Counseling adolescents with problem pregnancies.

Marecek, Jeanne

doi:10.1037/0003-066x.42.1.89

Cited by 16 publications

(21 citation statements)

References 13 publications

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“…Nas últimas décadas, a gestação na adolescência tem sido considerada um importante assunto de saúde pública, em virtude da prevalência com que esse fenômeno vem ocorrendo ao redor do mundo 1,2,3,4,5,6 . A chamada epidemia da maternidade na adolescência só foi reconhecida por volta de 1970, quando as taxas de fecundidade nesta faixa etária já começavam a cair nos Estados Unidos 2 e em outros países do primeiro mundo.…”

Section: Introductionunclassified

Gravidez na adolescência: perfil sócio-demográfico e comportamental de uma população da periferia de São Paulo, Brasil

et al. 2007

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Com objetivo de identificar o perfil sócio-demográfico e comportamental de gestantes adolescentes, foram entrevistadas mil adolescentes, admitidas entre 24 de julho de 2001 e 27 de novembro de 2002, em um hospital municipal de São Paulo, Brasil, correspondendo a 24,3% das internações para resolução da gestação. Setenta (7%) adolescentes foram admitidas para curetagem pós-abortamento e 930 (93%), para parturição, com idade média de 17 ± 1,5 anos. A maioria (72,4%) residia próximo ao hospital e 93% pertenciam às classes econômicas C, D e E. Na época da parturição, 627 (67,3%) adolescentes não estudavam. Apenas 23,7% das adolescentes faziam uso de método contraceptivo, 81,2% não tinham planejado a gestação e 80,1% eram primigestas. Dos partos, 67,4% foram vaginais. Dos bebês, 13,3% foram pré-termo e 15, 9%, baixo peso. Durante a gestação, o consumo referido de tabaco, de álcool e de drogas ilícitas foi, respectivamente de 17,3%, 2,8% e 1,7%. Conclui-se que gravidez na adolescência é um fenômeno complexo, associado a fatores econômicos, educacionais e comportamentais, precipitando problemas decorrentes da maternidade precoce. O presente estudo fornece subsídios para políticas públicas de saúde, visando a prevenir a gravidez na adolescência.

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Section: Introductionunclassified

Gravidez na adolescência: perfil sócio-demográfico e comportamental de uma população da periferia de São Paulo, Brasil

et al. 2007

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“…Teenage pregnancy has become a major issue in the United States. Each year more than one million American teenagers become pregnant (Maracek, 1987). Pregnancy affects the developmental course not only of a large number of adolescents, but also of the children of those adolescents who opt to become parents (Gibbs, 1984; Furstenberg, Brooks-Gunn, & Chase-Lansdale, 1989).…”

mentioning

confidence: 99%

Formal operational thinking: The role of cognitive-developmental processes in adolescent decision-making about pregnancy and contraception.

Gordon

1990

American Journal of Orthopsychiatry

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The role of formal operational thinking in adolescent decision-making about pregnancy and contraception is explored through an integration of the cognitive-developmental and pregnancy-contraception literatures. The ways in which cognitive-developmental change mechanisms initiate or hinder formal thinking on pregnancy-contraception are considered, and implications for counseling pregnant adolescents are discussed.

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“…The use of less mature defenses such as denial appears to be more common among younger adolescents, typically resulting in greater delay in seeking abortion and the use of abortion procedures entailing greater physical and emotional risk. Postabortion young women who have not born children often harbor fears about future infertility (Marecek, 1987), an anxiety which may or may not have been alleviated by sensitive patient education at the time.…”

Section: Identifying Abortion-related Issues In Clinical Practicementioning

confidence: 99%

“…The fact that delay has occurred may bespeak stronger ambivalence in the first place (Bracken & Kasl, 1975;Smith, 1973), inadequate social support, or more problematic decisionmaking skills (Kerenyi, Glascock, & Horowitz, 1973). Adolescents often postpone confronting an unwanted pregnancy out of fear of parental reactions (Marecek, 1987). Lack of knowledge about abortion facilities and delays introduced by the medical system may also contribute to delay (Mallory, Rubenstein, Drosness, Kleiner, & Sidel, 1972).…”

Section: Characteristics Of the Medical Environment And Abortion Procmentioning

confidence: 99%

“…Griefwork may focus on the potential child, on the difficulties of life that constrain childbearing, or on the lost innocence that an adolescent may experience in the wake of making difficult "adult" decisions. Educational approaches have been suggested, including contraceptive education where the unwanted pregnancy resulted from misinformation about sexuality and contraception (Marecek, 1987). Education focusing on normalizing the woman's experience and helping her make appropriate attributions about her feelings may be in order.…”

Section: Approaches To Treatmentmentioning

confidence: 99%

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Emotional Sequelae of Abortion: Implications for Clinical Practice

Lemkau

1988

Psychology of Women Quarterly

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The literature is summarized on normative reactions to abortion and factors that increase risk of negative emotional sequelae. Four areas of inquiry for identifying psychotherapeutic issues in regard to abortion are elaborated, including: (a) characteristics of the woman prior to and at the time of the abortion, (b) the nature of social support and the cultural milieu around the abortion, (c) characteristics of the medical environment and abortion procedure, and (d) events subsequent to the abortion which may have aroused post‐decisional conflict. The implications of the research literature for psychotherapeutic treatment of women who have had abortions are discussed. SUMMARY For women in therapy who have had abortions, an exploration of the context and aftermath of each abortion has been suggested. This inquiry should include: characteristics of the woman herself before and at the time of the abortion, the nature of the interpersonal and cultural milieu at the time, characteristics of the medical environment and procedure, and any events subsequent to the abortion that may evoke regrets about the earlier decision. Whether or not such an inquiry results in the identification of unresolved issues surrounding the abortion, it is likely to enhance one's general understanding of the client. Exploring a woman's decision to have an abortion can bring into relief developmental and family issues, relationship conflicts, and her aspirations for education, work, and family. A woman's approach to establishing and asserting her priorities and values in making difficult personal decisions becomes clear as does her ability to tolerate and resolve the ambivalence inherent in making difficult decisions. In psychotherapy, it is important to understand and address those aspects of experience that women have difficulty resolving. Hence, the emphasis on categories of experience that may have a negative impact on a woman's emotional well‐being after abortion. Nevertheless, the clinician should remember that even women who report negative post‐abortion sequelae overwhelmingly report that they feel that the decision was the right one for them. Having ambivalent feelings to resolve does not necessarily mean that one has made a wrong choice, only that one has made an emotionally significant choice with far‐reaching personal implications, in a sociocultural environment that reinforces the ambivalence inherent in such decisions.

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Counseling adolescents with problem pregnancies.

Cited by 16 publications

References 13 publications

Gravidez na adolescência: perfil sócio-demográfico e comportamental de uma população da periferia de São Paulo, Brasil

Gravidez na adolescência: perfil sócio-demográfico e comportamental de uma população da periferia de São Paulo, Brasil

Formal operational thinking: The role of cognitive-developmental processes in adolescent decision-making about pregnancy and contraception.

Emotional Sequelae of Abortion: Implications for Clinical Practice

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