Second in a series

Her whole mind-set has to be changed.

Telegram photo / Joel Hodges (ENLARGE)

Jodie Collie, 15, listens to instructor Abby Pridgen during a child-bearing class for pregnant teens Thursday at the Pregnancy Care Center on Sunset Aveune.

The average teenage girl has much on her mind, some of it serious – school, peer pressure – and some of it not – clothes, friends.

But when a she becomes pregnant, she has a new list of issues to face – health care for her and the baby, balancing motherhood and school and finding good childcare – said Doris Stith, executive director of the Community Enrichment Organization in Prince-ville. Helping girls to face that can be a struggle.

"It is ... teaching this young child, this teen mother, this future teen mother, if you want a healthy baby, you are going to have to do this health care, you are going to have to eat healthy," Stith said.

Health care during and after pregnancy and childcare once the baby is born are heavy issues for any pregnant woman to consider, said Bill Albert, chief program officer at the National Campaign to Prevent Teen and Unplanned Pregnancy in Washington. But when those decisions are being made by or for a teen, her maturity and lack of training and education about motherhood can make the task even more daunting.

"In the heat of the moment, when young people are having sex, I am not sure how much they are thinking about, 'Gee, can I get money for health care? Gee, is the federal government going to support me and my baby?'" Albert said.

In 2004, teen childbearing in North Carolina cost taxpayers at least $312 million, including $36 million going to child welfare and $54 million for public health care in programs such as Medicaid and State Children's Health Insurance Program, Albert said.

Medicaid eligibility is determined based on income, state residency and being a U.S. citizen or legal immigrant, said Nikicia Randall, income maintenance supervisor for the Family and Children's Medicaid office at the Edgecombe County Department of Social Services. It is possible to have private health insurance and be eligible for Medicaid as a secondary provider.

For a teen mother who has Medicaid, it offers regular prenatal visits, nutrition counseling and after-birth care, said Karen Ramsey, health education supervisor at Nash County Health Department.

The care for teen mothers is not that much different than for other women.

"They would get monthly checkups. If they have any special issues, any problems arise during their pregnancy, we would see them more often than that. If everything is going well, that is pretty standard care I believe," Ramsey said.

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Things generally have been going well physically for Jodie Collie, 15, during her pregnancy. The prenatal care paid for by Medicaid has been good, she said. She has been attending her doctor's appointments regularly and eating right.

Emotionally, though, she has noticed a big change.

"I am more depressed sometimes and a lot angrier when I get mad. I cry a lot more," said Collie of Elm City.

These are two of the areas that teens are usually deficient in, said Kay Gurganus, executive director of Pregnancy Care Center in Rocky Mount. Teenage mothers tend to have poor eating habits, are less likely to take daily multivitamins and keep up with prenatal appointments.

The center offers free classes to teach pregnant women of all ages the importance of staying healthy, Gurganus said.

"With the day care parenting classes, they will cover nutrition in all stages of pregnancy, what to eat while they are breast feeding, to eat right both during the pregnancy and after the pregnancy and be sure they get plenty of sleep. Then we also offer free childbirth classes for the client and her support person," Gurganus said.

Jodie, who is home-schooled, has taken classes on being an unmarried mother, bonding with her unborn baby and what happens during the second trimester of pregnancy to prepare for the birth of her baby, due on June 10. She is still making plans for the future. After she turns 16 in December, she wants to earn her GED and go to community college.

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But, if a relative can't take care of her baby, she is not sure what she will do for child care.

If relatives cannot watch the baby, a teen mother's choices can sometimes be limited if she cannot afford private child care, said Isham Spann, program manager for Edgecombe County's child care services program. The counties provide assistance to some teen mothers and refer others to organizations such as the Down East Partnership for Children, which has a limited number of child care scholarships.

"When the teen parent does apply for childcare services, they usually apply because they are in school and we want them to stay in school," Spann said.