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Table 2 Study characteristics of papers to be synthesised

From: No straight lines – young women’s perceptions of their mental health and wellbeing during and after pregnancy: a systematic review and meta-ethnography

Source paper and country-Young women sample N
-Age range
-Pregnant/parenting stage
(where provided)
-Ethnicity (as defined by papers)
-Children’s details
-Mental health status
(where provided)
AimsQualitative methodsReported data analysis
(Lesser et al., 1999) [40]
USA
N = 15; ‘adolescents’
Parenting: 2 years postpartum
Sample of ‘adolescents’ not defined in terms of age but quotations from young women age 17 (n = 1); age 18 (n = 5)
N = 11 Latina; n = 3 African-American; n = 1 Caucasian.
N = 8 had one child; n = 4 were pregnant with their second child; n = 3 had two children.
Reported symptoms of depression either during pregnancy or postpartum, measured by the Center for Epidemiologic Studies Depression Scale (n = 14) or reported a history of suicide attempt(s) within the past year (n = 1)
To provide a description of the affective component of depressed adolescents’ maternal role by eliciting young mothers’ perceptions of their maternal roles and their experiences of depression.Ethnographic interviews, 2 h long conductedContent analysis
(Clemmens, 2002) [41]
USA
N = 20, age 16–18
Parenting: 1–11 months postpartum
9 African American; 8 Hispanic; 3 White
All had one child
Depressive symptoms
To address the phenomenon of depression from the perspective of adolescent mothers. Explore their memories of feeling depressed after the birth of their babies.In depth face to face interviews, 15–45 min (20 mins average)Descriptive phenomenological design (Colaizzi, 1978)
(Renker, 2002) [42]
USA
N = 40; age 18–20
Pregnant or parenting
Average age for conception for the current pregnancy was 18.
N = 17 African American; N = 18 White; N = 5 teens Hispanic, American Indian, or mixed racial background.To explore adolescents’ experiences of abuse in the year before and during pregnancy.Structured and focused interviews 30–90 minGeneralized qualitative approach blended content/thematic analysis. (Creswell, 1994)
(Kennedy, 2005) [43]
USA
N = 10; age 16–20
Pregnant or parenting
N = 7 Mexican American; n = 3 African American.To explore urban adolescent mothers’ experiences with community violence; witnessing parental violence, familial physical abuse, and partner violence; their methods of coping and resistance.Individual,
open-ended interviews (45–90 min)
Grounded Theory
(Strauss & Corbin, 1990)
(Stevens, 2006) [44]
USA
N = 18, age 15–21 Parenting – at least 3 months postpartumN = 6 Black; n = 7 White; n = 3 Black/White/Indian; n = 1 Black/White/Mexican; Mexican/White n = 1
Age of children: 0–3 months n = 2; 3–6 months n = 3; 6–9 months n = 3; 9–12 months n = 1; 12–24 months n = 5; 2–4 years n = 6
To explore how adolescent women who are parenting describe what “being healthy” means to them and how they define their own health needs.Ethnographic methods
Including in-depth interviews and participant observation, photovoice
Participants’ views /meanings of health as described in interviews and narratives of photographs (ethnographic and photovoice)
(Shanok & Miller, 2007) [45]
USA
N = 42; age 13–19
39 pregnant; 3 parenting
N = 18 Hispanic; n = 19 Black; n = 4 Black and Hispanic, n = 3 undisclosed
Subsection with depressive symptoms
To explore the nature of the participants’ depression and the factors that helped them to feel better.Mixed methods. Analysis of therapy sessions with participantsInductive qualitative analysis LeCompte and Schensul (1999)
(Erdmans & Black, 2008) [46]
USA
N = 27; average age 20,
Parenting
Average age 17 years old when they had their first child
12 White, 9 Puerto Rican, 5 African American, and 1 biracial (White and Puerto Rican).To listen to victims of child abuse tell their life histories to better understand the trajectories linking child sexual abuse to adolescent motherhood.Two face to face interviews, 1.5–2 hLife story method (Bertaux & Kohli, 1984)
(Meadows-Oliver, 2009) [47]
USA
N = 8; age 18–19
Pregnant (n = 2); parenting (n = 5)
N = 7 African-American, n = 1 Latina.
N = 4 one child; n = 4 two children – ages between 7 months to 5 years.
N = 2 pregnant at time of interview
To explore the lived experience of homeless adolescent mothers’ caring for their children while living in a shelter?1:1 face to face interviews lasting 20–30 minPhenomenological approach
(Colaizzi, 1978)
(Kulkarni, 2009) [48]
USA
N = 24, age 18–22
Parenting
Age at first pregnancy 14–16 n = 19; 17–18 n = 5
African American n = 9; Asian n = 1; European American n = 4; Mexican/Mexican American n = 10
Number of children 1 n = 18; 2–3 n = 6
To explore the effects of IPV on their adolescent mothers’ important relationships.Semi structured interviews 35 mins to 2 h with n = 24; second interviews with n = 15‘Qualitative analysis’ (Miles and Huberman, 1994)
(Brown, Brady & Letherby, 2011) [49]
UK
N = 9; age 16+
Parenting (1–5 years)
Age range time of giving birth 13–18 years.
