How Adolescent Mothers Interpret and Prioritize Evidence About Perinatal Child Protection Involvement: Participatory Contextualization of Published Evidence

Abstract

AbstractPregnant and parenting adolescents are more likely than adults to live with economic and social vulnerability, contributing to a higher risk of poorer maternal and newborn health outcomes. These same factors contribute to higher rates of postpartum child protection investigations among adolescents. This study describes an innovative approach to contextualize evidence on factors contributing to perinatal child protection involvement in the perspectives of pregnant and parenting adolescents. Using Weight of Evidence, an evidence-based participatory procedure, we conducted a conventional literature review and used fuzzy cognitive maps to contextualize evidence in the experiences of young mothers exposed to child protection investigations. Published evidence was contextualized through semi-structured mapping interviews with ten pregnant and parenting youth and subsequently shared with three child protection workers specialized in pre- and post-natal risk assessment. We developed and consolidated explanatory accounts describing how factors contribute to child protection involvement in the perinatal period among adolescent parents. We collaboratively designed and prioritized interventions strategies together with six adolescent parents. Young women highlighted mental health consequences of child protection involvement, including a reluctance to disclose their own health and social needs, challenges to their identity and self-confidence as parents, and social isolation. Women prioritized reducing the stigma they experience in accessing services, strengthening supportive relationships and greater understanding of their rights in child protection investigations as actionable intervention areas. Inputs of young women and service providers precipitated a reconceptualization of risk and identified how to support greater agency and self-determination among young parents experiencing child protection investigations.