Motherhood in Adolescence: A Qualitative Study of the Lived Experience of Participants in a Perinatal Home-Visiting Intervention

Motherhood in Adolescence: A Qualitative Study of the Lived Experience of Participants in a Perinatal Home-Visiting Intervention | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Motherhood in Adolescence: A Qualitative Study of the Lived Experience of Participants in a Perinatal Home-Visiting Intervention Débora Tseng Chou, Emilio Abelama Neto, Lislaine Aparecida Fracolli, and 10 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7730299/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 15 Feb, 2026 Read the published version in Child and Adolescent Psychiatry and Mental Health → Version 1 posted 12 You are reading this latest preprint version Abstract Background Adolescent motherhood represents a complex period of identity restructuring, characterized by negotiation of self-perception and the balancing of a new caregiving role. As a developmental stage, it can be complicated by a lack of preparedness, social stigma, absence of partner support, school dropout, loneliness, and emotional distress. Aiming to inform more developmentally attuned interventions, we explored the lived experience of adolescent mothers who participated in a perinatal home-visiting program. Methods We recruited 72 adolescents, aged 14–19, from low-income neighborhoods in São Paulo, Brazil. Most identified as Black or Brown and all were experiencing their first pregnancy. They took part in Primeiros Laços (“First Ties”), a nurse-led program that provides psychosocial support from pregnancy through the child’s second year. We enrolled participants into a qualitative study based on open-ended interviews during pregnancy and again at 3, 12, and 24 months postpartum, totaling 223 interviews. Using thematic analysis informed by phenomenology, we examined how their lived experiences changed over time. Results We identified five experiential domains: ( 1 ) Reactions to the Discovery of Pregnancy , marked by ambivalence and conflicting emotions, including those elicited by social stigma; ( 2 ) Changes Experiencing the Body , with adolescents experiencing their bodies as intensely present, sometimes expressing emotional suffering through physical sensations; ( 3 ) Forming a Maternal Identity , with a reshaping of prior adolescent roles into an emerging maternal persona; ( 4 ) Transformations in the Experience of Time , encompassing future-oriented aspirations and or a desire to hold onto the present; and ( 5 ) Reframing Relationships around the child, who became a central source of meaning and emotional reciprocity. Conclusions Our findings highlight how existential structures of temporality, embodiment, identity, and intersubjectivity shape the lived reality of adolescent motherhood. Pregnancy and early caregiving intensified bodily awareness and restructured temporal horizons, with some adolescents experiencing an expansion of future possibilities and others a sense of paralysis. Relationships were reorganized around the child as a new experiential center. These insights suggest that psychosocial interventions should be attentive to moments when the future feels overwhelming, provide clear, non-objectifying information, and support continuity in care. A non-judgmental stance that respects each mother’s values while gradually broadening life horizons can help strengthen maternal competencies and expand possibilities beyond caregiving. Adolescent parenting qualitative methods intervention Latin America parenting poverty Introduction The World Health Organization defines adolescent pregnancy as occurring between ages 10 and 19 ( 1 ). It is a global phenomenon, and births from women aged 15–19 account for 11% of all pregnancies worldwide ( 2 ), with an estimated prevalence of 16 million cases per year ( 3 ), 90% of which occur in low- and middle-income countries ( 2 ). These pregnancies are often unplanned ( 4 ) and associated with significant challenges across different aspects of life. A recent meta-synthesis ( 5 ) analyzing qualitative studies on adolescent motherhood highlighted that this experience can be marked by a lack of preparedness for motherhood, social stigma, frequent absence of partner support, school dropout, loneliness, and emotional distress. Another aspect adolescent mothers face is the complex process of identity restructuring, in which young mothers continuously negotiate their self-perception in relation to their new maternal role alongside their child ( 6 , 7 ). Despite these challenges, some adolescent mothers demonstrate resilience, adapting to their new role through key psychological and social mechanisms. The meta-synthesis also pointed out that self-efficacy and motivation to change one’s life trajectory can facilitate adaptation to the maternal role. Factors such as acceptance of the past, a sense of competence in motherhood, and an optimistic outlook were identified as elements that enhance self-efficacy. Additionally, social support from partners, family members, and friends who had also experienced adolescent motherhood played a central role in coping during this period. A key theme in the study was that, for some adolescents, pregnancy represented a time of maturation, the development of a sense of responsibility, and strengthened self-esteem. In other words, motherhood is a period of profound transformation in which adolescents face challenges that can lead to both emotional suffering and personal growth ( 5 ). One strategy designed to support young mothers in this transition is the implementation of home visitation programs, which aim to assist adolescent mothers in adapting to the maternal role while fostering their children’s healthy development ( 8 , 9 ). In Brazil, one initiative is the Primeiros Laços (PL) program (“First Ties”), which offers home visits conducted by nurses for adolescent mothers facing adverse conditions. The program supports mother and child from pregnancy until the child reaches two years of age, with the goal of fostering parenting skills, promoting adequate child development, and providing emotional and social support to young mothers ( 10 ). Evidence suggests the PL program has positive effects not only on infant outcomes — such as secure attachment ( 11 ) and expressive language skills ( 11 ) — but also on parental well-being and maternal behaviors such as reading or singing to the child ( 12 ) However, like many home visitation interventions, the PL program faces challenges in participant engagement and retention. High attrition rates are common and can significantly reduce the intended intervention dose. For example, in the Nurse Family Partnership program, implemented across various regions of the United States and internationally, only 35% to 40% of families remained engaged throughout the entire program ( 13 ). Similarly, both the PL and the Early Head Start program in the U.S. report retention rates around 60% ( 10 , 14 ). Dose adherence is also a concern: in the PL program, participants in the intervention group received, on average, 38 of the 66 planned nurse visits ( 10 ). These data raise important questions about how well such interventions align with the lived realities of adolescent mothers. High dropout rates and reduced number of visits may reflect a mismatch between program structure and participants’ needs and priorities. A deeper understanding of the adolescent motherhood experience is therefore necessary to refine and tailor home visitation models in ways that enhance their relevance and responsiveness. In this context, we go on to explore the lived experience of adolescent mothers, encompassing the period from pregnancy through the first two years postpartum. The overall goal of our study is to inform program adaptations and contribute to more meaningful, engaging, and effective interventions for young mothers navigating early parenthood. Methods We collected qualitative data in the context of a randomized clinical trial (RCT) conducted to evaluate the effectiveness of the PL program for adolescents recruited in 2018 and 2019 in São Paulo city. The study was reviewed and approved by the Ethics Committee of the University of São Paulo Medical School (reference number: 2286606) and the protocol was registered in the clinicaltrials.gov platform (NCT04362098). Full details of the PL protocol are available in previous publications (10,11) . Quantitative data from this RCT were under analysis at the time of writing. Sample We recruited nulliparous adolescents aged 14 to 19 years, between 8 and 16 weeks of gestation, from a low socioeconomic status (classes C, D, E according to Associação Brasileira de Empresas de Pesquisa, ABEB (15)), and living in São Paulo, Brazil. Recruitment took place between May 2018 and November 2019, after participants had started prenatal care in the public primary healthcare system. Eligible pregnant adolescents received an informational leaflet about the program and provided their contact details to the research coordinator. The coordinator then contacted them by phone or at the clinic to explain the methodological details, address any questions, and obtain consent. Data Collection Trained psychologists conducted interviews with the adolescents at four time points: during pregnancy, and at 3, 12, and 24 months postpartum. Researchers conducted individual interviews in person, at the research center, and audio-recorded them. Participants received the following open-ended instructions: During pregnancy: “We would like you to talk for 5 minutes about your pregnancy, your future child, and yourself as a mother.” At 3, 12, and 24 months: “We would like you to talk for 5 minutes about your child, yourself as a mother, and your relationship with your child.” Participants spoke freely for 5 minutes. If prolonged silence occurred, the interviewer used a prompt such as: “Please continue” or “Feel free to talk.” It was clarified to participants that their responses would have no bearing on the nature or content of the intervention provided. Interviewers were all female psychologists and post graduate students who had no prior relationship with participants and were not involved in home visits. They also did not participate in data analysis or in preparing the study results. To capture spontaneous narratives while minimizing participant burden, we chose a five-minute free speech interview format, in which adolescent mothers spoke uninterrupted about their thoughts and experiences. Short, unstructured speech samples have shown strong validity in diverse and vulnerable populations, including adolescents (16) and caregivers from low-income backgrounds (17). Even brief samples can yield rich emotional and relational data while reducing fatigue (18). Also, free speech formats are less directive and less influenced by interviewer input, enabling more natural and authentic expression (16). Overall, this method offers a practical, ethically sensitive, and scientifically grounded way to capture the