Mother-role development program and postpartum health-service utilization by adolescent mothers: A randomized, controlled trial

Abstract

Aim: To evaluate the impact of a mother-role development program on postpartum health-service utilization by adolescent mothers. Methods: A single center, parallel, randomized, controlled, open-label trial using a computer-generated sequence was conducted at Siriraj Hospital. In all, 120 teenage mothers who delivered February 2015–December 2016 were randomized into experimental and control groups. The experimental group participated in a 2-year, mother-role development program at the Young Family Clinic. The two groups' characteristics, pregnancy outcomes and postpartum follow-up details over the 2-year period were compared. The main outcome measure was the utilization of maternal healthcare services (MHS). Results: The teenage mothers were randomized into two groups of 60 participants each. Many were progressively lost to follow-up, leaving only 37 (experimental group, 19; control group, 18) for the intention-to-treat analysis. The results demonstrated a higher MHS utilization by the experimental group, but only at the 6-week postpartum follow-up. The usage of long-acting, reversible contraception (birth control implants and intrauterine devices) rose from 53.3% (immediate postpartum) to 95.5% (2 years postpartum). The two groups also had identical repeat pregnancy rates (6.67%; four participants in each), a marked decrease from 20% in a prior study. The breastfeeding rate was consistently higher among the mothers undertaking the mother-role development program. Conclusion: The program increased both MHS utilization during the initial postpartum period and the breastfeeding duration. Access to immediate postpartum contraception and long-acting, reversible contraception was associated with a reduction in repeat teen pregnancies. Having a multidisciplinary team was key to the health-service improvements.