The importance of youth-centered maternity care
Adolescent pregnancy and childbirth is a key area of global health. Physicians highlight the unique needs of pregnant adolescents and the importance of tailoring their care. Yet there is little research on pregnant adolescents’ perspectives of their maternity care, or how their perspectives compare to those of their healthcare providers.
To address this research gap, Bixby researchers conducted interviews and focus groups with Latina adolescents in Guanajuato, Mexico and Fresno, California to compare their maternity care experiences. Four main themes emerged from these interviews and focus groups:
- The need for communication and clear explanations: Many youth described interactions with providers where they were not given clear explanations of what was happening. In California, many providers described language barriers when communicating with immigrant youth and their families. One California focus group member shared, “I had asked them what’s the infection that [my baby] has; I wanted them to explain it better to me…They made me feel really frustrated that they weren’t really explaining it to me…”
- Respectful versus judgmental providers: While some youth had positive experiences with their providers and felt comfortable, others described experiences where providers were rude or judgmental. Most providers attributed their inability to provide patient-centered care to structural constraints like caseload and time limits with patients. A young person in the Mexico focus group said, “The doctor didn’t want to look after me, and even threw my papers at me…”
- Engaging youth in decision-making: In general, youth in California expressed more agency around decision-making than youth in Mexico. However, only a few providers mentioned the lack of youth engagement in decisions related to their care.
- A focus on the age of the youth and their partners: Many youths in California and a couple of youth in Mexico discussed how providers and clinic staff were often too focused on their age or the age of their partners. “When my doctor seen my age, he kept asking me a lot of questions and he was rude and he kept asking for who was the dad…” Providers in California focused on mandated reporting as a barrier to building trust. Although mandated reporting laws exist in Mexico, none of the providers mentioned them.
Despite differences in healthcare and sociocultural contexts, youth in both locations had similar perspectives and preferences regarding their care and provider interactions. The desire for respectful care appears universal and there is a clear need for more effective and respectful patient-provider communication in youth-centered care. Healthcare systems and providers need to readjust their approaches to focus on the needs and priorities of their adolescent patients.