A Qualitative Exploration of Past Family Planning Counselling of Adolescent and Young Mothers
Katherine Gerster, BSc, MD, FRCSC, Beth Murray-Davis, BA, BHSc, MA, PhD, Ebernella Shirin Dason, BSc, MD, and Dustin Costescu, BSc, MD, FRCSC
Objective: This study explores the family planning counselling that adolescents receive during pregnancy care, with the aim of identifying those factors that make counselling effective or ineffective.
Methods: The study population consisted of ten adolescents who had recently given birth and ten health care providers. Adolescents were recruited using posters; providers, by email. Individual semistructured interviews were conducted and analyzed in keeping with grounded theory. Analysis consisted of open coding (identification of initial concepts), axial coding (drawing connections between repetitive and similar concepts), and selective coding (clustering of categories to identify themes).
Results: The adolescent participants desired detailed information about pregnancy and motherhood, were challenged by the disruptive effects of pregnancy, and were strongly reliant on nonmedical support people. Our participants described that the adolescent-provider relationship was strengthened when providers sought to empower adolescents and to provide a balance of support and independence. Judgment and bias interfered with relationship building. Postpartum continuity with the pregnancy care provider and a positive relationship with the family physician were both highly desirable yet highly variable. In general, the adolescents found family planning counselling an awkward and intimate undertaking and preferred providers to slowly progress towards explicit counselling. The adolescents who opted not to initiate postpartum contraception still found the counselling process informative and beneficial.
Conclusion: Effective family planning counselling is not information driven but rather gradual, individualized, and context focused.
This article has been peer-reviewed.