Annotatated Bibliography

 Journal of Family and Reproductive Health http://jfrh.tums.ac.ir Vol. 11, No. 3, September 2017 165

Exploring the Challenges of Adolescent Mothers From Their Life Experiences in the Transition to Motherhood:

A Qualitative Study

Massoumeh Mangeli; M.Sc. 1 , Masoud Rayyani; Ph.D.

1 , Mohammad Ali Cheraghi; Ph.D.

2 ,

Batool Tirgari; Ph.D. 1

1 Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran 2 Department of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

Received June 2017; Revised and accepted September 2017

Abstract Objective: Early motherhood and its impact on mothers, children, families and communities is a prevalent

health challenge in developing countries that needs to be urgently explored. The aim of this study was

exploring the challenges encountered by Iranian adolescent mothers during the transition to motherhood.

Materials and methods: Inductive conventional content analysis approach was used in this qualitative

study. Face to face in-depth semi-structured interviews were conducted with 16 Iranian teenage mothers

in the Kerman province of Iran from March to December2016. Data collection continued until the point

of data saturation and MAXQDA software was utilized in the analysis of the data.

Results: Six main categories increasing burden of responsibility, experiencing physical problems,

receiving insufficient support, inefficiency in maternal role, emotional and mental distress; and role

conflict and 18 sub-categories were extracted from the data analysis.

Conclusion: The findings of this study showed that adolescent mothers experience many physical,

psychological, mental and social challenges. Therefore, it is expedient that special attention and care

support is made available to them by health care providers. A comprehensive understanding of the

challenges encountered by adolescent mothers, will aid the development of culturally appropriate health

promotion guidelines and strategie.

Keywords: Adolescent Mothers; Challenges; Iran; Qualitative Study; Motherhood; Kerman

Introduction 1

Motherhood is a significantly important event in the

life of a woman (1). Maternal role attainment is a

process that requires acquire necessary abilities, learn

appropriate behavior, and establish in maternal

identity (2). Preparation to accept the maternal role

Correspondence: Mohammad Ali Cheraghi, P.O.BOX. 6459, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, 1419733171, Iran. Email: [email protected]

has important effects on maternal adjustment and

transition to adulthood (3). However, increasing

number of teenage mothers is one of the important

concernsin many countries (4). According to the

World Health Organization, every year,

approximately 16 million teenage girls give birth

worldwide while South Koreahas minimum rate and

maximum rate is in sub-Saharan Africa (5). Among

1,000 Iranian adolescent girls, 27 become mothers (6).

Early motherhood has significantly affected not

only adolescent girls, but also their spouse, family,

Original Article

Mangeli et al.

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school and the society at large (7). Transition to

motherhood need to physical, psychological, social

and cognitive preparedness; but teenage mothers are

not ready to becoming a mother (8). Motherhood

becomes cumbersome and convoluted for teenage

mothers, who endure maternal role and developmental

task of adolescence simultaneously (3). They must

adapt with adulthood social roles, physical changes of

puberty, significant brain development, and nurturing

of an infant (9). Most of teenage mothers are not in a

good socio economic condition so transition to

motherhood becomes problematic for them (10).

According to the results of studies, Teen mothers

face many physical, psychological, social and

spiritual challenges: A constant need for support and

training (2), inability to planning and decision

making, lack of maternal skills (11) encountering

unknown situations and major changes (2), high risk

pregnancy and birth (4, 5, 12, 13), mental health

problems(depression, anxiety, shock, low self-

efficacy, isolation) (8, 12, 14), multiple

responsibilities (12, 15), role conflict and identity

confusion (12, 16), inadequate social and spiritual

support (12), disruption of education and employment

(4, 11, 14), financial problems (11), social stigma

and, religious or cultural negative reaction (4, 11, 14),

inappropriate behavior of health care providers (8),

and family conflicts (4).

Low accountability, emotional fluctuations, lack

of knowledge and experience, the influence of peers,

and high risk behaviors in adolescents; highlights the

important role of health care providers (17, 18). In

developed countries, early motherhood is be

considered asone of important public health issues

and is assessed by obstetricians & gynecologists,

pediatricians, child psychologists, sociologists, family

physicians, and nurses (19). Providing high quality

services requires understanding of the needs of

teenage mothers, their challenges and capabilities.

