Feminist perspectives on occupational (in)justices of adolescent motherhood

Paula Mesa Molina Pía Rodríguez-Garrido Juan Andrés Pino-Morán About the authors

Resumen

Introducción

La maternidad supone un importante desafío ocupacional para las mujeres, situación que se complejiza cuando son adolescentes.

Objetivo

Analizar las trayectorias de mujeres madres adolescentes desde la perspectiva de la Terapia Ocupacional Feminista.

Método

Estudio cualitativo que, a través de entrevistas en profundidad y un análisis temático, analizó seis experiencias de maternidades adolescentes en España.

Resultados

Emergieron tres categorías centrales de análisis que explican parte de las trayectorias ocupacionales. Destacamos dentro de éstas: la “Precarización ocupacional: una vulnerabilidad sexo-genérica”, la cual da cuenta de las condicionantes previas que posibilitan la gestación adolescente; “Una ocupación familiar: maternidad (inter)dependiente”, refleja la organización familiar de los cuidados y la crianza dando cuenta de la relevancia de las figuras femeninas que sostienen esta experiencia; y, finalmente, la categoría “El giro ocupacional: sus repercusiones psicosociales”, que considera el impacto de la maternidad en las proyecciones, tanto a nivel educativo como en su inserción laboral.

Conclusión

Las trayectorias de las mujeres madres adolescentes reflejan un vaivén de emociones y complejidades en sus maternidades asociadas al periodo de vida en el cual la llevan a cabo. Por ello, la emergencia de una Terapia Ocupacional Feminista consciente de las inequidades de género permite interpelar la injusticia ocupacional que enfrentan las mujeres madres adolescentes por una vida más justa y digna.

Palabras-clave:
Maternidad; Adolescencia; Género; Justicia Social; Terapia Ocupacional; Feminismo

Resumo

Introdução:

A maternidade é um importante desafio ocupacional para as mulheres, situação que se torna mais complexa na adolescência.

Objetivo:

Analisar as trajetórias de mães adolescentes na perspectiva da terapia ocupacional feminista.

Método:

Estudo qualitativo que, por meio de entrevistas em profundidade e análise temática, analisou seis experiências de maternidades para adolescentes na Espanha.

Resultados:

emergiram três categorias centrais de análise que explicam parte das trajetórias ocupacionais. Dentre elas, destacamos a “Precariedade ocupacional: uma vulnerabilidade gênero-sexo”, que dá conta das condições anteriores que possibilitam a gravidez na adolescência. A categoria “Uma ocupação familiar: maternidade (inter) dependente” reflete a organização familiar do cuidado e da educação, dando conta da relevância das figuras femininas que sustentam essa experiência. Por fim, a categoria “O turno ocupacional: suas repercussões psicossociais”, considera o impacto da maternidade nas projeções, tanto no nível educacional como na sua inserção laboral.

Conclusão:

As trajetórias de mães adolescentes refletem uma flutuação de emoções e complexidades em suas maternidades associadas ao período da vida em que a realizam. Por isso, o surgimento de uma terapia ocupacional feminista atenta às desigualdades de gênero nos permite desafiar as injustiças ocupacionais enfrentadas pelas mães adolescentes na luta por uma vida mais justa e digna.

Palavras-chave:
Maternidade; Adolescência; Gênero; Justiça Social; Terapia Ocupacional; Feminismo

Abstract

Introduction

Motherhood is an important occupational challenge for women, a situation that becomes more complex when they are adolescents.

Objective

To analyze the trajectories of adolescent mothers from the perspective of Feminist Occupational Therapy.

Method

Qualitative study that, through in-depth interviews and thematic analysis, analyzed six adolescent maternal experiences in Spain.

Results

Three central categories of analysis emerged that explain part of the occupational trajectories. We highlight within them, the “Occupational precariousness: a gender-sex vulnerability”, which accounts for the previous conditions that make adolescent pregnancy possible. The category “A family occupation: (inter) dependent motherhood” reflects the family organization of care and upbringing, giving an account of the relevance of the female figures who support this experience. Finally, the category “The occupational shift: its psychosocial repercussions”, considers the impact of motherhood in the projections, both at the educational level and in its labor insertion.

Conclusion

The trajectories of adolescent mothers reflect a fluctuation of emotions and complexities in their maternity wards associated with the period of life in which they carry it out. Therefore, the emergence of a Feminist Occupational Therapy aware of gender inequalities allows us to challenge the occupational injustice faced by adolescent mothers for a more just and dignified life.

Keywords:
Maternity; Adolescence; Gender; Social Justice; Occupational Therapy; Feminism

Introduction

Adolescence is a complex period of transition between childhood and adulthood. It involves physical, social, sexual, cognitive, and emotional changes that can cause identity conflicts during its development (Allen & Waterman, 2019Allen, B., & Waterman, H. (2019). Etapas de la adolescencia. American Academy of Pediatrics. Recuperado el 8 de octubre de 2020, de https://www.healthychildren.org/Spanish/ages-stages/teen/Paginas/Stages-of-Adolescence.aspx
https://www.healthychildren.org/Spanish/...
). In this sense, adolescence supposes a process of gendering (Freixas Farré, 1995Freixas Farré, A. F. (1995). La adquisición del género: el lugar de la educación en el desarrollo de la identidad sexual. Apuntes de Psicología, 30(1), 155-164.), which, according to Timoneda (2005Timoneda, A. B. (2005). Adolescencia femenina y riesgo social: una relación invisible. Educación Social, (29), 63-78., p. 66) implies “[...] the psychological, social and cultural construction of the characteristics considered feminine or masculine that are attributed to the members of each gender”. At this stage, adolescents undertake entire experimentation and search for what their personal and social identity will be, which is why it is the moment when they perceive themselves as their unit and different from other people (Arias et al., 2011Arias, E., Puntí, J., Torralbas, J., Naranjo, M. C., & Palomino, J. (2011). Terapia ocupacional en adolescentes con retraimiento social: análisis de las áreas de desempeño ocupacional. TOG (A Coruña), 8(13), 1-15.). However, this context is sometimes altered in circumstances such as unplanned motherhood.

