Teen pregnancies are associated with a variety of negative outcomes for both the mothers and the infants among which there are preterm births, low birth weight deliveries, maternal anemia, and other adverse birth outcomes (Hueston, Quattlebaum, & Benich, 2008; Leppälahti, Gissler, Mentula, & Heikinheimo, 2013). The researchers all around the world attempt to address this problem providing timely prenatal care to the pregnant teenagers. Adequate prenatal care is anticipated to minimize the mortality and morbidity of the adolescents, address the harmful effects of early pregnancies, improve newborn outcomes, and in turn, enable a significant saving of future costs (Ayoola, Nettleman, & Stommel, 2010; Christiansen, Gibbs, and Chandra-Mouli, 2013; Hueston, Quattlebaum, & Benich, 2008; Vieira et al., 2012).
Background
The article by Hueston, Quattlebaum, and Benich (2008) attempts to answer the question concerning the amount of cost savings that could be realized if pregnant teens were given adequate and timely prenatal care. To measure the costs and savings, the authors explore the perspective of Medicaid, the organization that insures early pregnancies in the US. Hueston et al. (2008) used a strategy of comparing the costs of child care without any prenatal care practices and those of the mothers who were provided child care starting with earlier or later months of pregnancies. Hueston and colleagues were not the first group of researchers investigating the benefits and outcomes of prenatal care based on the time when it was delivered.
The works by Leppälahti et al. (2013) and Vieira et al. (2012) investigated the adverse obstetric outcomes in teen pregnancies in Brazil and Finland accordingly. The Finnish study demonstrated that the majority of teen mothers registered in Finland were socioeconomically disadvantaged and required prenatal care (Leppälahti et al., 2013). The authors concluded that prenatal care provided at the earlier stages of pregnancies was more beneficial regarding the outcomes (Leppälahti et al., 2013). The study conducted in Brazil that observed multiple teen mothers showed the efficiency of prenatal care. The authors found that the adverse outcomes associated with the young age of the mothers were found only in teens, who lacked adequate prenatal care (Vieira et al., 2012). The study by Christiansen et al. (2013) explored prenatal care as a midstream intervention multiple health issues caused by preterm labor and low-weight deliveries. This research shows the need for the upstream approach to address teen pregnancies educating the adolescents about their health, nutrition, and lifestyle (Christiansen et al., 2013). The work by Ayoola et al. (2010) maintains that “the financial and emotional costs of poor newborn outcomes to families and society in the United States are enormous” (p. 550). The authors also find that almost 50% of all the birth defects and disabilities are associated with premature birth and low birth weight (LBW) (Ayoola et al., 2010). Initially, the time of initiation of the prenatal care was viewed as the failure of the teen mothers to report their pregnancies, but soon the scholars admitted that they never took into consideration the fact that some women may be simply unaware of their pregnancies for a while (Ayoola et al., 2010). The research found that early pregnancy recognition often resulted in delayed prenatal care initiation (Ayoola et al., 2010). Finally, the study by Hueston, Geesey, and Diaz (2007) revealed that most of the teenage mothers were reluctant to initiate prenatal care during the first trimesters of their pregnancies or had no prenatal care at all.
All of these studies provide evidence and information that emphasizes the need for prenatal care as it minimizes a variety of risks for maternal and infant health and reduces the costs spent on infant and child health care in the future. Employing the strategy of comparison of prenatal care costs and the further expenditures if prenatal care was not delivered adequately or in time, Hueston et al. (2008) were able to calculate the approximate savings due to prenatal care.
Analysis
To calculate the approximate costs requited to provide a good-quality prenatal care the authors referred to Medicaid that is involved in the insurance matters of teen mothers (Hueston et al., 2008). To measure the costs precisely, the researchers reviewed the average health care prices of 2006 in the US. The authors emphasized that the newborn care for the infants with LBW and those with normal weight differed significantly. Namely, the cost of LBW newborn care exceeded that of normal weight newborn care because the medical services provided to the low-weight babies during the first year of life are much more intense and expensive (Hueston et al., 2008). As a result, the difference between the two types of newborn care may comprise tens of thousands of dollars.