This goal can be achieved only through a

comprehensive qualitative study in different

cultures.Exploring teenage mother‟s experience of

motherhood can generate new insights for

policymakers and health care providers resulting in

efficient response to the challenges of teenage

mothers. This study conducted for exploring the

challenges of Iranian adolescent mothers during the

transition to motherhood.

Materials and methods

This qualitative study was conducted through

inductive conventional content analysis.

This study was conducted from March to

December 2016 in Kerman, Iran. Kerman is located

in southeastern Iran, and has a high rate of teenage

mothers. A total of 16 teenage mothers who met the

inclusion criteria (being a maximum of 19 years of

age at the time of first birth, have a child or children

up to 2 years of age, being able to speak Persian,

being willing to share personal experiences, living

with spouses, not having a history of severe mental

illness, and good cooperation with the researcher)

participated in this study. Participants were selected

purposefully with maximum variation in age, child's

age, place of residence (urban or rural), and

educational level.

Data was collected through face to face in-depth

semi-structured interviews conducted by first author

(nursing PhD candidate). The interviews were

focused on the experiences of the participants while

teenagers were asked to explain their experiences of

motherhood in adolescence and their challenges.

Central questions were asked and progression was

made into specifics, also in accordance with

participants' statements additional probing questions

were used. The interviews were conducted at specific

times and location and lasted for in agreement with

the participants45 to 60 minutes, during a 6-month

period from March to August 2016. Entire interviews

were recorded and transferred into audio files to be

entered in the computer and data collection continued

until data saturation was reached, when no new

information was obtained from the interviews.

The inductive conventional content analysis

approach (Graneheim & Lundeman) was utilized for

data analysis. The initial audio files of interviews

were listened and recorded interviews there after

immediately transcribed verbatim and then read

several times to gain a general impression. The

resulting text from the interviews was read line- by –

line and was broken down into meaningful units

(words or sentence or paragraphs), which were then

condensed, abstracted, coded, and labeled. Next, the

codes were re-read in order to be arranged into

categories and sub-categories based on their

similarities and differences. The first author

performed data coding and all co-authors supervised

the coding process. In cases where there is

disagreement over the coding, the authors discussed

and negotiated the codes until they come to a

compromise. Data analysis was done continuously

and simultaneously with data collection wherefore

Challenges of Iranian Adolescent Mothers

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the data and the generated codes were constantly

compared. MAXQDA10 software was used also for

management of data.

Spending sufficient time for collection and

analysis of data, appropriate communication with

participants, immersion in the data, member check

and peer check, Limiting the baseline review of

literature, consideration the opinion of an expert

(outside the research team), recording of the research

process accurately, and checking results of the study

with numbers of similar cases who was not among

the participants; were utilized to increase rigor (20).

The Kerman University of Medical Sciences

Human Research Committee approved this study

(ethics approval number: IR.KMU.REC.1394.591).

The study purposes, possible risks, and benefits were

explained to the participants. The anonymity of

participants, privacy and confidentiality were

maintained. Interviews were conducted in a private

and non-threatening environment and audio files

were kept anonymously in a secure place.

Participants were assured of the confidentiality of

their responses. Participants were also informed that

participation in this study was voluntary and they

could withdraw at any time. Written consent was

obtained from the participants for the recording of the

interviews. During the data collection, the first author

was ready to provide help and support; if necessary.

Results

In this study, participants were 16 adolescents, within

the ages of 14 to 18.5 at the time of childbirth. All of

them were housewives and had education levels from

middle school to diploma. Among most cases their

husband were at least 10 years older (Table 1).

Six main categories including increasing burden

of responsibility, experiencing physical problems,

receiving insufficient support, inefficiency in

maternal role, emotional and mental distress, and role

conflict and 18 sub-categories were extracted from

the data analysis (Table 2).

Most teenage mothers expressed increasing

responsibility as one of the main challenges and

described it as several responsibilities, lack of time and

energy, and restriction on spending for self-interests.

Following child birth, teenagers were faced with

multitude responsibilities and a sharp increase in

workload. Therefore, they experienced physical and

mental fatigue and needed help and support from others.

Most teens were unable to handle the workload. After

becoming a mother, teens have been unable to

managing timeand planning. So they did not find the

opportunity to consider all things.Many adolescents

when encountering various responsibilities of

motherhood feel restricted, imprisoned and unable to

fulfill self-desires (Table 3, Qutation1-3).