Motherhood in adolescent women is a situation that has been present in all societies and different geographical contexts. However, and despite this, it was not addressed as a public health issue, so no type of intervention was carried out to identify its conditioning factors and psychosocial implications (Hernández & Gentile, 2018Hernández, A., & Gentile, A. (2018). Nota de investigación: narrativas y representaciones de la maternidad en edad adolescente. Inguruak Revista Vasca de Sociología y Ciencia Política, 64, 111-122.). Recently, starting in the sixties, the States became aware of this social reality, generating policies that aimed to statistically reduce the social gap that this generates (Hoffman, 1998Hoffman, S. (1998). Teenage childbearing is not so bad after all... or is it? A review of the new literature. Family Planning Perspectives, 30(5), 236-243.). The concern about carrying out motherhood in this period is associated with the presence of biopsychosocial risks (García-Odio & González, 2018García-Odio, A., & González, M. (2018). Factores de riesgo asociados a embarazadas adolescentes en un área de salud. Revista Ciencia Médica, 22(3), 416-427.; Loredo-Abdalá et al., 2017Loredo-Abdalá, A., Vargas-Campuzano, E., Casas-Muñóz, A., González-Corona, J., & Gutiérrez-Leyva, C. (2017). Embarazo adolescente: sus causas y repercusiones en la diada. Revista Medica del Instituto Mexicano del Seguro Social, 55(2), 223-229.) that affect the health of women at the time of pregnancy, puerperium, and upbringing. These consequences occur mainly due to the physical, physiological, and psycho-emotional immaturity typical of the life cycle that the adolescent lives (Daguerre & Nativel, 2006Daguerre, A., & Nativel, C. (2006). When children become parents: welfare state responses to teenage pregnancy. Bristol: Policy Press.).

From an epidemiological perspective, Spain has an adolescent pregnancy rate of 9 cases per thousand pregnancies (The Save the Children Fund, 2016The Save the Children Fund – SCF. (2016). Every last girl: Free to live, free to learn, free from harm. Londres: The Save the Children Fund.). According to statistics from the World Health Organization (WHO), the trend of pregnancies in adolescent women has been decreasing since 1990. However, 11% of births worldwide are produced by adolescent women between 15 and 19 years old (Organización Mundial de la Salud, 2018Organización Mundial de la Salud – OMS. (2018). El embarazo en la adolescencia. Recuperado el 8 de octubre de 2020, de https://www.who.int/es/news-room/fact-sheets/detail/adolescent-pregnancy.
https://www.who.int/es/news-room/fact-sh...
). Likewise, the entity reveals that there is a prevalence of adolescents who, due to being women mothers early, present psychosocial consequences that directly affect their development (Organización Mundial de la Salud, 2018Organización Mundial de la Salud – OMS. (2018). El embarazo en la adolescencia. Recuperado el 8 de octubre de 2020, de https://www.who.int/es/news-room/fact-sheets/detail/adolescent-pregnancy.
https://www.who.int/es/news-room/fact-sh...
). The causes are associated with the little or no affective, sexual, and reproductive education they receive in school spaces and inside their homes (Ganji et al., 2018Ganji, J., Emamian, M. H., Maasoumi, R., Keramat, A., & Merghati-Khoei, E. (2018). Qualitative needs assessment: iranian parents’ perspectives in sexuality education of their children. Journal of Nursing Midwifery Science, 5(4), 140-146.).

Motherhood and Adolescence: An Approach from Feminist Occupational Therapy

Motherhood is one of the areas that generate the most debate and questioning in feminist movements today (Calquín-Donoso & Yáñez-Urbina, 2020Calquín-Donoso, C., & Yáñez-Urbina, C. (2020). Metáforas de la maternidad en un sistema de atención sanitaria de la infancia en Chile: entre la naturaleza y el capital humano. Musas, 5(2), 44-59. http://dx.doi.org/10.1344/musas2020.vol5.num2.3.
http://dx.doi.org/10.1344/musas2020.vol5...
; Sibrian-Díaz, 2021Sibrian-Díaz, N. (2021). Ética del cuidado gestante: entre lógicas tradicionales y nuevas formas de organización en un contexto chileno. Reflexiones, 100(1), 1-21. http://dx.doi.org/10.15517/rr.v100i1.41941.
http://dx.doi.org/10.15517/rr.v100i1.419...
; Vivas, 2019Vivas, E. (2019). Mamá desobediente: una mirada feminista a la maternidad. Barcelona: Capitán Swing.). Their concern reveals the precarious conditions in which women's sexual and reproductive health is addressed, by an entire institutionality that accounts for a particular form of exercise in a biopolitical key (Foucault, 2009Foucault, M. (2009). Defender la sociedad. Buenos Aires: Fondo de Cultura Económica.).

