Vol. 12. No. 4

Spring 2003

Six years ago, Laura Corwell was a pregnant 17-year-old high school student who was not sure where to turn for help. Today, Corwell works in customer service at Franklin Covey and has a six-year-old daughter, Brooque, who receives regular health care—thanks in large part to the Teen Mother and Child Program at the University of Utah School of Medicine.

“I didn’t have insurance, and I didn’t know what to do,” Corwell says. “They talked to me about all my options, set up doctor appointments, and helped me to get more motivated and to graduate so I could get a better job to support me and my daughter.”

Without the encouragement and services she received from the Teen Mother and Child Program, Corwell still might not have her high school diploma. “I was eight months pregnant when I graduated [from Granger High], but I wanted to walk down that line,” Corwell says. “It was something I had wanted to do all my life, and [the program] helped me reach that goal.”

Offering 24-hour on-call medical service and clinics for people like Corwell and her daughter, the program serves about 1,200 pregnant and parenting adolescents and their children.

Although the average age of its participating mothers is 16 1/2, the program has served pregnant girls as young as 12, according to Harriett Gesteland BS’85 MS’88, a pediatric nurse practitioner who has worked with the program for 13 years. Many patients live at or below the poverty level, and half no longer live with their parents. Midwives deliver about 200 babies each year.

Mothers age 18 or younger are referred by many sources, including high school counselors, the Division of Child and Family Services, physicians, the Division of Youth Corrections, Planned Parenthood of Utah, Baby Your Baby, friends, and relatives, and are served until they turn 20. The program cares for children until they turn five—or longer, as in Corwell’s case.

“Brooque has some disabilities, and they know her history, so I haven’t wanted to take her to another pediatrician,” Corwell says. “I’m 24 and Brooque is 6, and I’ve told them, ‘You guys can’t get rid of me’—not that they’ve tried.

“They’re always there for me and my daughter, even now. If I call them up, they’ll answer any questions I have,” she adds. “They’re like my second family. I just love them to death.”

Founded in 1980 by Arthur Elster, the Teen Mother and Child Program is the only multidisciplinary program offering services to pregnant and parenting adolescents and their families in the Intermountain West. The program has been directed by Kathleen McElligott since 1987. She and Mark Pfitzner MPHE’97 train residents in the program and provide on-call service for the adolescents. Midwives from the College of Nursing deliver babies (unless there are complications), social workers offer psychological help and encouragement to finish school, and registered dietician Barbara Eleison provides nutritional counseling. A pediatric nurse practitioner handles acute and postnatal care, and a licensed practical nurse specializes in lactation. The program also has a financial counselor and a secretarial staff.

The Teen Mother and Child Program interfaces with community agencies, including Catholic Community Services, LDS Social Services, and Valley Mental Health. Funding comes from government and private sources, including the Department of Pediatrics at the University Health Sciences Center, the Division of Child and Family Services, and the United Way.

Through generous donations, the program is able to run on an annual budget of about $581,000 with a staff of 12. “We are able to provide medication for the uninsured, thermometers, humidifiers, donated blankets and clothing, scholarship funds, and on-site access to food vouchers provided by Women Infants and Children (WIC),” Gesteland says.

The program’s wide-ranging care is evident—a social worker helps a young woman decide how to tell her family she is pregnant, a nurse explains the significance of an abnormal fetal ultrasound to a 15-year-old in foster care, a baby cries after getting his immunizations, and a nutritionist teaches a 16-year-old the importance of a balanced diet.

Research, including studies conducted by the Teen Mother and Child Program, indicates that adolescent parents who receive services through comprehensive care programs, rather than just medical care, are more likely to be in school or working, receive fewer entitlements through public assistance, achieve a higher child immunization rate, obtain a greater understanding of child development, and lower the risks of child abuse.

“We offer a unique kind of one-stop shopping,” Gesteland says. “With our multifaceted services, we are helping adolescents adjust to their new roles as parents. The rewards are wonderful.” When Brandy Romero got pregnant at age 18, a friend recommended the Teen Mother and Child Program to her. Romero has since recommended it to other friends.

“They got me on WIC and Medicaid, and that was so helpful when I didn’t know who to turn to,” Romero says. “They’re so nice. The nurses tell me to call them all the time when I have questions, and I do.”

Romero, who is now 23, has three boys—twins who are almost five and a baby just a few months old. She works at the day-care center her sons attend.

Back when the program was founded, it helped with 20-30 deliveries a year, Gesteland says. The number is higher now, not because there are more teenage pregnancies, but because the program has grown and is better known. A more centrally located clinic would be convenient for patients, but lack of money, facilities, and staff has prevented that so far. But being at the U has definite advantages. “It’s nice up here,” Gesteland says. “We have any kind of medical assistance on call at all times.”

The program also serves as a clinical teaching site for medical residents, social workers, nutritionists, nurse practitioners, and nursing students. Patients enrolled in the program also are enrolled in research projects exploring such issues as how medical care benefits the youngest mothers.

“[Teen pregnancy] is a complex issue, and there is not a simple solution,” Gesteland says. “But we believe in these young mothers and their potential for success.”

—Anne-Marie Wright is the author of A Bundle of Choices: The Option Overload of LDS Mothers Today and a frequent contributor to Continuum.