Supporting teen moms: A qualitative evaluation of a childbirth education and doula program for pregnant adolescents

Research indicates providing social support for pregnant adolescents can help foster good parenting practices and improve both maternal and infant health outcomes. In addition, doula support has been found to moderate better birth and postpartum outcomes, particularly among at-risk women. The YWCA's Teens Learning Childbirth (TLC) and Doula Program (DP) of Greensboro, NC provides childbirth classes and offers doula and mentor services to expectant teens. Current Y data indicated that teens utilizing doula services were more likely to have vaginal births (95% vs. 76%) and to breastfeed (81% vs. 61%) than those without doulas. Data also suggested utilization of the DP had been low and attendance at TLC classes inconsistent. This qualitative process evaluation was designed to examine stakeholders' perceptions of services in order to improve program utilization. Semi-structured interviews were completed with teen mother program participants (n=23), both pre- and post-natally, and with volunteer doulas and mentors (n=8). In addition field observations (n=19) of TLC classes were conducted to triangulate findings. Results identify gaps in both the framing and implementation of doula services. Teens were unaware that doulas provide support services during the entire pregnancy; were unaware of support doulas provide to family members; felt family members (particularly mothers) could serve as doulas; and had concerns with doulas replacing family members during delivery. Several teens also missed opportunities to be matched with a doula. Implications of these findings for improving utilization of doula services and coordinating support services and childbirth education for teen mothers will be discussed.