�Pregnant teens provide a particular challenge to childbirth educators because of their unique and often complex individual needs. Childbirth educators fill many roles for their patient�s, their role expands beyond prenatal issues� (Perrin, 1992, p.29). This article suggests new methods nurses need to implement when working with high risk pregnant teenagers. Perrin (1992) suggests a 4m model of managing each case so a teen�s basic survival needs are met. Perrin (1992) then describes mending by providing professional help for past issues or problems in their lives that need to be dealt with before they can deal with their pregnancy. The third M describes mentoring which is the education process of prenatal information and the last M is modeling which simply means being a role model of proper health behaviour and parenting skills for these girls (Perrin, 1992). The concept of this model is concentrating on the many issues and complex problems that a pregnant teenage girl encompasses. Health care professionals are in a privileged position to inform and reinforce knowledge about child bearing, pregnancy prevention and growing healthy babies (Dumas, 2002).

One study describes a large barrier of confidentiality for teenagers when it comes to accessing health care. Teenagers stated the reasons for not accessing health care or further resources were fears related to confidentiality and embarrassment (Wilson, Williams, 2000). This is an issue that relates to all areas of sexual health for adolescents, not only for pregnant girls, but also for preventing pregnancy. Preventing pregnancy is an issue health care systems spend a lot of money and time on. Many prevention programs have been developed but few successful strategies have emerged (Philliber, Williams Kaye, Herrling and West, 2002). This study looked into programs that have actually worked to prevent pregnancy. The most influential interventions were clinic-based centers that addressed adolescent health and the barriers of confidentiality (Philliber et al, 2002).

Another study states the most effective models of care for teenage pregnancy have included an adolescent-centered practice with an interdisciplinary team, home visits, and follow-up of mother and infant for postpartum (Bensussen-Walls, Saewyc, 2001). The literature focuses on teen-focused services that provided continuing care with caring stable relationships between the adolescents and the nurses (Bensussen-Walls, Saewyc, 2001).�Teens themselves identify caring and respectful providers and continuity with the same providers as two of the components most likely to encourage them to seek and continue health care� (Ginsberg, Menapace, & Slap, 1997, as cited in Bensussen-Walls, Saewyc, 2001, p.425). Despite the strong documentation of improved outcomes, adolescent teen pregnancy clinics are not a universal standard in health care systems (Bensussen-Walls, Saewyc, 2001). The issue on adolescent care is a topic that addresses cost affectiveness because of its positive implications. This is a topic nurses can be proactive in with further research and making changes in the health care system.

Bissell (2000) elaborates on the nurse�s role for teenage pregnancy by addressing programs that attract and encourage teenagers to attend. As health care providers if we are to make a difference in the negative consequences of teenage pregnancy, it is important to find ways to engage, attract, and sustain the attention and participation of adolescents (Bissell, 2000). There are many issues to why teens are not accessing resources. Participation seems to be a theme in the literature, and a cause of many obstacles. Those obstacles could be accessibility, availability, cost, the environment, confidentiality, lack of information, time restraints, and child- care (De Jonge, 2001).

Throughout the literature there has been an emphasis for health care providers to address the needs of the pregnant adolescents before addressing the pregnancy. The idea of presenting medical information to an anxious pregnant adolescent is unreasonable because the adolescent is not going to receive any of the information. However De Jonge (2001) suggests addressing their financial difficulties, specifically poverty and improving living standards. This will alleviate stress and harmful consequences that family and society no longer have to deal with.

Bensussen-Walls, W., & Saewyc, E. (2001). Teen-focused care versus adult-focused care for the high-risk pregnant adolescent: An outcome evaluation. Public Health Nursing. 18(6), 424-435.
Bissell, M. (2000) Socio- Economic Outcomes of Teen Pregnancy and Parenthood: A Review of the Literature. The Canadian Journal of Human Sexuality. 9(3) 191-203
De Jonge, A. (2001) Support for Teenage Mothers: a qualitative study into the views of women about the support they received as teenage mothers. Journal of Advanced Nursing. 36(1) 49-57
Dumas, L. (2002) Focus Groups to Reveal Parent�s Needs for Prenatal Education. The Journal of Perinatal Education. 11(3) 1-9
Perrin, K.M. (1992) The 4Ms of Teen Pregnancy: Managing, Mending, Mentoring and Modeling. International Journal of Childbirth Education. 7(4) 29-30
Philliber, S., Williams-Kaye, J., Herrling, S., & West, E. (2002) Preventing Pregnancy and Improving Health Care Access Among Teenagers: An Evaluation of the Children�s Aid Society-Carrera Program. Perspectives on Sexual and Reproductive Health. 34(5) 224-251
Wilson, A. & Williams, R. (2000) Sexual health services: what do teenagers want? Ambulatory Child Health. 6 253-260

Compiled by Lisa Cumiskey
Hosted by www.Geocities.ws