Review of Related Literature and Studies

Depression among pregnant adolescents as well as the factors that contributes to the said condition is being discussed in this review of literature. The things that could help prevent or lessen depression and the use of The Kutcher Adolescent Depression Scale is also introduced.

According to G. Tzilos et al,(2012). Depression during pregnancy is related to the increase number of mortality and morbidity among teenage mothers and infants. However, the cases of Adolescent pregnancy declined over the past years because of the strict implementation of contraceptive use in the United States still the number of occurring depression related to teenage pregnancy is alarming to the society nowadays. Early pregnancy does not only a threat to the mother but as well as the baby because when a teenager gets pregnant, it is expected that she will face many complications during and after her pregnancy and these complications could lead to death of her baby and herself. Adolescent Pregnancy is always perceived by the society as a major problem and a great threat that will add up to societal problems. These perceptions could make pregnant adolescents feel that they are being judged negatively by the society and could lead to depression. Majority of them felt that they are always seen as persons who don’t know how to take good care of the upcoming baby because they are not yet fully matured. Some even relate teenage mothers to Erik Erikson’s Theory to illustrate that they are struggling in fulfilling two roles that they should take part. Pregnant Adolescents are not seeking for medical attention because for them they are mistreated and they are scared for the criticisms that they will receive from the people around them. That is why most pregnant adolescents’ faces problems and complications during labor because of lack of prenatal check-ups. Also in the studies planned pregnancy is compared to the unplanned of course planned pregnancy commonly happens to persons who went under the sacrament of matrimony and they unlikely to face complications and depression during pregnancy because of the support of their family as well as the society and those unplanned pregnancies are most likely to feel the opposite. The highest number of depression during pregnancy in found in the ethnicity of Latinas and a history of alcohol consumption and abuse whether it may be physical or sexual is found to be a significant contributing factors that could lead to depression. Pregnancy at an early age was commonly associated to poverty and societal issues. According to A. Katz, (2011) Majority of them voiced out that life before pregnancy was difficult and early pregnancy in their family was common so there is a possibility that they will follow the things that they have grown upon. Social connectedness plays an important role most specially the pregnant adolescent’s family. Some of the articles pointed out that the mother of the pregnant adolescent should be giving her more attention and support since she had been on the same experience before. Also, nurses were said to play a very important role in helping pregnant adolescents to prevent developing depression since they are the ones who will interact longer with their patients. One of the article’s main topic suggests that childbearing or being pregnant was the main reason why pregnant teenagers are experiencing depression. They say that depression seems to be linked with pregnancy because previous studies focus only on small populations. So what they did was they conducted a study with a big population between pregnant teens and pregnant adults. The questionnaires are given out to measure the level of depression inside it are questions such as things that bother them, how they manage feelings of sadness and concentration problems. The results showed that teenage mothers have an increase in depression incidence than adult mothers. However, carrying a child inside her womb was not the cause. They found out that even before they got pregnant, their level of depression was greater than compared to their friends and remained high even after giving birth to the baby. The results pointed out poverty and an existing stressor can predict adolescent pregnancy because of the psychological thinking that if they become pregnant their life would be easier and the focus will be now given to the newborn baby. They observed that when they got pregnant, the chance is they become responsible for taking care of the baby inside her and the study suggested that research nowadays should focus on how the teenage mom going to pursue her ambitions in life after giving birth to the baby. Lastly, the study suggests that married teen pregnant mothers will likely develop a positive outcome in terms of behavior and decrease the likelihood of developing depression then unmarried teenage mothers. One study pointed out the factors that may increase the likelihood of teenage pregnancy. One factor that the researchers pointed to have a great impact on the incidence of teenage pregnancy was the age they started to engage in sexual intercourse they found out if a girl engages in sexual activity before 15 years old she is more prone in becoming pregnant. They also pointed out United States as the most developed country with the highest incidence of adolescent pregnancy and one of the factors that causes early pregnancy was the number of sexual partners that an individual has. They say that if a girl had 3 or more sexual partners’ chances of being pregnant are high and if their partner’s age is more than 3 years of their age. The level of anxiety of a teenage father was discussed. Although there were only few studies about teenage fathers they found out that teenage father who became father for the first time has a high anxiety level compared to those who have been to the same situation before.