Table 1: Demographic characteristics of participants

Participants

Age at

childbirt

h (year)

Children

age

(month)

Place

of

living

Current

Education level

Education

level of

husband

Age

difference

with husband

(year)

Job of

husband

1 18.5 6 Rural Diploma Bachelor 4 Worker

2 15 24 Rural Middle school Diploma 11 Farmer

3 17 6 Urban High school Diploma 2 Self employed

4 18 13 Rural High school Diploma 14 Worker

5 14 14 Urban Middle school University Diploma 10 Engineer

6 17 8 Urban Diploma University Diploma 7 Jobholder

7 16 4 Rural Middle school Diploma 11 Self employed

8 17 18 Urban Diploma Diploma 10 Self employed

9 18 14 Urban Diploma Diploma 13 Engineer

10 17 23 Urban University Diploma Bachelor 10 Engineer

11 15 10 Rural High school High school 7 Self employed

12 17 13 Urban High school Diploma 11 Jobholder

13 15 24 Urban Middle school Middle school 24 Self employed

14 17 22 Rural High school High school 10 Clergyman

15 14 3 Urban Middle school Diploma 12 Worker

16 16 24 Urban Diploma Diploma 6 Self employed

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Table 2: Main categories and sub categories of challenges of adolescent mothers

Categories Sub categories

Increasing burden of responsibility and its outcomes Several responsibilities in new condition

Lack of time and energy

Experienced restrictions on spending on personal interests

Physical problems Health problems related to pregnancy

Health problems related to childbirth

Health problems related to postpartum and breastfeeding

Receive insufficient support Received inadequate support from spouse

Received inadequate support from family and friends

Received inadequate support from health care providers

Ineffectiveness in maternal role Cognitive incompetency related to essential knowledge for Motherhood

Practical skill incompetency in the maternal role

Emotional and mental distress Fear and worry

Regret and frustration

Guilt and shame

Depression

Disruption in relationships of couples

Role conflict Conflict of maternal and student role

Conflict of maternal and adolescent role

Becoming a mother in some teens has been

associated with several health problems. These

problems could be related to pregnancy, childbirth,

postpartum and breastfeeding. According to

statements from the participants, some adolescent

mothers had experienced hyperemesis gravid arum,

eating disorders, anemia, bleeding, and preeclampsia

during pregnancy. Most participants had endured a

difficult birth, dystocia, disruption of the normal

process of childbirth, non-elective cesarean birth,

and physical consequences of hard labor. Also,

small breast, breast fissures, and mastitis were

expressed by the majority of teenage mothers

(Table 3, Qutation4-6).

Most teenage mothers needed to receive support

because they were faced with new roles, increased

responsibilities, health problems, rising costs, and

knowledge deficit. Without adequate support

they experienced serious challenges in adapting

to motherhood.

Table3: Quotation of Participants

Quotation 1 “I had to do all the child care, my baby was crying most of the timeand I had to calm him, I changed

diapers and washed clothes, I woke up several times at night to breast feed, I was in the hospital when

my baby was sick, The child was too much work, In addition I have to do housework. I was so

tired.”(p12).

Quotation2 “I do not have free time, I have several responsibilities in life, I am always faced with lack of time, I

cannot be oblivious to child-rearing and I must consider my child. I devoted all my time to my child; I

do not have any more time to do further work.”(p9).

Quotation3 “Since I became a mother I have become an unhappy person, I cannot go anywhere and do anything, I

can neither go out for recreation nor travel. I cannot think freely. I mustthink about wife, child and my

life” (p10)

Quotation4 “I was in very bad condition during pregnancy, I was often hospitalizedor I had to rest at home, I also

suffered from anemia, I was not on a good nutrition plan, I experienced bleeding in pregnancy, my

doctor said my problem was placenta Previa, I was very swollen, and my blood pressure had risen to

18. My doctor eventually said I had preeclampsia. I had a seizure at the time of delivery”. (p4)

Quotation5 “I had a very difficult birth.The last confirmed date arrived, but labor didn’t start, and I was

hospitalized for 3 days. When the pain began, I endured it for 15 hours. My doctor said, because your

age is low and growth is not yet complete, cervical dilatation does not progress”. (p15)

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Table3: Quotation of Participants (continue)

Quotation6 “My Nipples were very tiny, it was very difficult for me to give milk to my baby. I had so much pain in

my breast because it was sore, when the child feeds, I had to clasp my teeth together, to help bear the

pain”. (p8)

Quotation7 “My husband does not help me. He believes that mothers should do all child care. When our child gets sick,

he says that he does not care. He says the mother must assume responsibility for the care of child” (p5).

