A qualitative study exploring the experiences of adolescent mothers accessing perinatal services in Rwanda to inform the delivery of trauma- and violence-informed care: a double-edged sword
Bibliographic record
Abstract
INTRODUCTION: Adolescent mothers face several challenges when utilizing perinatal services, which can lead to (re-)traumatization due to their vulnerability, potential trauma histories, and ongoing violence, especially when those services fail to adopt trauma- and violence-informed approaches. PURPOSE: To explore and describe adolescent mothers’ experiences accessing perinatal services in primary healthcare settings in Rwanda to inform the delivery of trauma- and violence-informed care (TVIC). METHODS: This study utilized an interpretive description (ID) methodology and was carried out in eight Rwandan primary health care settings. Purposive sampling was used to recruit 15 adolescent mothers who accessed perinatal services to participate in an in-depth individual interview. Two relevant maternal-child health care guideline documents were also reviewed. Data were thematically analyzed. RESULTS: Two main themes were identified: (a) tailored care, and (b) re-creation of trauma. While some young mothers had positive experiences related to the provision of unconditional support/care, emotional and psychological safety and strength-based practices, the majority encountered challenges and barriers which re-activated trauma, including interpersonal violence and forms of institutional and structural violence. CONCLUSION: Adolescent mothers had mixed experiences accessing and using perinatal services, but these were primarily negative. It is important for perinatal services to accommodate the unique needs and especially the prior and ongoing traumatic experiences of adolescent mothers and to provide supportive and non-judgmental care. This can help ensure that adolescent mothers receive the care and resources needed for a positive pregnancy and childbirth experience. A TVIC approach is outlined to make perinatal services safe, supportive and inclusive.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.006 | 0.004 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".