Adolescent mothers: Functioning after bereavement

Abstract

Adolescents who become parents are at high risk for low educational attainment, unemployment, and poor mental health. This study investigated the differences in depression for adolescent mothers whose infants live and adolescent mothers whose infants die. Cleiren's (1993) theory of bereavement was the framework used to examine these differences because depression was a measurable component of functioning after bereavement. The 1988 National Maternal and Infant Health Survey (NMIHS) conducted by NCHS is a population-based data set that provided the opportunity to determine the predictors of depression for pregnant adolescent and adolescents who experienced an infant death. Results were based on 2307 adolescents, including 917 whose infant had died. Questionnaires were completed between seven and thirty-seven months after the birth. Depression was measured by the Center for Epidemiological Studies Depression Scale (CES-D) and adolescents were classified as depressed if their score was twenty-four or greater (out of a possible 60). Results of the univariate analysis revealed that 41% in the infant death group and 24% in the live infant group were depressed and this was in excess of the number previously reported in community-based samples. Social and demographic predictors of depression were determined using logistic regression. Results indicated that some mothers whose infants had died were depressed if they were not pregnant at the time of NMIHS completion, wanted the index pregnancy, and did not have a prior infant death. In contrast, mothers whose infant was alive were depressed if they were pregnant at the time of NMIHS completion and had a prior infant death. The findings of this study indicated that many adolescent mothers were depressed and further screening of the pregnant adolescent is needed. Depression is treatable and associated factors were identified for both groups. The results suggested that infant death had a substantial and independent impact on adolescent depression and was associated with additional risk factors beyond those caused by socioeconomic disadvantage. These findings demonstrated that these adolescent mothers should be targeted for immediate and intense intervention. A qualitative study to describe the adolescent's grief response and an intervention study was recommended.