lived experiences of adolescent mothers. Interviews with 72 participants of the intervention group were fully transcribed and anonymized. Three researchers (DTC, EAN and LB), all psychiatrists and native Portuguese speakers conducted data analysis. DTC and LB are female, EAN is male, and LB is a mother, demographic characteristics that informed our reflexivity. To ensure thematic saturation, we chose to code all available interview material. Although the total number of interviews (223) may appear high for a qualitative study, each interview was relatively short. Moreover, participants often provided brief responses, with long pauses, and found it challenging to elaborate, which further justified the inclusion of the entire dataset in the analysis. For reference, we found that the average word count per interview was 496, ranging from 105 to 1,014 words (the average number of words spoken by a young Brazilian in five minutes is about 530 (19). Data Analysis We focused on participants from the intervention group, as the qualitative approach is not suitable for comparative results. We conducted the analysis of the transcribed interviews using thematic analysis (20) informed by phenomenology (21,22). This method was chosen due to the large number of short interviews with lower individual depth, making it suitable for capturing common themes and patterns across participants. The short nature of the reports, however, did not prevent descriptions of rich experiences during pregnancy and motherhood. Thus, we carried out the analysis by coding all transcripts line by line, generating initial themes, which constituted general units of meaning. Throughout the analysis, we prioritized those that contained reports of the participant’s experiences. Based on these, we organized the content into the five domains described in the results section. Our approach is informed by a phenomenological perspective, which seeks to understand the experiences and personal meanings of the lived reality being studied (23), in this case, how adolescent girls experienced pregnancy and the transition to motherhood. Two researchers (DTC and EA) independently coded all transcripts in Portuguese and developed an initial codebook. Three team members (DTC, EA and LB) then discussed their interpretations and reached consensus through triangulation, refining the initial domains and themes. Subsequently, quotes were translated into English, and the thematic structure was further reviewed and refined in collaboration with the broader research team, involving all authors in the final interpretive process. We used Microsoft Word for coding and theme development; no software was used in the analysis. This study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) (24), with its criteria systematically addressed throughout the methodology section and included as Supplemental Table 1. Results Of the 83 participants enrolled in the intervention arm, 72 (87%) took part in at least one interview. 69 interviews were conducted during pregnancy, 36 at 3 months postpartum, 56 at 12 months, and 62 at 24 months, for a total of 223 interviews. The sociodemographic characteristics of participants can be found in Supplemental Table 2. Frequent themes in the interviews included general accounts of pregnancy and motherhood routines, with few personal details. Participants also frequently described what their child could do (such as crawling, playing, or laughing) or their child’s characteristics (such as being intelligent, energetic, or affectionate). While these insights are interesting, they fall outside the primary focus of this article. Therefore, we have chosen to center our results on lived experiences related to pregnancy and motherhood. We identified five key domains, which we will describe below: (1) Reactions to the Discovery of Pregnancy ; (2) Changes Experiencing the Body ; (3) Forming a Maternal Identity ; (4) Transformations in the Experience of Time , and (5) Reframing Relationships . We provide a summary of domains, themes, and representative quotations in Tables 1 and 2. INSERT TABLE 1 ABOUT HERE Reactions to the Discovery of Pregnancy We identified different patterns to how the adolescents received the news of their pregnancy. These reflections illustrate how motherhood is not merely an isolated event but a transformative process that involves reorganizing how one experiences the world. Many participants expressed ambivalence as they navigated the reality of impending motherhood. Their reactions often fluctuated between concern and happiness, reflecting the complex interplay of personal aspirations, social expectations, and life circumstances, as illustrated by the quotes: "At the same time, I didn’t want to have a child, but I did.” and “I was scared and happy at the same time”. Although ambivalence was the predominant reaction, some participants expressed complete rejection of the pregnancy, often linked to intense psychological distress, as reflected in: "It affected my mental health a lot. That’s when I attempted suicide." In contrast, some participants described pregnancy as a long-awaited source of happiness and personal fulfillment : "It was a dream come true. Thank God." The initial reactions of those around the young women also varied widely. Some families responded with rejection , which led to conflicts within the household. In some cases, the child’s father also failed to provide support, further compounding the young mother’s challenges: "Well, my pregnancy has been