Quotation8 “I could not rely on anyone, my mother could not get along with me, and I had a bad relationship with

my mother in law. I have no help from my family, caring for my child was solely my responsibility. We

had a lot of financial problems, we were tenant, and my husband was unemployed. We had no income

and the cost for pregnancy and baby care had increased, yet we could not get help” (p2).

Quotation9 “I did not know much about the care of children, I expected health care providers to pay more

attention to me, but they did not. When I asked about depression during counseling I was not given any

help. They only took statistics of child’s height, weight and my blood pressure. I often needed guidance,

but they did not answer my questions” (p7).

Quotation10 “In most situations, I do not know what to do. I did not know why the baby cries. I had to get help from

others. I reach out to others who might be able to give good advice. I did not know how to take care of a

sick child, what to give him medicine or food... Most of the time I had to ask my mother what I should

do” (p10).

Quotation11 “I wanted to breast feed my child but I did not know how to hold the baby and what position I should

be. My mother took care of me all the time; otherwise, when feeding the baby was suffocated” (p14).

Quotation12 “I was always worried, because I thought I could not take care of the kid or nurture him. I think I was

not capable of doing child care. I felt I was too young for such responsibility. I was convinced I would

not be successful in caring for child” (p13).

Quotation13 “Many times I wanted to go back in time. I regretted it when I was in a very bad state, especially when I

experienced though times in motherhood. I did not like being a mother. ” (p3).

Quotation14 “I had a very negative attitude towards children, especially when I lacked knowledge on what steps to

take. My baby cries because of my behavior, I do not tolerate children and end up hurting my child”

(p9).

Quotation15 “I was depressed after childbirth .I was crying, did not tolerate the crying of my baby. I had no desire

to get up my own or do something for myself. My relationship with others was reduced and I did not

want to go out of the house. I was always sad and had a desire to be alone always.” (p11).

Quotation16 “When I was pregnant, I and my husband were worried, about occurrences of dangerous problems for

me or my baby, so we were rarely happy. Sometimes I felt it was my husband's fault in causing early

pregnancy. I get aggressive whenever I feel inadequate as a mother. Our relationship is not as good as

before” (p7).

Quotation17 “When I became pregnant, the headmaster said should not come to school. She said the presence of a

student with this condition (swollen abdomen) is not right” (P3).”Sometimes, the night before exam,

when I should have been studying, my baby was sick and I had to leave studying and take care of the

child” (p6).

Quotation18 “Ever since I became a mother, my problems have increased. Usually I like to solve problems alone and

do not get help from others, but in this case it is not possible. Sometimes I have to break my pride and

call on others for help”. (p2)

Quotation19 “When I go to have fun with my friends, they are uncomfortable that there is a childalso. Child care

does not allow me to welcome my friends well and stay for a long time besides”. (p16)

Quotation20 “When I was in the hospital, nurses taught me and said: “give milk to child in sitting positions because

breastfeeding in supine position may lead to choking of child” But I believed that nothing will happen

somost times I breast feed my baby in the supine position”. (p6)

Quotation21 “Since I became a mother, I have relegated my personal needs and desires, I no longer place priority

on shopping, beauty salons and self-gratifying needs. I am more concerned about my child’s welfare at

all times.” (P11)

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It is evident that they did not receive sufficient

support from their wives, families and health care

providers. Teenage mothers expected support from

their husbands in all child-related responsibilities and

this lack of support from spouses was a bitter

experience for teenage mothers. Teen mothers were

dependent on others and expected their mothers,

other family members, friends and school training

teams to support them in their role as mothers. This

lack of the support has created problems for the teen

in the care and upbringing of the child, child-related

costs, continuing education and community. Health

care providers are the most professional source of

support for teenage mothers and are expected to meet

their educational and care needs. If health care

providers fail to give support to teenage mothers, they

would consequently suffer health challenges for them

and their child (Table 3, Qutation7-9).

One of the main challenges faced by teenage

mothers was ineffectiveness. They lack sufficient

knowledge and skills for successful maternal role and

therefore depend on others. Many teenage mothers had

a knowledge deficit and their information was not

enough to take responsibility for maternal and child

care. Teenage mothers showed limited skill in relation

to motherhood including prenatal care, breast-feeding,

caring for children (Table 3, Qutation 10, 11).