The Kutcher Adolescent Depression Scale is a tool that is used by clinicians and researchers to identify adolescents who are at risk for developing depression. It is created by Dr. Stan Kutcher, various clinicians and researchers and it is acknowledged to be an effective tool in assessing depression among adolescents around the globe. There are three different scales of KADS a 6-item which is designed to be used in different institutions such as schools, other health care professionals and primary health care settings to screen patients who are at risk for developing depression as well as to evaluate young people who are always in distress and can be seen with symptoms of mental health problem. The 11-item KADS is usually used by health care providers and different clinical settings to treat adolescents who are experiencing depression. On the other hand, the 16-item KADS is exclusively designed for clinical research purposes only. KADS is a simple tool that understandable by an individual who has a grade 6 reading level and ages 12 to 22 years old. Aside from being less complicated, the tool has been translated into many different languages for better understanding and it is free of charge. It has been recommended by many experts such as National Institute for Clinical Evaluation. In using the KADS the person should be instructed carefully by the health care provider, educator or any responsible person and should be clarified that the tool is for better understanding of the difficulties that the individual is facing. The last item of the scale is very sensitive to suicidal risk. Any individual who answered 1 or a little bit higher should be undergoing a further assessment for possible suicide. The KADS is free to use however it should not be copied or distributed without a written consent to Dr. Stan Kutcher. The people who created KADS appreciate receiving feedback on the said evaluation to determine whether KADS is still suitable or needs to be developed for better assessment.

There are a lot of different studies regarding depressions among teenage pregnancy. Different methods were done to gather results and data. Participants are usually drawn to conduct different methods such as interviews and surveys. Different factors are studied to determine factors what depression can bring to pregnant adolescents. The most critical factor in health problems among adolescents are incidence and in labor and delivery. Complications that can be prevented by this studies. Young mothers should be educated in controlling depression because in can lead to different problems like diseases and suicidal tendencies. Different studies show that it occurs more in pre-developed countries. So comparative studies in the Philippines in specific rural and urban areas. Findings have shown that counseling and nursing interventions and services of preparing adolescents in motherhood. Teenage mothers shows higher rate of depression. One study shows that depression after likely to become depressed after their babies were born than lower- or higher-resource adult mothers. Finding the root cause of depression of adolescents could help in a big way. Guiding 12-22 year old adolescents can prevent unwanted pregnancies and give them a reason to think this situation can affect them and their newborns. As researchers, information and statistics would be key in doing this comparative study in rural and urban areas. In Nigeria, the most important problem in health in adolescents especially in developing countries is from preterm labor and delivery. A teenage girl who is pregnant has a 40 % chance of women in Nigeria are 17.9 and 20.1 years and the incidence of abortion is about 25%. Millions of girls aged 15-19 have babies yearly but 10% of pregnancy due to the effect of early motherhood. Probably the cause of poverty in Africa. So the researchers assessed and explored the occurrence of complications in adult pregnancies and adolescents.

The Philippines is a slightly developed country than Africa. Couples who have a lot of children is very common in both countries. Most of the started at the age 17-19 years. A study in Taiwan showed what risk factors and birth outcomes affect adolescent pregnancies. Fertility rates declined in Taiwan recently even thou birthrate in teenagers is highest in Asia. It remains a challenging issue for Taiwanese to control adolescent pregnancy. Ages 12-22 is critical year for an individual in exploring various curiosity that can affect negatively and positively. Smoking had significant higher rates of smoking during pregnancy for adolescent mothers but in drinking it was almost alike. These are causes that affect a mother dramatically and especially the baby upon birth. This could different deformities and even miscarriage. In tends to be worse especially in communities of the third world. Another study pointed out that in view of socio-cultural factors and good nutrition in early life for girls is essential. Programs that can guide them in different ways would be key to prevent early conception. In India, nearly one third of babies are low in birth weight. The main cause would be poverty which leads to under nutrition and diseases. Kumar et al. (2007) showed a high result of (26.1%) and stillbirths (4%) while Bhalerao et al. (1990) have reported a significantly higher proportion (8.6%) of spontaneous abortion in addition to premature labor (14%) in teenage pregnancy. It is said that better planning of appropriate measures to improve the situation. Studies show that individuals living in rural areas are undernourished throughout childhood and adolescence. About 36% women of reproductive age in India have low body mass index (BMI <18.5 kg/m2. Poor prepregnancy nutritional status of young rural girls is a result of nutritional as well as social factors and therefore, it is necessary to examine their interactive effect on reproductive health.