From the different analytical paths that the movement vindicated –and continues to vindicate–, motherhood has been one of the fundamental trenches to energetically challenge the mandate exercised towards women by the heterosexual thought reflected in the hetero norm (Wittig, 1992Wittig, M. (1992). El pensamiento heterosexual y otros ensayos. Barcelona: Egales.). In that sense, human reproduction is an occupational, cultural, and political milestone, which has historically been produced as a form of naturalized exploitation for women in capitalist societies. Authors such as Hannah Arendt and more recently Silvia Federici, have been emphatic in pointing out that “[...] the entire sphere of central activities for the reproduction of life, domestic work, sexuality and procreation [...]” (Federici, 2018Federici, S. (2018). El patriarcado del salario. Críticas feministas al marxismo. Madrid: Traficantes de Sueños., p. 13) have been historically attributed to the human woman condition. In greater detail, Arendt points out that the tasks inherent to women are their own they have been socialized as “[...] activity corresponding to the biological process of the human body [...]” (Arendt, 1958Arendt, H. (1958). La condición humana. Buenos Aires: Paidós., p. 21).

The above is the reflection of a society that violates and makes motherhood invisible. This scenario generates in the corporeities of women a complete restructuring of care in all aspects of their daily lives (Gilligan, 2013Gilligan, C. (2013). Ética del cuidado. Barcelona: Cuadernos de la Fundación Victor Grifols i Lucas.). In this sense, we place emphasis on maternity wards that have seen their exercise intersected, insofar as the power relations that make them precarious are articulated as muddy networks preventing them from carrying out their occupations with dignity, that is, carrying out maternity wards that contemplate the support of the community, institutions, public policies, and an entire environment.

The aforementioned implies visualizing the complex axes that run through adolescent motherhood. Thus, age, gender, motherhood, physical and psychological immaturity, socioeconomic condition, and school are some of the issues of great interference in the free exercise of motherhood.

Vélez & Figueredo (2015)Vélez, E., & Figueredo, E. (2015). Impacto psicosocial del embarazo en las adolescentes. Revista Educación en Valores, 1(23), 18-28. exemplify this situation through the sudden transition from adolescence to adulthood that young women experience. This change is considered complex, since it can considerably affect their occupational balance, limiting and impairing their quality of life.

In this sense, Feminist Occupational Therapy (Grandón, 2019Grandón, D. (2019). Función económica de las ocupaciones feminizadas no remuneradas: una crítica desde la economía feminista. Revista Ocupación Humana, 18(2), 54-67. http://dx.doi.org/10.25214/25907816.228.
http://dx.doi.org/10.25214/25907816.228...
; Morrison & Araya, 2018Morrison, R., & Araya, L. (2018). Feminismo(s) y terapia ocupacional: preguntas y reflexiones. Revista Argentina de Terapia Ocupacional, 4(2), 60-72.; Sanz, 2012Sanz, S. (2012). Reflexiones y aprendizajes en torno a la rehabilitación basada en la comunidad. TOG (A Coruña), 9(5), 206-325.; Vidal et al., 2017Vidal, M. I., López, E., & Royo, N. (2017). Visibilizando los cuidados desde una perspectiva feminista en terapia ocupacional. Revista Terapia Ocupacional Galicia, 15(27), 185-190.) is an emancipatory perspective to problematize and break with stigmatizing gender and ageist stereotypes since it considers that the tensions experienced by adolescent mothers derive –among other issues– from the gender and power inequalities that exist in hetero-patriarchal society, as well as the role assigned to women as the main caregiver, with total co-responsibility being almost non-existent in dedication to gestation and upbringing. In this way, occupational alienation is revealed (Moruno & Fernández, 2012Moruno, P., & Fernández, P. (2012). Análisis teórico de los conceptos privación, alienación y justicia ocupacional. TOG (A Coruña), 9(5), 44-325.) generated by a sexist and patriarchal model. On the contrary, the emergence of Feminist Occupational Therapy as an epistemological perspective provides us with inputs to rethink and orient policies that have the purpose of preventing situations of occupational injustice that affect the different areas of occupational performance. In this case, the female adolescent mothers.

In this sense, we follow the proposal to achieve occupational justice, understood as “[...] the recognition and attention to the occupational needs of individuals and communities as part of a just and empowered society [...]” (Wilcock & Townsend, 2000Wilcock, A., & Townsend, E. (2000). Occupational terminology interactive dialogue. Journal of Occupational Science, 7(2), 84-86. http://dx.doi.org/10.1080/14427591.2000.9686470.
http://dx.doi.org/10.1080/14427591.2000....
, p. 84) to achieve an ethical and fair horizon of occupational transformation (Hocking, 2020Hocking, C. (2020). La justicia ocupacional como justicia social: la demanda moral de la inclusión. Journal of Occupational Science, 24(1), 29-42. http://dx.doi.org/10.1080/14427591.2017.1294016.
http://dx.doi.org/10.1080/14427591.2017....
).

Thus, this research aimed to analyze the trajectories of female adolescent mothers from the perspective of Feminist Occupational Therapy.

Methodology

Study design

This study is framed in a qualitative methodology since it seeks to deepen the representations and meanings of adolescent mothers, as their experiences and stories generate a situated and comprehensive approach to the study phenomenon (Valles, 2002Valles, M. (2002). Entrevistas cualitativas. Madrid: Centro de Investigaciones Sociales). This approach was chosen since it allowed us to get closer to the reality that adolescent mothers live through their occupational careers. We also explore and identify the information collected from a feminist (Sanz, 2012Sanz, S. (2012). Reflexiones y aprendizajes en torno a la rehabilitación basada en la comunidad. TOG (A Coruña), 9(5), 206-325.) and critical (Guajardo, 2012Guajardo, A. (2012). Enfoque y praxis en Terapia Ocupacional. Reflexiones desde una perspectiva de la Terapia Ocupacional critica. TOG (A Coruña), 9(5), 18-29.) occupational position, while occupational problems and needs were considered as possible psychosocial risk factors that conditioned and influenced development vital of adolescent women and in their role as mothers expressed in their occupational careers. The constant exercise of attending to the narratives based on substantial premises such as power relationships, gender inequalities, social representations of adolescent motherhood, and socioeconomic inequality, to name a few, were instances that allowed us to approach reality and its analysis, from a reflective and critical position when interpreting the information obtained.

