, while older adolescents reported more issues with pain control. Crucially, unmet expectations did not predict PBT.

Conclusions:

• Prenatal care should prioritize open discussions about labor knowledge, fears, support systems, and expectations, especially concerning pain.
• Multiparous adolescents require prenatal screening for posttraumatic stress (PTS) symptoms, potentially linked to previous traumatic births.
• Post-birth assessment for acute stress and PTS symptoms is recommended for all adolescents, particularly those with multiple unmet labor expectations.