Collecting data for the research, Hueston and colleagues included a wide range of participants in the study. The teen mothers observed for the research could be characterized by the time of their prenatal care initiation (from no care at all to the prenatal care initiated during the first month of pregnancy). Further, the costs of prenatal and newborn care were evaluated and compared using a scheme that included a standard number of milestones for the development of the pregnancies. The observed teen mothers and their outcomes could be conveniently compared to one another based on the main characteristics of their pregnancies and the costs required to support them (Hueston et al., 2008).
Working on this research, the scholars made an assumption that the implementation of prenatal care would address most of the health issues of mothers and newborns and, in turn, minimize the costs spent to go through with the necessary care. That way, prenatal care was seen as an intervention serving to provide two types of benefits – those for the mothers and their babies, and those for the government and programs insuring teen pregnancies. The researchers found that among the women participating in the study, those who received no prenatal care were the most likely to have LBW babies (Hueston et al., 2008). Further, among the mothers who started their prenatal care at various stages of pregnancy the LBW outcome was present at a lower rate and did not differ much depending on the time of the prenatal care initiation (Hueston et al., 2008). The only exceptions were the teen mothers who initiated their prenatal care at the very beginning if the pregnancies (Hueston et al., 2008).
Regarding the cost-benefit model evaluating the financial advantages of prenatal care, the researchers found that the teen mothers with late prenatal care and those who received no prenatal care ended up with the highest costs of overall care (Hueston et al., 2008). As a result, the scholars concluded that the initiation of prenatal care before the seventh month of pregnancy saves approximately 2500 dollars (Hueston et al., 2008).
The assumption Hueston and colleagues relied on in the very beginning of the study was confirmed through their research. The scholars established the high value of prenatal care for the teenage mothers that was likely to save thousands of dollars invested in the newborn care and support of the pregnancies (Hueston et al., 2008). Prenatal care initiated at any stages of pregnancies in teens showed a tight connection with the birth outcomes. The women who received no prenatal care were more likely to have LBW babies, which was the main factor impacting the care cost. That way, since prenatal care was rather helpful in addressing this problem, it resulted in significant savings.
Overall, this study is rather substantial and explores an important and relevant subject. The main strength of it is the focus on a practical issue that (if resolved) carries many positive outcomes (financial and social benefits). Besides, the article is written in a succinct and presentable way, the findings are demonstrated by means of tables and charts, the scheme of research is shown as well. However, the study contains several weaknesses. First of all, it focuses only on a narrow range of outcome, excluding such outcomes as congenial disabilities and birth defects that are rather costly. Besides, the section with limitations is not presented separately. The introduction and background sections are merged into a rather brief passage. Finally, the authors fail to describe implications of the study and recommendations for the further research.
Recommendation
Even though the benefits and value of the prenatal care are obvious, there are still many teen mothers who do not receive it. The chart below shows the percentage of mothers regarding their initiation of prenatal care.
The initiation of prenatal care has been growing as a tendency ever since the 1980s. The chart below demonstrates the increasing popularity of prenatal care among various communities.
The promotion of prenatal care and the engagement of more pregnant teens would maximize the savings. The main challenge is finding the women eligible for the care (Hueston et al., 2008). The majority of pregnant teens with a high risk of having babies with a low birth weight come from low-income environments (Leppälahti et al., 2013). Due to socio-economic factors such women are more likely to have children with various health problems than teenage mothers who come from more privileged communities (Hueston et al., 2008). Besides, the research by Hueston et al. (2008) agrees with Ayoola et al. (2010) stating that the prevention of teen pregnancies could be even more beneficial than prenatal care. That way, the latter can be seen as a midterm intervention, whereas the upstream preventative approach would target the teenagers and adolescents of both genders improving their health literacy concerning the subject of early pregnancies and sexual relations.