Children age 1–5 yearsTo explore a range of issues pertinent to young women’s lack of agency, disempowerment and experiences of power, control and domestic violence with reference to intimate and familial relationships.In-depth, semi-structured
interviews 1–2 h
Grounded theory “style” (Glaser & Strauss, 1967)
(Smith & Roberts, 2011) [50]
UK
N = 13 under age of 25 at interview ParentingN = 5 White British; n = 3 Mixed race; n = 2 Black British; n = 1 Indian; n = 1 Caribbean; n = 1 Black AfricanTo explore the experience of being a young parent and some of the influences on their sexual and reproductive behaviours in young mothers from a variety of socioeconomic backgrounds.Semi structured interviewsThematic analysis (Braun and Clarke, 2006)
(Crawford et al., 2011) [51]
USA
N = 24, age 16–19 at baseline Pregnant or parentingData not provided for the sub sample of those interviewed for qualitative research.To follow a sample of young homeless females over a 3-year period as they moved from late adolescence into early adulthood informed by in-depth interviews with a subsample.Semi structured interviews of 1 hThematic coding
(Boath et al., 2013) [52]
UK
N = 15; age 17–19
Parenting - first time mothers with babies under the age of one.
Age range at the time of giving birth 16 to 18 years (mean 16.9).
Children under age of one
Identified by their health visitor as suffering from postpartum depression following clinical assessment.
To elicit the experiences of teenage mothers with postpartum depression and to further explore those factors associated with depression in younger mothers.40 min – 1.5 h face-to-face semi-structured interviewsThematic framework analysis (Ritchie & Spencer, 1994)
(Herrman, 2013) [53]
USA
N = 26; age 14–18
N = 22 16–39 weeks pregnant; n = 4 parenting
N = 7 Hispanic; N = 10 African American; N = 6 White; N = 3 mixed origins
Children age 1–3 months.
To provide a voice to young mothers about their thoughts and perceptions of TDV within the context of their relationships and experiences in pregnancy and parenting.Semi structured focus groupsQualitative coding of typologies (Rubin and Rubin, 2005)
(Aparicio et al., 2015) [54]
USA
N = 6; age 19–22
Parenting, mothers in foster care
Age 14 to 17 years at the time of their first pregnancy.
n = 5 African American; n = 1 Latina, born in the U.S.
Three participants had one child, one participant had two children, and one participant had three children.
To explore the lived experience of motherhood among teen mothers in foster care with a history of maltreatment. To inform teenage pregnancy prevention and to elucidate practices to give teenage mothers in foster care and their children the very best start possible in cases where a birth occurs.Three in-depth interviews for each participant 1–2 weeks apartInterpretative Phenomenological Analysis (IPA)
(Kinser & Masho, 2015) [55]
USA
N = 17; mean age: 17.5 +/−  1.3 years PregnantN = 17 African AmericanTo evaluate pregnant, AA adolescents’ perceptions of depression and stressful experiences and assess feasibility and acceptability of adjunctive/ complementary, non-pharmacologic stress and depression management strategies for this underserved population.Qualitative interviews using nontherapeutic focus groupsContent analysis with phenomenological overtones (Sandelowski, 2000)
(Leese, 2016) [56]
UK
N = 12; age 16–19
Parenting
To capture young mothers’ journeys to understand the reality of individual and collective experiences within cultural context of support group (Flick 2009).Ethnographic narrative interviews and participant and non-participant observation collected over yearThematic analysis
Gomm (2008)
(Fortier & Foster, 2017) [57]
Canada
N = 10; age 21–25
Parenting
Conception age 13–19
All identified as Anglophone and CaucasianTo understand better the experiences of young mothers with subsequent pregnancy and motherhood in Canada’s capital.Semi structured depth phone interviews av. 60 minsQualitative content analysis (Elo and Kyngäs 2008)
(Bledsoe et al., 2017) [58]
USA
N = 20; age 14–20
Pregnant
46.5% African American; 46.5% Latina.
Pregnant: average gestational age 16.85 weeks (SD = 4.63)
6 prior depression diagnosis; 1 bipolar; 1 mood disorder,1 panic disorder
To address knowledge gaps regarding the experience of U.S. low-income, minority, depressed pregnant adolescent women’s perceptions of pregnancy, depression, and help-seeking.In depth, semi structured interviews and questionnaireDescriptive qualitative approach