Study context

This is a study developed in the city of Terrassa (Barcelona), whose capital occupies 2nd place in the ranking of the most populated communities in Spain (Cano, 2019Cano, L. (2019). Así han evolucionado las ciudades españolas: grandes capitales venidas a menos y otras en expansión. Recuperado el 8 de octubre de 2020, de https://www.abc.es/sociedad/abci-evolucionado-ciudades-espanolas-grandes-capitales-venidas-menos-y-otras-expansion-201903270343_noticia.html
https://www.abc.es/sociedad/abci-evoluci...
). However, statistics show a relevant decrease in pregnancy rates in adolescent women in recent years (Espanha, 2020Espanha. (2020). Interrupción Voluntaria del Embarazo. Datos definitivos correspondientes al año 2018. Madrid: Ministerio de Sanidad.).

Approach to the participants

Due to the impossibility of accessing the group through diagnosis and intervention in an adolescent care center, women who had been adolescent mothers and who wanted to share their experience were contacted through social networks, inviting women who had been adolescent mothers to participate in the study. We used the snowball sampling method (Martín-Crespo & Salamanca, 2007Martín-Crespo, M., & Salamanca, A. (2007). El muestreo en la investigación cualitativa. Nure Investigación,27, 1-4.) in which the women proposed and facilitated the participation of other known women who had experienced the same or similar situation.

Selection criteria for the participants

The main selection criterion considered the experiences of women who had been adolescent mothers between the ages of 14 and 19, who spoke Spanish, and who were capable of making decisions independently, that is, who did not present cognitive difficulties at the time of the interview.

The sample finally consisted of six women residing in Terrassa (Barcelona) from different countries and cities (Table 1).

Table 1
Characteristics of the study participants.

Information collection technique

The technique used consisted of conducting in-depth interviews (Robles, 2011Robles, B. (2011). La entrevista en profundidad: una técnica útil dentro del campo antropofísico. Cuicuilco, 18(52), 39-49.) whose objective was based on exploring and knowing those aspects of the occupational history of women who were mothers during their adolescence, along with the social and daily scenarios that surrounded them.

The interviews were administered only in an online format gradually, that is, in different instances for each interviewee (Table 2). To avoid the mental and emotional overload that virtuality implies, for the same reason that they were proposed to respond through the audio format, to consider the emotional character that narrating certain moments and fundamental life experiences implied in the development of their adolescent maternity wards and that could be perceived through the audios.

Table 2
Online interview sessions.

This material was consigned as a field note by the authors and later included in the information analysis.

Ethical considerations

After contacting the participants, an informative process was carried out in which they were explained about the criteria involved in participating autonomously and legally in the research. In this sense, and to use the information obtained, the informed consent was signed by the participants. This procedure was carried out virtually, due to the complexity regarding their physical access and their limited availability of time.

The management of information and the approach to the participants was always kept under the minimum ethical standards required in qualitative research that interacts and dialogues with people. In this way, the privacy, integrity, and anonymity of the interviewees were protected at all times during their participation in the study.

Methodological rigor

Throughout the research process and for the preparation of the final manuscript, we used the qualitative research guide “Standards for Reporting Qualitative Research” (O’Brien et al., 2014O’Brien, B. C., Harris, I. B., Beckman, T. J., Reed, D. A., & Cook, D. A. (2014). Standards for reporting qualitative research: a synthesis of recommendations. Academic Medicine, 89(9), 1245-1251. http://dx.doi.org/10.1097/ACM.0000000000000388.
http://dx.doi.org/10.1097/ACM.0000000000...
).

Data analysis

For the analysis of the information obtained in the interviews and the considerations of the field notes, we carried out a qualitative thematic analysis of the information.

In the first instance, an in-depth reading of the transcripts of the collected material was carried out and then began its process of open coding and categorization (Corbin & Strauss, 2008Corbin, J., & Strauss, A. (2008). Basics of qualitative research: Techniques and procedures for developing grounded theory. Thousand Oaks: Sage Publications.).

Subsequently, we used the constant comparison method for the interpretation and analysis of the information (Dye et al., 2000Dye, F., Schatz, I., Rosenberg, B., & Coleman, S. (2000). Constant comparison method: a kaleidoscope of data. Qualitative Report, 4(1), 1-10.). It consists of carrying out an analysis in which the coding of the categories that arise from the collection of information is combined with a simultaneous comparison of all the codes that are identified. We also compare the different categories, the process of which allowed discovering the relationships between the different phenomena that were observed, as well as knowing the reality of the problem that arose from the viewpoint of Feminist Occupational Therapy (Sanz, 2012Sanz, S. (2012). Reflexiones y aprendizajes en torno a la rehabilitación basada en la comunidad. TOG (A Coruña), 9(5), 206-325.).

Results

We present the results graphically and descriptively according to the different categories considered relevant in the selection of the information (Figure 1).

Figure 1
Categories and subcategories analysis. Figure elaborated by the authors.

Occupational precariousness: a gender-sex vulnerability

When we analyze personal situations before adolescent pregnancy, we identify several factors that, from the authors' point of view, can be considered as triggers of motherhood at this stage. According to the information collected through the experiences of the women interviewed, the existence of the following structural situations is revealed: absence of a stable family, emotional emptiness after the death of a relative, and defiant or rebellious adolescence due to social and/or economic problems. However, we observed that the aforementioned situations are experienced in a particular way when one is an adolescent woman since it shows in all its magnitude the gender-gender vulnerability of the occupations and her trajectories.

