Although the transition to motherhood is often a joyful experience, there is evidence that teenage motherhood can present many stressful challenges, potentially leading to the development of postpartum depression. Postpartum depression (PPD) remains a public health issue with negative consequences for both mothers and their babies. The aim of this study is to assess the feasibility of implementing childbirth education underpinned by salutogenic and self-efficacy perspectives among teenage mothers in low-income settings. The study also aims to provide preliminary findings on the intervention's effectiveness in preventing postpartum depression among Ethiopian teenage mothers. The theoretical based childbirth education approach can enhance the psychosocial well-being of first-time teenage mothers. The intervention consists of six sessions: three during the antenatal period and three in the postpartum period. These sessions contain two individual face-to-face educations (each lasting 60-90 minutes), two phone calls (each lasting 30 minutes), and two group discussion (each lasting 90-120 minutes), as supported by the existing evidence. The study expected to support the feasibility of the study design. Preliminary findings are anticipated to show a significant difference in postpartum depression scores between the intervention and control groups, with teenage mothers in the intervention group having a lower risk of postpartum depression compared to those in the control group. Integrating sense of coherence and self-efficacy theories into maternity care services could provide empirical support for preventive efforts against postpartum depression. The findings of this study may address research gaps regarding the psychosocial wellbeing of teenage mothers, serving as baseline evidence for large scale interventional studies that consider the sociocultural and economic contexts of low-income countries.
married first-time teenage mothers aged 13-19 years attending antenatal follow-up in the selected hospitals
a single pregnancy with 28-30 weeks of gestational age
no pregnancy complications contraindicating vaginal delivery
plan to have institutional delivery and postnatal visits at the selected health hospitals and who reside for a minimum of 12 weeks postdelivery around the selected hospitals
have self-reported history or current mental health problems
participated in similar interventional programmes
have serious medical and obstetrics problems
having foetus with diagnosed congenital anomalies
Parallel
Childbirth education programme
BehavioralThe intervention framework is underpinned by a converging of salutogenic and self-efficacy perspectives, aiming to enhance mothers' ability to adapt to new motherhood life despite stressors, and to address the question, "How do teenage mothers stay well despite stressful events of transition to motherhood?" The intervention consists of six sessions: three of which will be provided in the antenatal period and the other three in the postpartum period. The sessions contain two individual face-to-face educations (each lasting 60-90 minutes), two phone calls (each lasting 30 minutes), and two group discussion sessions (each lasting 90-120 minutes), as supported by the existing evidence.
Usual Care
Other interventionThe control group will receive the usual maternity care.
Edinburgh Postnatal Depression Scale
Edinburgh Postnatal Depression Scale is a 10-item self-report scale assessing the presence of depressive symptoms in the postnatal period. Each item is scored on a 4-point scale with total scores ranging from 0 to 30. Higher score indicates greater depressive symptoms, i.e. worse outcome.
Edinburgh Postnatal Depression Scale
Edinburgh Postnatal Depression Scale is a 10-item self-report scale assessing the presence of depressive symptoms in the postnatal period. Each item is scored on a 4-point scale with total scores ranging from 0 to 30. A higher score indicates greater depressive symptoms, i.e. worse outcome.
Sense of Coherence Scale
Sense of Coherence Scale is a 13-item scale assessing the extent to which teenage mothers perceive the transition to motherhood as meaningful, comprehensible and manageable. Each item is scored on a 7-point scale, with total scores ranging from 7 to 91. Higher scores indicate a stronger perception of life coherence, i.e. better outcome.
Sense of Coherence Scale
Sense of Coherence Scale is a 13-item scale assessing the extent to which teenage mothers perceive the transition to motherhood as meaningful, comprehensible and manageable. Each item is scored on a 7-point scale, with total scores ranging from 7 to 91. Higher scores indicate a stronger perception of life coherence, i.e. better outcome.
Parenting Self-Efficacy Scale
Parenting self-efficacy scale has 20 items, scored on a 4-point Likert scale, assessing teenage mothers' beliefs about their abilities to handle a set of stressful situations during the childbearing period. Higher scores indicate a stronger parenting self-efficacy, i.e. better outcome.
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