201983 St. Mary's Home: A unique Canadian community outreach program providing obstetrical and follow-up contraceptive care for pregnant adolescents

Wednesday, November 11, 2009

Tania Dumont, MD , Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada
Diana Belder, MD , Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
Amanda Y. Black, MD, FRCSC , Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada
Nathalie Fleming, MD, FRCSC , Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada
  
Adolescent pregnancies are associated with increased risks that may be reduced with multidisciplinary adolescent clinics. We describe the only community outreach program providing obstetrical and post-partum contraceptive care for adolescents in Canada and examine its impact on pregnancy outcomes and repeat pregnancy rates.

St. Mary's Home is a non-profit social service agency providing a full range of programs/services for young pregnant women. Medical providers ensure on-site supportive antenatal care and regular post-partum contraceptive follow-up, while St. Mary's staff provides specialized programming. The goal is to provide programs and accessible timely prenatal and contraceptive care in a supportive, non-threatening environment to help these high risk pregnancies have more favourable outcomes, foster better parenting skills, and avoid repeat unintended pregnancies. In the first 18 months of the program, data on 58 completed pregnancies demonstrated: mean gestational age 39.4 weeks, birthweight 3190 grams, 9% preterm delivery, and 6.8% caesarean section rate. By developing a satellite clinic that came to the adolescent mother, we achieved a 49% rate for first obstetrical visit in the first trimester compared to 26% in the literature.

Maternal and fetal outcomes during the first four years of the clinic will be analyzed and compared to matched population-based controls. Reported outcomes will include: gestational age at first visit, weight gain, preterm labour, length of labour, mode of delivery, birthweight, and repeat pregnancy rates.

St. Mary's is a unique community outreach program that benefits pregnant adolescents and their unborn children. Attempts should be made to develop similar programs across North America

Learning Objectives:
1. Identify risks associated with adolescent pregnancies 2. Describe how the St. Mary's Home Community Outreach Program functions, including the roles and interaction of St. Mary's staff and health care providers with the young pregnant women who attend the program. 3. Demonstrate that a supportive community outreach program like St. Mary's has benefits for maternal and fetal outcomes and may help to decrease the rates of repeat unintended adolescent pregnancies.

Keywords: Adolescents, Pregnancy Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PGY-4 resident in Obstetrics and Gynecology at the University of Ottawa who has participated in the care of pregnant adolescents at the community outreach program we are presenting. Additionally, I am involved in the data analysis of the program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: MCH Poster Session General III
See more of: Maternal and Child Health