Unplanned pregnancy: mixed emotions

The information collected shows that none of the experiences analyzed was a planned pregnancy. However, all the participants continued their pregnancies. In that sense, when asked about their initial reaction to the knowledge of the pregnancy, most agree that they felt happiness and enthusiasm for the news, recognizing at the same time, the lack of maturity and awareness they had about motherhood. This is how these participants point out:

Well look, when I found out that I was pregnant with the first one, I reacted well, I felt happy… But of course, I was 16 years old and I didn't know anything about life and I was in love and then I said… oh so good! When I was 16 years old, I thought that I could eat the world and that I was already grown up and could do whatever I wanted and not… (D, 2020).

No, it was not planned, but when I found out about his arrival… I never thought of aborting him or giving him up for adoption. Since I found out I was pregnant I gave her a lot of love and to date, I always say that it is the best thing that has happened to me! (MI, 2020).

These experiences reflect some of the emotions that pregnancy can generate, considering the diversity of this process and the particularity of each case, even without considering the transformations that will develop in motherhood or subsequent care. The emotions reflected by the participants imply, on the one hand, the happiness they felt upon receiving the news of their pregnancy, and on the other hand, the difficulty that they understood in the face of not planning and at the age at which it was happening.

Neglecting the body: embodied emotions of conception

The dominant representation of motherhood generates an illusion linked to femininity mandates as a culmination of a natural process for women. However, in adolescents’ contradictions are generated as a result of the material and symbolic conditions of their life cycle, in which fear and joy take over their subjectivities, generating a sway of emotions and meanings. In this sense, the interviewees reported feeling dissatisfied with the change in routine, as well as dissatisfaction in the performance of the self-care area to which they attached great importance. They expressed significant abandonment in personal care during parenting, accompanied by an unfavorable self-perception of body image. This is how this participant describes it:

In self-care when I was pregnant and when I gave birth it was bad because I did not take care of myself, that is, I already ... I did not care as if I went out with a bow ... I did not care ... The neglect of self-care because that was it, not getting ready, not buying things for myself, eating whatever... it was more or less like that. In addition, for example, I did not rest, I did not rest, I rested very little for the child… (D, 2020).

In these cases, most of the women interviewed when they reported going through these difficult times, recognized the important work that their family and environment did in the care and support. In this way, family support becomes essential through favoring spaces and self-care activities that allow adolescent mothers to carry out the activities of daily life that they carried out before their pregnancy.

A family occupation: (inter) dependent motherhood

Motherhood in adolescence and Western culture, particularly, supposes a position of dependence that involves the entire family nucleus who must accompany the care and upbringing of the newborn (Ibarra, 2003Ibarra, L. (2003). Adolescencia y maternidad: impacto psicológico en la mujer. Revista Cubana de Psicología, 20(1), 43-47.). In the case of the group studied, we observed that it is preferably the grandmother –maternal– who occupies a central place in the organization of family care. This situation provides containment and support to women during the gestation and upbringing process.

The chain of maternal care: reproduction of the intimate family sphere

Both the maturity in development typical of the adolescent stage and the socio-structural conditions are determining factors that hinder carrying out the free and responsible exercise of motherhood. This is why the interviewees point out as fundamental the presence of family members who accompany and support the care of their children, as well as some of them highlight their direct involvement in the economy during parenting, while others highlight as necessary the help of family members to enable their development and work participation. This is how this participant describes it:

When I got pregnant, my grandmother helped me, well my grandmother was always there for everything, whether she could or not always, she was there encouraging me (N, 2020).

In the same way, they refer to the essential financial support that the family environment provided them. As the following participant points out:

My mother, my sister… my husband's family, like any pregnant woman… helped me in the sense that they listened to me or the doubts I had, they clarified them… In the economic sense, my father helped me a lot um… and my husband is the same (D, 2020).

With these experiences, it is possible to appreciate the family genderization of care, how it passes through preferably female supports, and how male figures occupy the function of economic provision, consolidating gender roles and their occupations.

In most cases –initially–, there was an annoying and disappointing reaction from the close family environment of the adolescent woman to the state of pregnancy, as well as negative speculations about the thoughts of others due to stigma and prejudice of the society. According to the narratives, the existence of conflicts before pregnancy is observed. One of the participants refers:

In part my family, my whole family talked about me that I was so small and pregnant and that what was I going to do with my life! … And if I was going to continue studying… and things like that, then it was more difficult in that aspect because they were never aware of me (MA, 2020).

With this, we can appreciate the relevance of the family and community social networks in the support in adolescent maternity wards, especially and with special emphasis, when the support and presence of the father figure are not available.

The co-responsibility of care: the absence of the father figure

The women interviewed fully agree on the absence of co-responsibility of the father figure in the care of the newborn at the time of assuming upbringing: separation and/or abandonment by the partner, absence of support from the biological father of the newborn, sexist ideology, and behavior influencing the participation of the couple in the care, total responsibility by the adolescent woman in the upbringing of her child, immaturity and fear by the biological father after the situation and avoidance of the acquisition of the new role as a parent. These are some of the scenarios that the interviewees report having experienced, particularly, as expressed by these participants:

The father was not responsible because he only brought her food and things and that's it, but I only took care of her, I took her shower, changed her and gave her everything ... but the father did not, whoa, the father is very macho, he said that it was the woman who had to take care of the children and that is what happened to me (N, 2020).

My son's father helped me until a year, 3-4 months so Ian's responsibility was more for me than for him because my son lived here with me and his father would see him on Saturdays or Sundays, so I was the one who if he was bad I battled at night and things like that... He helped me financially and gave me when he could, not always. So yeah… the responsibility was always on me. And yes, I think that if there is a lot of difference in my case, that the parents are separated (MI, 2020).