complicated because I’m not with the baby’s father, and my mother doesn’t accept it either." However, most families were described as a source of support for the adolescents, helping them feel that it was possible to get through this period: "And despite the pregnancy at this age being a bit complicated, it has been a little easier for me because of my family’s support, my parents’ support. Even though my situation is very difficult, knowing I have my parents makes my pregnancy feel safer." and "Knowing that I have my parents’ love is what keeps me going." In a few cases, the baby’s father was described as the one who wanted the child and that was very happy with the pregnancy news: “He (partner) ended up being really happy when it happened, and I was happy too”. Participants also described society’s reactions to adolescent pregnancy, which were often marked by prejudice and discrimination concerning the pregnancy itself and the educational status that she would be able to achieve in life: "Some people called me crazy, totally out of my mind for getting pregnant so young.", "Because I was still in school I faced a lot of prejudice. Everyone would say, ‘Oh, now it’s over, you won’t study anymore’" In these interviews conducted during pregnancy, one striking observation was the scarcity of reflections on what motherhood would actually entail. While some participants briefly mentioned their hopes of raising their child well, encouraging them to study and become a good person, such future-oriented reflections were relatively rare. Instead, the predominant themes were uncertainty, hesitation, and a lack of concrete expectations. Many young women struggled to articulate what they envisioned for themselves as mothers, often pausing for long periods or expressing an inability to imagine what lay ahead. Their words illustrate this: "Wow, I’m going to be a mother, how am I going to manage?","I keep thinking about how it will be when I have my child, how I will do things, because being alone is completely different from having a child." Despite the wide range of initial reactions to the pregnancy, all participants described undergoing a profound transformation, not only in anticipation of the baby’s arrival but even more so after childbirth. Regardless of whether they initially faced the news with joy, ambivalence, or distress, they consistently portrayed motherhood as a pivotal experience that reshaped their daily lives, relationships, and identity. Across the interviews, the perception of motherhood as a deeply life-altering experience was a recurring theme: "Once you realize you are carrying a life, everything shifts.", "After he was born, my whole world changed." Changes Experiencing the Body The Body in the Foreground of Consciousness During pregnancy, bodily transformations were visible, and physiological changes were deeply felt. Even before the baby existed physically in the world, their mother’s body was the place where new life manifested, in corporeal dimensions that changed: "You put on clothes that used to fit, and now they don’t anymore," and in discomfort such as nausea and abdominal pain. The account of one participant, who had conflicting relationships with her family, revealed how these tensions translated into physical discomfort in her abdomen: "Every time I argue, I feel pain in the lower part of my belly, every time. It’s horrible, like little stabs." Lived Experiences Manifest in the Body The feeling of being unprepared for motherhood was not limited to an idea or representation but could be experienced as a perception of physical immaturity. "Whether we like it or not, teenage pregnancy is very difficult. Because my body is still not fully developed, I don’t have a woman’s body yet to carry a life inside me." On the other hand, participants who had positive experiences and accepted their pregnancy described taking pleasure in the changes in their bodies and the early development of affectionate feelings toward their future child: "It’s going to be a wonderful feeling, it already is! Carrying a life inside me, watching my body change." The Body in the Transition from Pregnancy to Motherhood In the transition from pregnancy to motherhood, the experience of continuity between the two stages was not always present: "When I hold him in my arms, sometimes I stop and think: I can’t believe he came out of me. Because, how is it possible, right? A baby like this came out of me…" This statement reveals the difficulty of integrating pregnancy and motherhood as part of the same experience. The maternal body, which previously housed the baby, now finds itself separate from the child, generating feelings of surprise and unfamiliarity. Childbirth emerges as a crucial event in this transition, acting as a process through which the body adapts to separation from the baby. Some women describe this moment as marked by intense pain, closely linked to feelings of fear and vulnerability: "During his birth, the only thing I could think about was that I was going to die because the pain was unbearable." Following the birth, physical closeness remained intense through breastfeeding. Some participants described this experience as an act of giving their own body to nourish the child, despite pain and discomfort: "Wow, I suffered so much while breastfeeding in the first two weeks because he actually tore off a little piece of my breast.". INSERT TABLE 2 ABOUT HERE Forming a Maternal Identity Adolescence as a Period of Discovery Adolescence is inherently characterized