Teenage mothers stated that accepting the role of

motherhood is associated with emotional and mental

distress such as fear and worry, regret and frustration,

guilt and shame, depression, and disruption in

relationship of couples. Fear and worry was mainly

derived from incompetence to accept the

responsibilities of motherhood. Teenage mothers also

worried about difficult situations in pregnancy and

childbirth which were caused by insufficient physical

maturity. The regret was associated with unwanted

pregnancy, problems related to pregnancy and

motherhood, and loss of previous desired position.

Incompetence in performing the maternal role

developed a sense of guilt and self-blame. Some

teenage mothers experienced depression, particularly

in the postpartum period .Emotional and physical

changes of teenage mothers led to tension and

disruption of relationship with partner and family.

(Table 3, Qutation 12-16). Early motherhood causes numerous conflicts in

adolescent mothers such as conflict of maternal and

student role, and conflict of maternal and adolescent

role. Pregnancy and child care results in the inability

of teenage mothers to studying and are eventually

deprived of education. Early motherhood was in

conflict with the special features of adolescence.

Although teenage mothers tended to be independent

but they had to receive help from others to perform

motherhood roles. This causes conflict between

independence and dependence in adolescents. Most

of teenage mothers were willing to continue their

relationship with their friends, but after becoming a

mother lost the opportunity of being with

friends. Childcare had deprived them of fun with

friends and peers. Despite becoming a mother,

adolescents were still willing to take risks. They do

not understand the need for caution in pregnancy,

childbirth and child care. They also do not show

interest towards safety and health advice. Some teen

mothers struggled between personal need and child

care, this resulted in a neglect of them or their child,

and the presence of the child disallowed self-centered

behaviors (Table 3, Qutation17-21).

Discussion

This study conducted for exploring the challenges of

Iranian adolescent mothers during the transition to

motherhood. Increasing burden of responsibility,

experiencing physical problems, receiving

insufficient support, inefficiency in maternal role,

emotional and mental distress, and role conflict were

the main challenges of Iranian adolescent mothers.

Increase burden of responsibility was one of the

challenges of teenage mothers in this study. It was

difficult for teen mothers to meet the multiple needs of

child, do housekeeping, going to school, and be present

in community alongside friends. Some studies were

showed that fatigue and inability have been reported

frequently by adolescent mothers and they were not able

to establish a good interaction with friends, continue

their education and be employed (1, 15).

Participants also had experienced physical

challenges. Physical problems that have been caused

by pregnancy, childbirth and breastfeeding; made

difficult the maternal role for teenage mothers.

Several studies were shown that physical problems

are higher in adolescent mothers. Pregnancy and

childbirth in adolescence may be associated with

preeclampsia, anemia, dystocia, cesarean section,

breast fissures, and postpartum fever (21, 22).

Some of teenage mothers in this study did not

receive sufficient support. Inadequate support was

able to exacerbate the challenges of teenage mothers.

Teen mothers needed support on many issues such as

child care, financial issues, education, and multiple

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needs of their own and their children. In Iran, teen

pregnancies are the result of legal marriages and

often families trying to provide adequate care and

financial support for teenage mothers. But

sometimes, teenage mothers do not receive adequate

support from family, community and health care

providers. Several studies showed adolescent mothers

do not receive adequate social support (8, 16, 23).

Stroble (2013) stated teenage mothers are faced with

new expenses related to infant nutrition and care and

costs arising from the treatment of mother and child;

so had to request financial help from family and

friends (24). Wives, mothers, and health care

providers are the most important sources of support

for teenage mothers and play an important role in life

planning and child care (15).

Ineffectiveness in maternal role was the other

problem of teenage mothers. Teenage mothers in this

study were not able to take care of the child

independently. They had not adequate knowledge and

competence. Teen mothers were exposed their

children at risk due to knowledge deficit. They might

even refer to invalid information resources and

aggravate problems. Williamson et al (2013) believed

that teenage mothers are not ready to motherhood.

They stated that low commitment, inability to change

life styles,low accountability, lack of confidence, and

dependence on others; show teenage mothers are

unpreparedness to maternal role (2).The study of

Pogoy (2014) showed that most of teenage mothers

acknowledged that they are not able to perform

proper care of the child independently (25). know ledge

deficit and skills of teenage mothers are about

pregnancy and birth, postpartum care, breastfeeding,

maternal and child health, child care, contraception,

diet, infection control, drug treatment, physical activity,

sex, health behaviors, and support resources (26).