The stories of the interviewees not only denote the precariousness in terms of care and affective, economic, and social responsibilities towards their children but also reveals the cruel normalization by them when assuming that the responsibility that the figure must adopt paternal, in this case, is reflected in the “help” or “collaboration” that this provides at home or in care. The normalization of this type of help by the father figure is one of the reasons why feminist movements direct their struggle towards the demand for an ethic of care, emotional responsibilities, as well as the appreciation of motherhood. Also, a struggle is sustained in the debate on the reproductive/productive, as well as on the public/private and the general conditions that result from these issues and that for years has relegated the role of women to undervalued spaces of care by society (Amoroso et al., 2003Amoroso, M., Bosch, A., Carrasco, C., Fernández, H., & Moreno, N. (2003). Malabaristas de la vida: mujeres, tiempos y trabajos. Barcelona: Icaria Editorial. Grupo “Dones i Treballs” de Ca la Dona, Barcelona.).

The occupational shift: its psychosocial repercussions

Parenting shows an occupational impact on the routine and occupational performance of the interviewees, which entails an important change compared to the daily routine they maintained before the birth of their children. Most of the informants agree and refer that this was a typical routine of adolescence with a favorable balance between productivity (studies), significant leisure and free time activities, together with their varied relationships and social ties. From the birth of their children, the women report that their routine focused on parenting, productivity, and housework, as well as presenting endless routines and establishing schedules according to the demands of their children. For this reason, a relevant absence of significant occupations is observed daily, which causes an occupational imbalance. On the other hand, they highlight the loss of the role as an adolescent to occupy the new role of mother.

Occupational deprivation: socio-community relationships in crisis

It is relevant to present the information obtained about the social relationships of the group during parenting since the following problems have been identified in most of the interviewees: loss or absence of friends and limitation of participation in significant occupations related to life social, great importance, and low satisfaction in terms of social relationships during upbringing, presence of support from friends during pregnancy - which is lost after the birth and upbringing of the infant -, experience of stigma and negative criticism from family members and external persons towards the adolescent woman due to her motherhood. This is how the following participant relates it:

When I gave birth and was 16-17 years old, in social life, the people I was dating and going out and everything, because no one ever wrote to me again ... (D, 2020).

There are few cases in which the participants declare that they have support from friends. Regarding the occupational environment during parenting, women confess to presenting a sense of loss of adolescence due to their limitation in participating in meaningful activities and social interactions, at the same time that they express feeling sadness and longing for abandoning the routine before the birth of their child. In the narratives, they point out that they cannot afford to spend time with their leisure and meaningful activities daily. As this participant points out:

In other words, I kept thinking about wanting to continue having the life of before, but ... but no, when I realized that I would not be able to have it well ... I felt very sad (D, 2020).

The information collected shows that it is not frequent for the group to receive professional care after the birth of their children. Therefore, they report a lack of psychological support and they said that the health care received has been only from the professional pediatrician who assists for the development of the infant.

I would have wanted support from another professional, more than a socio-sanitary emm… a psychological one because I was left with postpartum depression and all that I think I got over it alone because I didn't… I mean, I had it very much for me and that's it. But no, I didn't have any help (D, 2020)

The participants report the need to receive psychological care, especially in the postpartum period, since it is socially recognized that the ideal professional to provide biopsychosocial support at those times are the psi professionals with a view to their knowledge of pathologies such as postpartum depression. However, the contribution that Occupational Therapists professionals can make in this period is unknown.

Educational interruption: an occupational conditioner of the future

In the same way, as in work activity, we observed the need and the dependence of the women on resources and/or family support as caregivers. The participants reported needing such support during study hours to combine parenting and encourage their participation in the educational process. This is how these participants mention it:

I had my first daughter when I was 16 years old, at that time I was studying and working. And the second I had it with 18 and she was no longer studying, she was working because she had a responsibility that she was the girl (G, 2020).

My level of studies, well… (laughs) A IPQP [Initial Professional Qualification Program], and then well, that's just an IPQP and I want to take it up again, but I'm good at that while I work because I'm studying online administration to be able to be with my daughter too (MA, 2020).

With these experiences, we could identify their needs regarding the support of other people for the care of their children when combining parenting and their studies and/or work life. We observed that most women have relied on the help of their close relatives more frequently from their parents. However, despite having family support, problems are identified to be able to develop favorably in the educational and/or work environment. This is due to the scarce resources and support they have to be able to leave the infant during the hours they dedicate to productivity since they require a flexible schedule and/or an adaptation of the study or employment method to avoid overload by the family caregiver, comply with the assistance, as well as cover the basic needs of the infant and invest the desired time with it.

Employment: the mandatory demand for (re) production and productivity

The situations and problems that are identified in the area of ​​productivity correspond to the difficulty in obtaining employment with flexible hours and compatible with parenting, unstable and changing work-life, and cases in which women are in a situation of inactivity or part-time work. Women attach great importance to employment to develop independently both personally and economically. However, the narratives of the women interviewed show an economic dependence –initially– on their parents to cover both their basic needs and of their children. Some of the women interviewed report having lacked work assistance for reasons of caring for their children, due to incompatibility and/or lack of resources and support. In this sense, they claim to justify this absence for personal reasons, hiding the reality out of fear and insecurity of being fired because of the responsibilities that the role of mother entails. The following participant described it with an example:

I learned not to say… that is, not to make excuses for my children because I knew I was going to create a problem in my work and by creating it for me… I create them. Because of course, imagine… if they kick me out of work, I don't have a way to support them, so it was because it had to be done like that (D, 2020).

