Caring for pregnant teens and their mothers, too.

PIP: The Teenage Mothers-Grandmothers (TAM-GM) program was developed at a hospital in the Bronx, New York, to help the adolescents' mothers understand and communicate with their pregnant daughters. Eligible adolescents were no more than 32 weeks pregnant, had no previous live birth, would be aged 17 or younger at due date, and maintained an ongoing relationship with their mother or mother surrogate (their grandmother or the mother of the adolescent's boyfriend). The TAM-GM program consisted of a series of structured, hour-long sessions coinciding with prenatal visits. During sessions one, two, and four, a social worker met with the adolescent's mother alone; the adolescent joined them for the third session. Additional sessions occurred after the birth. An evaluation was undertaken in 1993 to determine if program participation improved school completion, reduced repeat pregnancy rates, and improved the adolescent-mother relationship. The grandmothers reported that participation in the program helped them deal with the situation and improved their relationships with their daughters. Adolescents and their mothers reported improved communications. Program participants suggested that the program be extended beyond clinic hours, possibly using a hotline approach. The adolescents who participated in the program were less likely to drop out of school and had a lower repeat pregnancy rate and significantly higher self-esteem than those who did not participate. High self-esteem was a significant predictor of staying in school.^ieng