by exploration, change, and the shaping of aspirations. Becoming a mother during this period did not close off that openness but rather introduced new variables to be navigated alongside existing dreams and uncertainties. As one participant expressed, "It’s a little difficult because of my age, where you’re just starting to achieve things, starting to explore the world. Then you look to the side and see that there’s a responsibility there." For some, the arrival of a child became part of this ongoing process of discovery, reshaping their expectations but not necessarily limiting their sense of possibility. For others, the weight of new responsibilities brought feelings of apprehension, as they adjusted to an unanticipated shift in their path. From Unpreparedness to a Sense of Capability Many participants reported difficulties in caring for their newborn during the first days of life: "During the first week when I got home, I would look at him and feel like I wasn’t capable of taking care of him on my own." The perception of the newborn’s fragility led to fear of accidentally harming the baby while performing basic caregiving tasks: "And when he was born, everything was so new. I was even afraid to bathe him because newborns are slippery, their skin is so delicate, and I was scared I might drown him." However, after a few months, many developed a sense of confidence in their ability to care for their child, were surprised by how much they had learned and integrated this confidence into their sense of identity: "I am a completely different person today. I stopped being a girl, I became a woman, a mother, a homemaker, totally different from who I was before she arrived.", "I think I have gone beyond what I expected from myself." Motherhood in adolescence often led to significant shifts in daily habits and priorities, prompting some young mothers to adopt a greater sense of responsibility. For many, the arrival of a child reshaped their routines, influencing how they spent their time and what they valued. As one participant reflected, "When I got pregnant, I used to go to many funk parties, now I stopped going." Another described a transformation in her attitude toward responsibilities, stating, "I used to be really irresponsible with things, I didn’t care about anything. I didn’t want to work, I didn’t want to do anything." Revisiting the Experience of Being a Daughter The experience of motherhood frequently led participants to reflect on their relationships with their own mothers. Many reported increased empathy and understanding toward them: "To us, our mothers seem annoying, but when we become one, we realize they only want the best for their children." Some recognized their own upbringing as a positive reference, and saw their mothers as resilient figures who overcame challenges and imparted valuable lessons: "I want to pass on to him everything I’ve learned, everything my mother taught me too." For others, motherhood also prompted a critical reassessment of negative aspects of their own upbringing, leading them to reflect on cycles of care and behaviors they wished to avoid in raising their own children: "I used to get punched when I was a child for not doing house chores.". Transformations in the Experience of Time Pregnancy as Openness to the Future Throughout the interviews conducted during pregnancy, discussions about the future were abundant. The very expression "expecting a child" encapsulates how this stage of life is often filled with anticipation, centered on what is yet to come. Many participants expressed this sense of looking ahead and making plans. As one participant shared, "We are already starting to make plans ahead, already thinking about what it will be like, what to do." Another reflected on how pregnancy shifted her perspective, saying, "Oh, I don’t know, it’s different. You think more about the future, you think that now it’s not just you, you have another person to take care of, to feed." This openness to the future often manifested as expectations regarding life with the baby. Curiosity also played a role in these expectations, with participants wondering about their baby’s characteristics: "And I also feel anxious at the same time to see what my child will be like, if they will look like me, if they will look like their father." and "I’m anxious to know how they are, if I will be able to hear their heartbeat, to know the sex." However, not all expectations were positive. In some cases, uncertainty gave way to fear, with participants expressing concerns about the unknown aspects of childbirth and parenting. One young mother admitted, "I’m scared. I don’t know how it’s going to be... I’m very, very scared." Experiencing Novelty Through the Child The experience of moving towards the future continued after the baby was born, a similar experience to the pregnancy, however with different themes. Many participants described how their perception of time became shaped by their baby’s rapid development and constant changes. The early months of motherhood were filled with daily discoveries, both for the mother and the child. As one participant observed, "They are discovering the world, each day that passes, a different situation happens, and they are adapting to that situation." Some mothers looked at their child as the continuity of life goals that they weren't able to achieve, almost as giving up of their personal plans and living the progression of time and unfolding of plans by proxy, as illustrated by this excerpt: “when it comes to my son's future, I can help him to do what I couldn’t do, finish his studies, and when he finishes his studies, start a good college, so that in his future, he can become a much better person than I am.” Motivation to Build a Better Future Other participants described how motherhood became a driving force for them to pursue a better future for them and for the child. The responsibility of providing a good life for their baby made education and work more meaningful and urgent. As one young mother explained, "Because for me to be someone in life, to give them a future, I need to at least have my studies." Another spoke about adjusting her academic goals, saying, "I won’t be able to go to college now, but in two years, I will, to set a good example for my child". Some participants also felt a strong need to prove their ability to succeed despite the challenges of young motherhood. One mother proudly shared, "But I was able to prove to everyone that I was going to make it (study) even with the baby." The motivation extended beyond education to financial independence, as one participant expressed: "I want to have something to give my child, to have an income." However, despite their motivation, balancing personal goals with childcare responsibilities was not always easy. Many mothers spoke of the overwhelming burden of managing studies, work, and household duties, especially when they lacked external support. One participant illustrated this struggle, saying, "And right now, I’m going through a really tough phase because I have to juggle my studies—I’m close to finishing school—and I’m looking for a job. Then, taking care of the baby every day, doing the housework, I take care of everything alone, it’s really hard." Desire to Freeze the Present In contrast to those who were focused on the future, some mothers expressed deep satisfaction with their current stage of life, leading them to wish they could slow time down. For these participants, the present moment with their child was so fulfilling that thoughts of change or planning ahead felt unnecessary. As one mother shared, "As a mother, I’m living the best experience of my life." This contentment sometimes translated into a desire for time to pass more slowly, preserving their current relationship with their baby. One participant reflected on this feeling, saying, "I feel like they are growing too fast. I wish time would pass more slowly, but unfortunately, life is like that." The attachment to the present also led to a reluctance to imagine their child growing up and becoming independent. Some mothers playfully idealized keeping their child close for as long as possible, as one joked, "I already told them that I’m not going to let them leave home before they turn forty." Reframing Relationships Child’s Centrality in the Mother’s Life For many participants, the arrival of the baby brought about a powerful emotional bond, in which the presence of the child became central not only to their daily routines but also to their identity. This intense connection was often marked by a desire for constant proximity, reflecting how the baby had become a vital source of emotional fulfillment. As one participant expressed, "I can’t be without her at all, not even for a little while!" In some cases, this relationship was described as the mother’s main purpose in life, with the child representing the core of her existence: "She is everything to me, my reason for living." Such statements reveal how motherhood, for many, reshaped the way they perceived themselves and the world around them. For some, the experience of becoming a mother filled an emotional void, offering a renewed sense of wholeness and purpose: "I didn’t feel complete without her... Now I feel totally complete, I don’t need anything else, anyone else except for her." In particularly strong expressions of this transformation, the sense of self became so closely tied to the presence of the child that the two identities appeared almost fused. As one young mother put it, "Without her, there’s no me anymore." Mother Prioritizing the Child Over Herself Some mothers reported prioritizing their child’s needs over their own. As one participant shared, "Everything I do is for her. I even end up putting myself aside a little to do more things for her, and I don’t really mind that." Such accounts reflected a daily routine shaped by the child’s needs, with mothers often viewing self-sacrifice as a natural part of caregiving. Child as an Active Participant in Emotional Support In addition to the central role of the baby in their lives, some participants described the mother-child bond not only as a source of affection but also as a relationship marked by reciprocity. The child was not seen solely as someone in need of care, but also as someone who contributed meaningfully to the mother’s emotional well-being: “I think she helps me more than I help her.” In these accounts, the children were perceived as emotionally attuned, capable of recognizing the mother's feelings and offering comfort, even at a very young age. The mother of a one-year-old, for example, described her child’s attentiveness: “A child who always notices when I’m sad. As incredible as it may seem, despite her young age, she notices and gives me affection.” This emotional sensitivity and exchange of care were described as particularly significant during moments of vulnerability. For some mothers, the presence of the child not only provided daily companionship but also symbolized a