The extensive and exhausting life routines that the interviewed women lead cannot but affect their performance and occupational balance. As the following participant pointed out:

Now my routine is to get up at 6:30, make food for my husband to take to work, wake up the children at 7:30 to have a shower, I put on clothes, have breakfast, take them to school… After 9 o'clock, I go to work for a few hours that I have to leave because cleaning hours are coming out (D, 2020).

It is impressive that, despite the intense struggles and demands by feminist movements and various social groups that demand a dignified and just life, women have to “decide” whether to raise, develop professionally, or bond emotionally since all these variables together end up causing the observable phenomenon of the “double presence” (Estevan-Reina et al., 2014Estevan-Reina, L., Rodríguez-Sánchez, R. M., Romero-González, B., Rodríguez-López, A., & Romo-Sola, M. (2014). Doble presencia: un riesgo psicosocial que evidencia la desigualdad entre hombres y mujeres en la conciliación de la vida familiar y laboral. Reidocrea, 3(22), 172-179. http://dx.doi.org/10.30827/Digibug.32323.
http://dx.doi.org/10.30827/Digibug.32323...
), as the total responsibility that falls on women as a result of the need to respond and dedicate to work, family and care, being forced to sacrifice participation in significant activities in different areas (Amoroso et al., 2003Amoroso, M., Bosch, A., Carrasco, C., Fernández, H., & Moreno, N. (2003). Malabaristas de la vida: mujeres, tiempos y trabajos. Barcelona: Icaria Editorial. Grupo “Dones i Treballs” de Ca la Dona, Barcelona.).

This occupational imbalance highlights the need to strengthen Feminist Occupational Therapy, which deepens its interventions and research from a situated, political, and gender perspective. This enables to promote balanced participation in meaningful occupations challenging the hetero norm pattern, reducing and/or eliminating the occupational injustices.

Discussion

The occupational trajectories of adolescent mothers show a particular structural position in which their life experiences circulate ratifying the factors that precarious their gestation and upbringing processes. In this sense, the findings indicated in “Occupational precariousness: a gender-sex vulnerability” express the importance of socio-cultural variables and how they affect the development of motherhood for women. Thus, internal characteristics are mentioned such as the complex life period in which motherhood develops, and external characteristics linked to the absence of a stable family nucleus that accompanies the gestation and upbringing process, mainly associated with the paternal figure or biological father of the newborn, but not the role that the adolescent's grandmother or mother occupied –in most cases–. Authors such as Henríquez-Valencia (2016)Henríquez-Valencia, G. (2016). Madres adolescentes: significados y experiencias: una mujer debe poder decir sin sentirse culpable ¿Quién soy y qué quiero de la vida? (Tesis de pregrado). Universidad de Sevilla, España. point out that, along with the aforementioned characteristics, socioeconomic capital is added as a conditioning factor that exacerbates risk factors and therefore makes it more complex to carry out motherhood, especially if the socioeconomic level of the pregnant woman is medium-low or short.

This situation becomes more complicated even when it is an “unplanned pregnancy: conflicting emotions” since there are rare cases of adolescent women who wish to plan a pregnancy in this period of life. However, in extreme poverty scenarios, it becomes distracting from reality to give meaning to their lives in the face of an adverse environment (García, 2014García, G. (2014). Embarazo adolescente y pobreza, una relación compleja. Revista de Ciencias Sociales y Humanidades, 35(77), 13-53. http://dx.doi.org/10.28928/ri/772014/atc1/garciahernandeze.
http://dx.doi.org/10.28928/ri/772014/atc...
). However, in this study, the interviewees report not having planned their pregnancies, despite being excited about the news. In this sense, Rojas & Méndez (2016)Rojas, M., & Méndez, R. (2016). El embarazo en adolescentes: una lectura social en clave cuantitativa. Revista de la Universidad Industrial de Santander : Salud, 48(1), 81-90. point out that the immaturity typical of adolescence sometimes does not allow to elucidate the complex panorama they will face. Therefore, it makes them feel positive emotions about their pregnancy without dimensioning other variables. In agreement, the interviewees report having experienced a sudden maturity with the news of the pregnancy, a situation expressed in the subcategory “Neglect of the body: embodied emotions of conception.” The sudden maturity that they indicate translates into the socio-cultural role learned by women and that links them directly with motherhood. On this, Chodorow (1984)Chodorow, N. (1984). El ejercicio de la maternidad. Psicoanálisis y sociología de la maternidad y paternidad en la crianza de los hijos. Barcelona: Gedisa. identifies that woman become mothers as they are socialized as such from childhood onwards of family interactions throughout their development. In this way, for the family environment, motherhood is a dimension instilled indirectly from childhood in adolescent girls. In this sense, the category “Family occupation: (inter) dependent motherhood” is understood as the plot that articulates the socialization of motherhood in the family environment and the support given to the adolescent mother, although sometimes the latter does not happen due to circumstances of estrangement and/or family breakdown, as pointed out by Diniz et al. (2012)Diniz, E., Garcia-Dias, A. C., Neiva-Silva, L., Nieto, C. J., & Koller, S. H. (2012). Características familiares y apoyo percibido entre adolescentes brasileños con y sin experiencia de embarazo. Avances en Psicología Latinoamericana, 30(1), 65-80..

In this sense, the support of the family environment is reflected in the figure of the adolescent's mother, a situation expressed in the subcategory “The chain of maternal care: reproduction of the intimate family sphere”. The findings of this study identify ambiguous feelings from the mother towards the adolescent that go from annoyance and anger due to the pregnancy, to support and containment.