Emotional and mental distress was another

problem faced by teenage mothers. They had

experienced fear, worry, regret, frustration, guilt,

shame, depression, and disruption in relationships of

couples.yates (2013) showed that teenage mothers

experience fear of inability to accept the maternal

responsibilities, shock, depression, denial, fear,

shame, regret, loneliness, social isolation, and mental

exhaustion (27). adaptation to mothering and

adolescence, dependence on others, unwanted

pregnancy, poor decision making and problem

solving, severe fatigue, unpreparedness, lack of time

and energy, repetitive tasks, lack of social support,

stigma, and taking responsibility alone are sources of

stress for teenage mothers (12). Multiple mental

stress can affect the performance and health of the

mother and her family adversely (7).

Role Conflict had appeared in numerous forms in

adolescent mothers. They were wandering between

two worlds. One of these was the conflict between

motherhood and being a student. School rules were in

conflict with the tasks of motherhood that created a

conflict between childcare and meet the expectations

of school. Barmao-Kiptanui et al(2015) stated that

childcare will prevent teenagers from going to school

and sometimes they are forced to drop out of school

(23).Participant of this study also faced with the

conflict between the roles of mothering and

adolescence. They were interested in independence

and self-centeredness but in order to meet the child's

needs they had to rely on others. They, although were

became a mother but tended to take risk and were not

interested in caution. Bah (2016) showed that teenage

mothers experience serious conflicts between

motherhood- image and Self-image (28). Many

teenage mothers do not pay attention to prenatal care

and refer less to health centers. This can cause low

birth weight, iron deficiency anemia and dystocia

(29). High-risk behaviors such as substance abuse

and smoking are higher among adolescents (17).

When teenage mothers are faced with these

challenges, health care providers can help them

through several interventions. Health care providers

can help teenage mothers to planning and

management, requesting help from friends, family

and health team to reduce burden of responsibilities

(30). Health care providers can assess the physical

health of teenage mothers in the prenatal, perinatal

and postpartum; and apply appropriate interventions

to reduce physical health problems (17). In addition

to providing professional care, health care providers

must strengthen the role of the family in the support

of teenage mothers(7). Psychological and economic

support, supportive social environment, providing

opportunities for education, counseling, and spiritual

support are also other supportive approaches that

must be considered by health providers (31). Health

care providers can compensate lack of awareness of

teenage mothers, provide educational and

psychological counseling, identifying and correction

of high-risk behaviors, help them to accept

responsibility of motherhood, and attract social and

familial support to teenage mothers (7, 17). Health

care providers can identify stressors in teenage

mothers and reduce tensions by guidance on adapting

Mangeli et al.

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to new role. Health providers can help teenage

mothers to learn skills of parenting and child care,

and plan for better performance in playing the role of

mothers and other roles concurrently (32).

Limitations: This qualitative study explored the

challenges of teenage mothers in only one province

of Iran. Therefore, the transferability of findings from

this qualitative work should be considered with

caution. A comprehensive research requires the

inclusion of different provinces in geographical status

and cultural and environmental conditions.

Conclusion

This study explored challenges of Iranian teenage

mothers. The results of this study showed that teen

mothers are facing many physical, mental,

psychological and social challenges. Achieving such

results shows that teenage mothers need to the

comprehensive support from healthcare providers.

Health care providers must help teenage mothers

through consultation, education, support,

coordination, prevention, and care interventions.

Further studies are necessary to explore consequences

of early motherhood, and strategies that help teenage

mothers to overcome this challenges. However,

providing health care for teenage mothers can also

result in family and community health.

Conflict of Interests

Authors have no conflict of interests.

Acknowledgments

It's worth mentioning that there are no conflicts to be

disclosed. Authors declare that they have no

competing interests.

All procedures performed in studies involving

human participants were in accordance with the

ethical standards of the institutional and/or national

research committee and with the 1964 Helsinki

declaration and its later amendments or comparable

ethical standards.

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Citation: Mangeli M, Rayyani M, Cheraghi MA, Tirgari B. Exploring the Challenges of Adolescent

Mothers From Their Life Experiences in the

Transition to Motherhood: A Qualitative Study.

J Fam Reprod Health 2017; 11(3): 165-73.

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