new beginning. In certain cases, the birth of the child was associated with a break from past difficulties and the possibility of emotional healing: "Even though I became a mother when still young, my daughter was a big way out of my problems." Care Dynamics in Family Relationships Some mothers described feelings of jealousy over their child’s closeness with other family members, often with a light-hearted tone: "Sometimes I get a little jealous of her with my family because she’s really attached to them too, sometimes I feel silly jealousy." These emotions sometimes coincided with a reluctance to delegate caregiving, as some preferred to manage all aspects themselves: "I love taking care of her. I love doing things for her: bathing, changing, everything. I like doing it myself; I don’t like anyone else doing it for me." As they experienced these sentiments, most mothers reported receiving support, primarily from their own mothers, and occasionally from the child’s father. Although paternal involvement was not deeply explored, accounts ranged widely: "Listen, the affection she has for her father, my God, it’s huge." vs. "His father, he’s not present in his life, he doesn’t really know what he’s like." Beyond the mother-child bond, participants described the baby’s birth as positively influencing broader family dynamics. For many, the child’s arrival improved relationships within the extended family and, in some cases, served as a unifying presence in previously tense environments: "He brought happiness into the house because where there used to be only fighting, he brought peace." Discussion In contemporary Western society, adolescence is often seen as a time of openness to novelty and the future (25). It is a key stage for identity consolidation and investment in education and a career. Pregnancy, likewise, is marked by movement, growth, and change (26), qualities that resonate with the inherent indeterminacy of adolescence. This convergence makes the period more prone to anticipation than certainty and may explain the long silences observed during interviews, as motherhood represents a transition into the unknown (27). The arrival of a child during adolescence introduces a new variable. As shown in the results, this process was marked by the idea that everything changes, though the nature and direction of those changes varied among participants. For many, motherhood was a catalyst for maturation, increased responsibility, motivation to pursue education and work, and a strengthened sense of identity. Caring for the child became a driver of personal growth, fostering agency and self-confidence. The overall positive tone observed in the interviews is noteworthy. It may suggest that feelings of pleasure or capability outweighed the challenges, or alternatively, that some participants were hesitant to delve into more painful topics during the brief interview. Further research is needed to explore this dynamic in greater depth. Nevertheless, these findings align with existing literature, which highlights how adolescent motherhood, despite its challenges, can promote personal development and maturity (5). We believe the PL program’s focus on self-efficacy supported this perspective, though the interview question did not directly address the intervention. At the same time, for some, the maternal role offered emotional security. In these cases, the child served as a solution to past difficulties and became a central organizing presence in the mother’s life. Some mothers expressed a desire to maintain the child’s dependence, finding purpose in that dynamic. This was sometimes accompanied by anxiety about the child growing up and becoming more independent, as well as discomfort when others received the child’s affection, reflecting a desire to remain the primary caregiver and emotional anchor. These mothers often saw their child as emotionally attentive, sometimes even comforting them when they were sad. Paradoxically, while desiring to maintain the child’s dependence, some perceived the child as more emotionally mature than they actually were. This dynamic may relate to emotional parentification, where the child assumes excessive emotional responsibility within the family (28), potentially affecting their development. Although this role reversal may foster certain caring abilities, it can also result in emotional overload and long-term relational difficulties (29). Some participants also voiced hopes that their children would achieve goals they had not, such as completing school or becoming “a better person.” While common in parenting (30), these aspirations may also reflect a vicarious pursuit of progress. The child’s development becomes not just a goal but a symbolic continuation of the mother’s own interrupted paths. Rather than pursuing certain ambitions directly, some mothers appeared to invest in their child’s success as a way to fulfill postponed trajectories. Thus, adolescent motherhood can take on diverse meanings. For some, it sparks growth, encouraging maturity, education, and work. For others, it marks a stabilizing endpoint that interrupts the exploratory nature of adolescence. In such cases, motherhood becomes the central experience around which identity forms. While this profile has also been noted in adult women, such as in Sharon Hays’ concept of Intensive Motherhood (31), it may be even more pronounced in adolescence, when few other roles have yet been formed. Understanding these experiences from a phenomenological perspective can