Gilligan (2013)Gilligan, C. (2013). Ética del cuidado. Barcelona: Cuadernos de la Fundación Victor Grifols i Lucas. points out that care work has historically been gendered. The author attributes to this situation that the tasks related to the reproductive and female visualization implied that this understanding was internalized with greater force, this would explain, in part, the reason why the mothers of adolescents would tend to take charge of their grandchildren as if they were their children and not the parents of pregnant adolescents, a situation that would become more enjoyable if the figure of the adolescent's father or companion were more active.

In the subcategory “Co-responsibility for care: the absence of the father figure” we revealed irresponsibility by the biological father in emotional, economic, and care matters. Female adolescent mothers have to deal with pregnancy and upbringing precariously and sometimes with the null intervention of the father figure of their children. This event occurs not only in adolescent maternity wards. As Federici (2018)Federici, S. (2018). El patriarcado del salario. Críticas feministas al marxismo. Madrid: Traficantes de Sueños. explains, the patriarchal culture has normalized that reproductive, domestic, and care work be provided by women. Therefore, for society, it does not represent an “abnormality” that the father figure evades his responsibilities or symbolically “aborts” to the child once it is born.

The foregoing shows a significant burden for adolescent mothers, their activities of daily life are affected, as expressed in the category “The occupational shift: its psychosocial repercussions.” Casanueva (2017)Casanueva, N. (2017). Adaptación psicosocial al embarazo en la adolescencia: un programa de intervención (Tesis doctoral). Escuela Universitaria de Extremadura, España. points out that age turns out to be the predictor variable of adaptation problems in pregnancy. In this sense, the author shows important psychosocial consequences that the parenting stage entails in those women who occupy the role of mother. From the subcategory “Occupational deprivation: socio-community relationships in crisis”, authors such as Arias et al. (2011)Arias, E., Puntí, J., Torralbas, J., Naranjo, M. C., & Palomino, J. (2011). Terapia ocupacional en adolescentes con retraimiento social: análisis de las áreas de desempeño ocupacional. TOG (A Coruña), 8(13), 1-15. consider that parenting can impact both the social and autonomous development, as well as the construction of the adolescent's identity. They coincide in this assessment, Hernández & Gentile (2018)Hernández, A., & Gentile, A. (2018). Nota de investigación: narrativas y representaciones de la maternidad en edad adolescente. Inguruak Revista Vasca de Sociología y Ciencia Política, 64, 111-122. pointing out that adolescent mothers have complicated and unwanted situations that seriously affect both their current well-being and that of their plans.

The subcategory “Educational interruption: as an occupational conditioner of the future” reflects the difficulty of carrying out the work of study, upbringing, and personal care. In this sense, Vélez & Figueredo (2015)Vélez, E., & Figueredo, E. (2015). Impacto psicosocial del embarazo en las adolescentes. Revista Educación en Valores, 1(23), 18-28. show a reduction in the possibilities of receiving an adequate education, as well as the opportunity to develop skills to guarantee the economic future in the population of adolescent mothers. Along with this, they affirm that adolescent motherhood harms the occupational regime since they present a radical change in the occupations they carried out before occupying the role of mothers. The subcategory “Employment: compulsory demand for (re) production and productivity” reflects the incompatibility between the mentioned variables. Bombino & Quintana (2015)Bombino, Y., & Quintana, N. (2015). Ser madre adolescente: “una experiencia bonita, pero complicada”. Estudio de casos en Barinas, 2012. Novedades en Población, (21), 78-88. point out that the autonomy that adolescent women seek once visualizing themselves as mothers, overlaps with the occupations of their age, hindering them from accessing a job that allows them to raise and at the same time continue with their studies.

The limitations of this study are associated with the number of the sample since a larger number of participants could have enriched the findings and also the difficulty of fully accessing the interviewees in person. This scenario would have provided greater fluidity in interaction and dialogue, based on the experiences narrated by the participants.

Conclusions

The motherhood of adolescent women has great challenges for public health and social policies, especially care. In this sense, the dimensions analyzed reveal not only an occupational imbalance reflected in the diversity of occupations that adolescent mothers are deprived of doing, but also reflect an occupational alienation, while their experimentation of significant and enriching occupations is restricted in this period of life, in addition to an intensification of paid and unpaid work in the daily experience of young mothers, who must restructure their occupations based on care and productivity.

For this reason, occupational therapists, as health promoters, can act by identifying possible risk factors that affect the daily quality of life of adolescent mothers, considering occupational justice as a basis, to prevent or reduce limitation or deprivation that they present regarding their collective participation and in the upbringing of their child.

Faced with this scenario, Feminist Occupational Therapy emerges as an epistemological position of resistance to the various manifestations of injustices, marginalization, and occupational alienation that we find in everyday life, and that experience and surround the group of adolescent mothers since it understands that the origin and reproduction of these injustices are caused in large part by the generic inequalities between men and women, the stigmas associated with motherhood and the precarious conditions of viability that emerge from capitalist, patriarchal and ageist models.

Acknowledgments

We thank all the women who unselfishly collaborated with their experiences in this investigation.

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Publication Dates

  • Publication in this collection
    11 Oct 2021
  • Date of issue
    2021

History

  • Received
    08 Oct 2020
  • Reviewed
    10 Nov 2020
  • Reviewed
    09 Feb 2021
  • Accepted
    01 Mar 2021
Universidade Federal de São Carlos, Departamento de Terapia Ocupacional Rodovia Washington Luis, Km 235, Caixa Postal 676, CEP: , 13565-905, São Carlos, SP - Brasil, Tel.: 55-16-3361-8749 - São Carlos - SP - Brazil
E-mail: cadto@ufscar.br