According to ( Echa Kai,2008) who conducted a research on teenage pregnancy in Rajavith Hospital in India. Pregnancies occurring in adolescent girls have a higher risk than in adult females. Women ages <20 year is more prone to complications than of 20-34 years. Teenage girls have higher incidence of cesarean deliveries because of fear to pain and ureadines. Also, their body is not ready to this kind of procedure. Teenage pregnancy can lead to anemia, pregnancy induced hypertension and premature labor than in pregnant adults. In adolescents, physical and mental development is slower in adolescents. Thus giving a higher risk in complications on teenage pregnancies.

According to the study (A.Katz,2011 and K Mccormick,2012) teenage pregnancy decreased because of the strict implementation of contraceptives in the United States.

The US being a first world country, its resources are expandable and can be able to focus on different problems that country encounter. The United States was able to control teenage pregnancy because of health education by the use of contraceptives. Sex education is thought during high school to show teenagers the risk of unwanted pregnancy physically and mentally. The proper use of contraceptives is shown in order for them to be aware how unwanted pregnancies and diseases unsafe intercourse can affect an individual. As early as this age students are sexually aware.

Pregnant adolescents are having difficulties in terms of playing 2 roles in life, being a mother and in the process being fully matured ( B.Tumage et al,2013 and J Magness

2012)

. Being a mother is big transitional change in a teenager. For her, able to care for the baby and herself would be a difficult task. At the adolescent age, an individual is starting to be mature enough in everyday responsibilities. Having a baby can affect an individual physically and mentally. At this young age, a drastic change can cause negative effects which can lead to depression. Guidance by family, counselors and health providers would be a key factor for them to be able adapt to this changes.

Nurses play a vital role in preventing the development of depression by being approachable and providing assistance to them without any negative judgment (J.Magness, 2012).

As health care providers. Nurses are aware how depression affects an individual. A nurse will be able to do interventions that will benefit the patient. Giving assistance without any judgment, for a nurse being a professional it is strictly not a personal matter but the goal is to provide care. The Patient-Trust relationship would be a vital key .Depression can lead to negative effect physically and mentally so it is necessary to prevent this.

Unplanned pregnancy are most likely to develop depression (M. Phipps et al, 2012, K and Mccormick, 2012).

An accidental pregnancy would be drastic change in lifestyle. Nowadays, people tend to hide if they are accidentally pregnant especially if they are young of age. For a person not be ready to bear child would be very difficult in the shift of living. It is common that both partners who did not planned for a baby tend to separate thus, the mother would suffer and she alone would give care and provide for the baby. This things could lead to depression that may lead various effects on the mother and the baby.

Poverty was the main cause of teenage pregnancy and depression (G,Tzilos et al (2012), M Phipps,(2012) & J Collingwood (2010).

For an individual who is not educated, having a sexual relationship is some sort of pleasure without any consequences. Poverty, the most common problem of countries causes a negative effect in every aspect. Third world countries are usually the ones with the biggest population. Those not being able to afford contraceptive and the lack of health education causes unwanted pregnancy. An unwanted baby would cause depression. Gathering resources for the baby’s need would be a difficult task and would lead crimes and desperation. The baby would be most certainly affected by these by having inadequate care and nutrition.

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