December 6, 2007

By Sandra Jordan, St. Louis American, December 6, 2007

Pregnancy sends adolescents on the fast track to adulthood during teenage years, which themselves can be quite tumultuous as youngsters undergo intellectual and physiological growth as they develop into young adults.

Airwaves, music lyrics and magazines are bombarded with sexual messages, yet pregnant teenagers often endure disapproving looks, unwelcome behavior and isolation from so-called friends, family members and strangers because they will soon become young moms.

Once pregnant, many teens get little or no prenatal care and too many get bad information from peers. The Teen Pregnancy Center at Barnes-Jewish Hospital is changing that. It is a place where adolescent pregnant girls can get accurate answers to questions, receive medical care and spend time with others who are like them - no stigma attached.

Carolyn Jones, 16, and her boyfriend, DéMario Johnson, 17, are expecting a baby girl in a few months. They have been center participants since June.

"I learned different ways to cope with stress, anger, labor positions and ways to tell if I'm going into labor or not," Jones said. "We made rice socks to heat in the microwave for back pain. After each visit, we get baby books so after our baby comes, we can read to our baby."

Johnson said he didn't want to come to the center at first.

"I originally came to support Carolyn, but after I came the first time, we had a tour of Labor and Delivery and I got to look at the pregnancy rooms, then I said, ''this is cool."" Johnson said.

"It's helpful for them to have another tool to bond with the baby during pregnancy and to think reflectively about the topic we are addressing that day," said Kate Barbier, MPH, MSW, women's health educator, OB-GYN Clinics at Barnes Jewish Hospital. "For example, if I live with grandma and she smokes, how do I make healthy choices for my baby?"

The center operates every other Monday evening after school. Teens receive both prenatal care and education in a group setting. Instead of visiting a doctor's office where they may feel self-conscious or uncomfortable around older mothers, teens see either a nurse practitioner or a midwife at the center.

"Girls take their own weight, blood pressure and use the pregnancy wheel to determine when they are due," Barbier said. "Nurse practitioners listen to the baby''s heart and measure her belly to make sure the baby is growing properly. Also, nurses check their urine and prescribe anything they need."

Two young mothers formerly enrolled in the TPC serve as peer assistants for the staff and serve as role models for the patients to help promote healthy prenatal care and supply accurate information.

"We tell them about our experience as parents," said Cesily Sanders, 18, peer assistant, who described the best part of her personal experience at the center as "Knowing that I had the support of the coordinators, the doctors and hearing my baby's heart beat."

The new mothers answer a lot of labor and delivery questions as well.

"Just knowing that someone else (other teenagers) has been through it and made it rather than having advice from others who haven't been through it was helpful for me," said Marybeth McGee, 18, peer assistant.

The center takes a rounded approach to the teen pregnancy by involving both parents through a partnership with the Fathers Support Center of St. Louis. Dads-to-be (under age 25) attend weekly sessions at the TPC on responsible fatherhood education, employment assistance and support services.

The biggest misconception is that if they pay child support, they get to see their child," said Mohammed Witherspoon, who leads the dad's group. "If they sign a birth certificate in the state of Missouri, they are legally the father, even if a later paternity test shows that they are not the blood relative. If there is a question in your mind at all, don't sign the birth certificate."

Not all of the fathers' topics are that heavy.

"I talk about something as simple as changing diapers to some of the struggles of being a dad and the positive things about being a dad." Witherspoon said.

The center brings in experts to discuss touchy topics for rational, factual consideration that could become heated, emotional issues at home. The day the American visited the center, male and female participants sat together in a discussion about paternity and child support. The warm-up eye-opener was a hand out on the estimated financial cost of raising a child to age 18 today: $178,590.

"Does anybody see paternity as child support?" asked Debby Shaller, administrator of the eastern regional office of the Child Support Center.

Most of those who spoke up said they did not know of anyone who was receiving child support.

"We are getting rid of myths about paternity, child support and visitation. All three are separate categories," Shaller said.

"Establishing paternity is very important. When a child is born, they need to know their mother and father, so father would have legal right to a child if something happens to the mother. Or, if the father dies, if you haven't established paternity, the child can't get Social Security," explained Carolyn Lockhart, from the Division of Child Support Enforcement.

"Did you know that if dad talks to the baby in utero, the baby knows you and looks for you?" asked Granada Walker, MSW. The social worker's question brought about a few surprised looks. "Blood pressure and heart beat goes down when moms and dads talk to the baby. You make a big impression even before the baby gets here."

Johnson understands that sessions at the center are just as much for him as they are for his pregnant girlfriend as they both prepare for parenthood.

"I got little cousins that are little babies, but for me to have my own, it will be somewhat easy—somewhat hard," Johnson said.

"The biggest question I had was how long I was going to be in labor, and how bad it's going to hurt," Jones said. "They said it would be 11 - 48 hours."

She is not sure if she wants an epidural for pain. However, after learning about child nutrition at the center, she wants to breastfeed her baby the first year.

"But ''daddy'' said only six to seven months," Jones added -referring to her boyfriend.

"Like my mom did," he concurred with smile and a nod.

The center offers nutrition support services, and a social worker to make sure birth/delivery and parenting plans are in place prior to the baby's arrival.

Patients are encouraged to write out their thoughts in journals on such topics as, "What type of male role models will your baby have? How do you plan to provide for your baby financially?"

The teens also earn "Baby Bucks" from the center to exchange for car seats, baby clothes, bottles, blankets and other items for their infants.

Goals of the TPC are to decrease negative medical outcomes, such as premature deliveries and low birth rates and to increase access to parenting and social support services for pregnant and parenting teenagers. Most of the patients are between 15 and 17 years old. Girls are self-referred or referred from health professionals, agencies, and social workers in Missouri and southern Illinois. For more information on the Barnes Teen Pregnancy Center, call 314-454-8259.