Ryerson University, Toronto
Karline Wilson-Mitchell RN, RM, CNM, MSN has been practicing midwifery since 1992 and has been on the Midwifery Education Program Faculty at Ryerson University since 2008. She continues to support and mentor in the Chang School’s International Midwifery Preregistration Program. She previously taught in the Nursing Program at Florida International University, Miami and preceptored for the Midwifery Program at U of Miami. She has practiced in Florida, North Carolina, Georgia and Ontario both in large hospital-run midwifery practices and private clinic -based practices. Karline’s interest in international health and health policy stems from years of working with international nursing and midwifery students as well as clients.
For many adolescents, motherhood is unplanned and so requires exceptional resilience. This was a key finding in a study of 46 Jamaican pregnant adolescent mothers attending antenatal clinics in Jamaica. Of the 30 adolescents who participated in individual interviews, 7 cases were referred for counseling due to their need for emotional and psychological support. One of the adolescents reported recent sexual violence and another reported having experienced childhood sexual abuse. In addition, 2 cases of suicidal ideation or attempts were identified. Amongst the 2 focus groups, the 16 participants provided insights into their experience following contact with the healthcare system and environment in which they lived. For these young mothers, pregnancy may follow experiences of reproductive coercion, violence, poor social support and limited access to reproductive health information. Yet, most of the mothers were able to overcome social challenges, become future oriented and demonstrate resilience. The venue in which maternity care is provided can help to support social capacity and resiliency in these young mothers. This paper proposes a model of care delivery informed by Antonovsky’s Sense of Coherence framework and provides psychological counseling, access to activities that build agency and decision-making, and the provision of respectful, culturally safe care by engaged healthcare providers.