Pitt program aims to educate teenage mothers

Over the last century, couples have increasingly had children out of wedlock. Unfortunately, this also means that more teenage mothers are raising children on their own or struggling to raise children without traditional family support.

But physician Jeannette South-Paul found a remedy to this modern problem in an old source: an indigenous culture of southern Africa.

According to the U.S. Department of Health and Human Services, Pennsylvania was ranked 38th in the country for the highest teen birth rates among young women age 15 to 19 years old. In 2011, 10,816 women between 15 and 19 years old gave birth in Pennsylvania, while a total of 392,772 women between 15 and 19 gave birth that year in the United States. 

This issue is being addressed by South-Paul’s Maikuru Program, which is focused on preventing second unwanted teen pregnancies of women younger than 19 years old.

South-Paul works in the Department of Family Medicine in Pitt’s School of Medicine. She founded the Maikuru Program, a mentoring program for teen mothers, four years ago. 

She said she wanted to do something to help teen moms while she worked in maternity care with pregnant teens. Between 60 and 80 women have participated in the program. Those accepted to participate are teenagers younger than 19 with only one child, as the goal is to prevent a second unplanned pregnancy.

“These young women’s lives have been irrevocably changed,” South-Paul said about her time in maternity care. “So I thought maybe we could set up a program that could address multiple issues, and that’s how I envisioned the program.”

The term “maikuru” comes from the Shona language, which is spoken in Zimbabwe and some neighboring countries. South-Paul, whose husband is Shona, said she chose this term for the title of the program because in Shona culture, a maikuru is a wise woman and the anchor of her village.

South-Paul said she started the program because she believes that modern society has lost the cohesiveness of villages.

She noticed that teenage mothers often don’t have close relationships with an older individual, and she decided to pair them with older women who could support them and serve as parental figures and advisers.

South-Paul calls her program’s volunteer mentors “maikurus.”

She realized it was difficult to encourage sizeable groups of young women to leave their home neighborhoods, and decided a central location for the program would prove most convenient. “So that’s when we said, ‘Let’s just see what happens if we try it in Oakland,’” she said. “And that became a winner. It’s a neutral zone. People feel comfortable coming to Oakland, and all the buses come here, which solved a lot of problems.”

Each group study consists of six weekly group sessions held in the Department of Family Medicine’s building on Fifth Avenue. The pairs of mothers and mentors come in once every three months for follow-up surveys for 24 months. The program has had 12 participating groups so far.

One student who has become increasingly involved in the program is Kelsey Moyer, a junior majoring in biology in the pre-physician’s-assistant program. She started working with the study her first year at Pitt through the First Experiences in Research program run by the Dietrich School of Arts and Sciences, which offers freshmen and sophomores the opportunity to become involved in faculty research projects in the social sciences, humanities or natural sciences.

“It’s interesting because you get to actually interact with people,” Moyer said. “A lot of it is phone calls, tracking people down and running group sessions.”

Moyer works with graduate students part time on the research project.

“It’s a really cool experience,” she said. “It’s cool to work alongside doctors and researchers in that atmosphere.”

When the participating young women started talking at the beginning of the program, the mentors and facilitators realized there were issues in the mothers’ lives that the program managers did not know about.

One significant issue was domestic violence. Now, in addition to discussing this topic in group sessions, an instructor from a women’s shelter comes to each group meeting and informs the teens on what abuse is.

South-Paul also has a physician and three research assistants analyzing data collected through the program.

Data from South-Paul’s program also showed that many girls were depressed at the beginning of the study. South-Paul made depression a topic of discussion at the group meetings.

The maikurus go through training regarding stress management, depression and mentorship before being assigned to a teenage mother. Researchers measure the mothers’ mental and emotional progress by having them take surveys on school, their personal lives, their babies’ lives, significant others, support systems, birth control usage and mood. 

The goal of the program is to keep the teenagers engaged throughout the 24-month period to prevent a second pregnancy. Each weekly group session covers a specific topic, with additional meetings for further discussions that may include speakers or film screenings, such as “Waiting for ‘Superman.’”

The Heinz Endowments, a foundation based in Pittsburgh, gave the study its first grant. South-Paul asked that the amount of the grant not be printed.

The foundation provided the first grant to determine whether there were access problems to health care for pregnant teens in 2008. They gave two additional grants to survey teens in 2009 and 2011. The funding is used for babysitters, food for both maikurus and moms, bus passes, pre-paid Visa cards for each mom, parking passes for the maikurus, core facilitators and the students who work part-time at the program.

Other individuals assisting South-Paul are doctoral- and master’s-degree candidates in public health. Their responsibilities include setting up for meetings and developing group projects and presentations. Some students have even babysat for the mothers.

“It takes a lot to get teens to show up on time,” South-Paul mentioned. “Students are very good about Facebooking, tweeting and calling to communicate with the teens.”

The women who act as mentors to the teenage moms are all volunteers who devote their time to give advice and support to the teenagers. Mentors must undergo criminal background checks, because the program wants to model wholesome, trusting mentors. Mentors, who are at least 15 years older than their partners, can participate alone or with their spouses.

Support, education and providing the young women with information regarding contraception are the three most-emphasized aspects of the program. Although those involved in the program have not published their findings yet, they’re seeing strides made in the lives of the enrolled mothers.

According to a report by the researchers for the end of year 2012 and beginning of year 2013, two-thirds of participants reported that they used birth control at the end of their intervention and during a follow-up 12 months later.

Additionally, the report stated that at the end of the 12 months, the birth rate among participants was about 1 in 10, compared to about 1 in 7 for adolescent mothers under the age of 20 years in all of Allegheny County.

Results have already shown promise through the creation of continuation groups, which have become important in the program. These are groups of teen moms who don’t want to stop attending the program after their 24-month period is over.

“They have developed a relationship, a safe zone to discuss things, give advice, get dinner and have a babysitter,” South-Paul said.

The Grable Foundation, which supports programs that aid childhood development, gave the program a grant to cover the expense of continuation groups. They meet every six weeks and allow the women to choose a topic to discuss. Anyone from previous groups can attend, as well.

Lannea Adamson, a graduate student in the School of Public Health, has been a research assistant with the study since April 2012.

She said that connecting the teen moms with mentors allows them to have additional support, an adviser and a cheerleader to help them achieve their goals, all of which aids in their progress into adulthood.

“I do see progression in the teen moms,” Adamson said.

Adamson noted that some of the young women have graduated from high school or GED programs, entering into secondary education or the workforce. 

“I just can’t begin to tell you how important it is for these teens to feel like they have social support and somebody that can coach them in life,” South-Paul said.