Mentors help teen moms avoid second child

NEW YORK (Reuters Health) - A home-based mentoring program seems to be effective in preventing rapid second births among low-income, black adolescent first-time mothers.

Among a cohort of 149 first-time teen mothers, 27 (18 percent) gave birth to a second child 2 years after the first child was born. Mothers who were assigned to a mentor right after delivering their first child were far less likely to have a second child than "control" mothers receiving the usual care after the birth of their first child.

Of the 70 teens in the intervention group who were still in the program after 24 months, 8 had a second child and 62 did not. Of the 79 girls in the control group available for 24-month follow-up, 19 had a second child and 60 did not.

Although teenage pregnancy rates are on the decline in the United States, many efforts to delay second births in teen mothers have been unsuccessful, Dr. Maureen M. Black from the University of Maryland School of Medicine in Baltimore and colleagues note in a report in the journal Pediatrics this month.

"Mentoring programs, which connect adolescents with adults for support and advice, have attracted national attention as a strategy to reduce risk behaviors among adolescents," they point out.

The mentors in their program were black, college-educated, young mothers, each of whom had one preschool-age child. By portraying themselves as "big sisters," they took on a supportive role rather than an authoritarian role.

The teen moms and mentors aimed to meet twice a month starting when the first child was born and continuing, if possible, for 12 months. Mentors were trained to follow an established curriculum that touched on everything from sex education to taking care of a baby.

The effectiveness of the mentoring program was evident after only two visits and increased over time, Black and colleagues found.

Having just two or more "big sister" meetings increased the odds of not having a second child more than threefold, they report. Only one mother who had six or more meetings with her mentor had a second infant.

Teens who gave birth to a second child after 24 months reported high-self esteem, positive life events, and were romantically involved and living with the first infant's father.

The study also provides evidence that, at least in some communities, rapid second births among teen mothers, may be valued and regarded as "growing up" and entering adulthood, as opposed to a risk behavior. If so, than interventions aimed at "risk reduction" are likely to fail, the investigators warn.

SOURCE: Pediatrics, October 2006.