Occasionally a midwife or doctor will suggest that teenage mothers should not have home births, because they are worried that this group are at higher risk of labour complications. However, the research listed below suggests that even very young mothers are actually less likely to suffer complications of labour than women in their twenties.
If you are very young or small for your age then your caregivers may be worried about cephalopelvic disproportion, which means that the baby's head may be too large to pass through your pelvis. However, there is no indication from the research listed here that this is actually more likely to be a problem for a young mother than for anyone else.
I have not found any research with suggests that simply being young should disqualify a mother from home birth. It seems that those who oppose home birth for young mothers reveal more about their prejudices than their knowledge.
The most recent study of teenage mothers and pregnancy found that, for teenagers having their first baby, there was no increase in risk compared to older women, and in fact teenage mothers were less likely to have a caesarean section. However, for teenagers having their second child, there was a significantly increased risk in premature birth and stillbirth. The researchers looked at over 110,000 teenage pregnancies in Scotland in the 1990s to draw these conclusions.
BMJ 2001 Sep 1;323(7311):476
Teenage pregnancy and risk of adverse perinatal outcomes associated with first and second births: population based retrospective cohort study.
Smith GC, Pell JP.
Medline Abstract
The next study looked at women of under 18 years of age. Comparing over five thousand mothers under eighteen with women aged 18-34, it was found that younger mothers were more likely to give birth prematurely, and to suffer from anaemia, and chest or urinary tract infections. However, as far as the birth itself went, the younger mothers were far better off - they had less maternal and perinatal morbidity (illness for mother and baby) than older women, and were about half as likely to have a caesarean or an assisted delivery.
Obstetric Risks of Pregnancy in women less than 18 years old, by Jolly, Sebire, Harris et al. Published in Obstetrics and Gynaecology, vol 96 No 6, Dec 2000, p962-966.
This study looked at outcomes for 261 women having their first babies below the age of 15 in the USA. Compared to mothers in their twenties, the teenage mothers were actually better off; they were no more likely to have complications of labour, but they were significantly more likely to have shorter labours, and they were far less likely to end up with caesarean sections. The authors concluded:
“Pregnancy at the lower limit of reproductive age in an urban American population is not associated with an abnormal labor course, as is commonly believed.”
Obstetric characteristics among nulliparas under age 15
AUTHORS: Lubarsky SL; Schiff E; Friedman SA; Mercer BM; Sibai BM
Department of Obstetrics and Gynecology, University of Tennessee, Memphis.
Obstet Gynecol 1994 Sep;84(3):365-8
PMID: 8058232
This study of women in Hong Kong who gave birth aged under 17 years, and 17-19 years, found that both groups had fewer complications than women who were aged 20-34 years. The younger mothers were more likely to have preterm labour, but were significantly less likely to have a caesarean or assisted delivery.
"While there was no difference in the types of labour, there were fewer Caesarean and instrumental deliveries, a finding that persisted even after excluding the preterm deliveries. .. teenage mothers aged < 17 years had similar outcomes to those aged 17-19 years. These results indicated that teenage mothers had better obstetric outcomes, despite the higher incidence of preterm labour, and that young adolescents (<17 years) performed as well as their older peers."
Hum Reprod 1998 Nov;13(11):3228-3232
Obstetric outcome of teenage pregnancies.
Lao TT, Ho LF.
Department of Obstetrics & Gynaecology, The University of Hong Kong, PRC.
If you are aware of any more research on this subject, please contact me on angela@horns.freeserve.co.uk
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