As mentioned by Leppälahti et al. (2013), the populations affected by the issue of early pregnancies tend to be characterized by such features as low-income status and harmful habits (alcohol and substance abuse). They were more likely to have various pregnancy-related complications could lead to further disabilities for the mothers and infants. Besides, LBW babies are forty times more likely not to survive their first months of life (Teenage Pregnancy, n. d.). These facts emphasize the need for intervention.
The problem can be tackled by timely education for the adolescents at schools. For example, the children can be targeted right where they study, and the education concerning their health, lifestyle choices, early pregnancy, and sexual relations, can be added to the curriculum. Besides, medical professionals could visit the schools with educational lectures, speak to the parents, and provide the information about the importance of prenatal care, and the ways to obtain it. The results of such intervention can be researched by means of collecting data about the number of teen pregnancies per school enrolled into the educational programs. The researchers could cover a period of several years to see the long-term results of this approach. The number of teen mothers initiating prenatal care at any stages of their pregnancies can be measured the same way.
To conclude, teen pregnancies are not only serious threat to the health of the young mothers and their babies, but also to the state budget. The research by Hueston et al. (2008) showed that the teenage mothers who received prenatal care ended up saving thousands of dollars normally invested in the newborn care as the cases of low birth weight deliveries are a rather frequent outcome of teenage pregnancies. The research also pointed out that regardless of the obvious advantages of prenatal care, there are still teen mothers who do not receive any prenatal care. Since the majority of teenage mother’s dwells in low-income environments and tend to have harmful habits, their pregnancies and babies are the most likely to have complications (Leppälahti et al., 2013). That is why it is logical for the medical professionals and the researchers to start targeting the teenagers exposed to these health threats in their schools. The problem may be minimized with the help of appropriate information and the enrollment of the children in the special classes and courses designed to improve their health literacy in reference to the subjects of lifestyle, diet, health, and sexual relations. In addition, it is important to notice that the savings estimated as thousands of dollars are short-term outcomes of the intervention targeting teen pregnancies. Long-term outcomes may include such factors as the reduction of crime rates, poverty, and homelessness.
Reference List
Ayoola, A., Nettleman, M., & Stommel, M. (2010). Time from Pregnancy Recognition to Prenatal Care and Associated Newborn Outcomes. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 39(5), 550-556.
Christiansen, C., Gibbs, S., & Chandra-Mouli, V. (2013). Preventing Early Pregnancy and Pregnancy-Related Mortality and Morbidity in Adolescents in Developing Countries: The Place of Interventions in the Prepregnancy Period. Journal of Pregnancy, 2013, 1-5.
Hueston, W., Geesey, M., & Diaz, V. (2007). Prenatal Care Initiation Among Pregnant Teens in the United States: An Analysis Over 25 Years. Journal Of Adolescent Health, 42(3), 243-248.
Hueston, W., Quattlebaum, R., & Benich, J. (2008). How Much Money Can Early Prenatal Care for Teen Pregnancies Save?: A Cost-Benefit Analysis. The Journal of The American Board Of Family Medicine, 21(3), 184-190.
Leppälahti, S., Gissler, M., Mentula, M., & Heikinheimo, O. (2013). Is teenage pregnancy an obstetric risk in a welfare society? A population-based study in Finland, from 2006 to 2011. BMJ Open, 3(8), e003225-e003225.
Teenage Pregnancy. (n. d.). Web.
Vieira, C., Coeli, C., Pinheiro, R., Brandão, E., Camargo, K., & Aguiar, F. (2012). Modifying Effect of Prenatal Care on the Association between Young Maternal Age and Adverse Birth Outcomes. Journal of Pediatric and Adolescent Gynecology, 25(3), 185-189.