Teenage parents in NICU
2007 NICU Teen mother project
Problem Identified
 Number of young mothers in NICU
(anecdotal) .
 Awareness the NICU staff/mother
communication and care planning did not
meet the needs of teen mothers (nor
engage them)
Teenage mothers in NICU project group
GOALS:
•Provide an environment that will support teenage mothers/babies in NICU.
•Develop a careplan for teenage mums in NICU
Assessment
Explore all available resources
Develop careplan
Communicate/educate staff
Implement careplan
Audit effectiveness
Make appropriate
changes
Explore all available resources
Communication
─ Resources about
communicating with
teenagers
─ Teenage Support
group Development
─ ? Primary nursing
model of care
─ Use of rules and
boundaries
─ Relationship building
Literature
review
─ Teenage
mothers in
NICU
ADHB
Other DHB’s
 Social work
assessment tool
Sth Auckland
resources
 Explore SSH
resources
Nth shore
resources
 Accommodation
West Auckland
resources
 Legalities
Community
Schools
available with
teenage mum
unit attached
Support
agencies
available
Teen mothers
Increased risk of –
• Socioeconomic deprivation - lacking health and social services
• Lack stable family environment & adverse child experiences –
(including sexual abuse)
• Involved in crime and substance abuse
• Mental illness
• Poorer educational achievement
• Health conditions- related to psychosocial circumstances
i.e. Smoking related cancers, Suicide , Violent inflicted injuries
• Lack knowledge of infant and child development
• Rate infants’ behavior as more difficult
• Further teen pregnancies
BUT many of these are due to their poor social and developmental
circumstances rather than teenage pregnancy itself
American Academy of Pediatrics 2001, Andreozzi et al 2002, Flanagan 1994, Horwitz et al 1991, McCullough 1991,
National Center for Health Statistics 2006, Wilson et al 1990,Woodward et al 1999
Consequences of Teenage Pregnancy
Infants
• Low birth weight & prematurity
• Increased hospitalisation
• Developmental disability & behavioural problems
• Poor educational achievement
• Abuse, neglect and family disruption
• Early sexual activity
• Depression
• Criminal activity
• Intergenerational teen parenting

High risk infant identified
American Academy of Pediatrics 2001 , Horwitz et al 1991, National Center for Health Statistics 2006
Wilson et al 1990,Woodward et al 1999
Dual role for teen parents
• Adolescent development
• Parental roles & responsibilities
+ SICK NEWBORN
Care plan Introduced
Document kept at baby’s bedside and discussed with mum
1 Nurse Specialist – Family Liaison assigned.
Referrals- ADHB Social work service, TEEN PARENT SUPPORT SERVICE,
cultural support , consult Liaison, SLT, Mental health
 Communication with MDT
With mother
 Assess need for transport and accommodation
 Offer meal vouchers
 Ensure that teen mother receives ‘Teenage mother resource book', discuss this
with her.
 Explain daily routine, show around NICU, explain who is who
 Develop clear lines of communication with mum i.e. TXT, email.
2 Primary nurses identified
 Develop a rapport with teenage mother, assist her to identify her own supports.
 Give teen mother NICU young mum resource book and discuss document.
 Develop infant care plan with parents and explain purpose of the document.
 Establish responsibilities and complete the day to day care plan for baby
together.
Careplan cont.
Social worker
 HEADDS assessment completed
Consult Liaison
 Arrange Psycho educational session -Emotional self care,
stress management session
MDT Discharge Planning - Document evidence in clinical
notes of the following
 Community follow up/support systems in place
 Contraception discussed.
 On going schooling discussed
 Follow up appointments for baby
Staff Education
Presentation / education sessions developed
 Developmental issues for teenage parents
 Communication Issues- tips for working with teenage
parents
2011 Evaluation – Is it working?
Achieved
 Staff education – positive attitude.
 Careplan to direct care.
 Offer meals for teen mothers.
 Work with PNW’s to maximise teen
mothers stay.
Today's issues  social work access.
Change in services.
• Build relationship with new teen support service – Thrive
• Need to explore resources available/written information.
Accommodation/transport/financial assistance for teen
mums (<18yrs) remains a challenge.
Particular issues for support/services for <16 yrs mothers
Audit care provided.