help health professionals and researchers design interventions that broaden these young women’s life possibilities. We go on to consider participants’ accounts through key phenomenological categories to deepen insight into how adolescent mothers experience and navigate motherhood. Importantly, we do not assume that adolescent motherhood corresponds to a specific psychopathological structure. Rather, we describe common aspects that appeared in participants’ narratives, recognizing that these can reflect characteristics that are intrinsic to adolescence and to the perinatal period. In this sense, we refer to the phenomenological “conditions of possibility” (22): the basic structures that shape human experience. Classic authors such as Husserl (32,33) have emphasized how dimensions like temporality, spatiality, embodiment, identity, and intersubjectivity are not just contents of experience but the very ground that allows it to unfold. Approaching adolescent motherhood through these categories offers a framework that links subjective narratives with clinical understanding that informs practical recommendations. In TABLE 3 we integrate these theoretical constructs with our study’s empirical findings. INSERT TABLE 3 ABOUT HERE Embodiment The maternal body is the first environment where new life emerges, a space of transformation. Participants described a wide range of sensations during pregnancy, from visible changes to discomforts like nausea and pain. These heightened bodily sensations stood in contrast to the usual transparency of the non-pregnant body. In daily life, the body often functions invisibly, responding to intention without drawing attention, serving as both a medium for action and a spatial anchor. Phenomenology refers to this as the experience of the "body-subject" (21). However, this seamless relationship shifts when the body becomes an object of awareness — felt in its mass, weight, and limitations — as in illness or physical discomfort (34). Pregnancy is a paradigmatic moment where these two experiences, body-subject and body-object, coexist. Bodily changes such as the growing belly and altered movement bring the body into focus. Yet for some, the pregnant body remains a means of intentionality and agency. When pregnancy is welcomed, the body may be experienced as powerful, a vehicle for realizing life goals (26). In our study, however, many adolescents experienced unplanned pregnancies and expressed ambivalence. Their narratives often centered the body as an object, marked by nausea, pain, and sudden changes. In these cases, the body became external, even burdensome, perhaps more accessible than confronting emotional and social complexities. For many, the feeling of “my body is unprepared” was more vivid than recognizing a lack of readiness for motherhood. In moments of family conflict, often intensified after revealing the pregnancy, participants reported somatic symptoms, like abdominal pain. This focus of the conscience on the body happens unintentionally and pre-reflectively: the body becomes a point of focus, offering concrete contours in the face of overwhelming emotional complexity. Identity and Intersubjectivity Identity forms through the interplay of personal history, bodily experience, and the surrounding world. It is not fixed, but dynamic, shaped by time, space, and cultural context. Spatially, identity reflects one’s felt sense of ownership and orientation in the world. In adolescence, identity is especially fluid, marked by cycles of exploration and commitment (35). It requires integrating past experiences, future aspirations, and shifting roles within family, peers, and broader society (36). At a stage of life characterized by minimal responsibility and identity fluidity, the abrupt shift toward motherhood introduced tension and uncertainty. However, through childbirth and early caregiving, feelings of insecurity gradually gave way to the formation of a maternal identity. This identity first takes shape during pregnancy through imagined representations of the baby and deepens postpartum through interaction. Maternal identity is relational and develops gradually until a personal style of mothering is formed (37). For adolescent mothers, this evolution overlaps with their own identity formation, demanding a reconfiguration of roles and expectations. While disorienting, this process can also catalyze growth and deeper bonding with the child (38). Literature describes three phases in this transformation: an initial disorientation and loss of prior identity; the emergence of a revised self that integrates motherhood; and finally, a deepening of emotional capacities such as empathy and responsibility. This process may also confront the mother with emotional and psychological limits, as idealized views of motherhood clash with lived experience (36). Some participants reflected on their own mothers, highlighting how past maternal models shape current caregiving, whether through repetition or differentiation. Pregnancy often signals a symbolic shift from daughter to mother, inviting a reevaluation of childhood experiences and one’s place in the generational chain (39). These reflections offer an opportunity for identity reconstruction. This narrative process plays a crucial role in shaping the relationship with the new child. Research indicates that a mother's ability to reflect on and coherently narrate her own experiences of being mothered — regardless of the relationship’s quality— is associated with secure attachment in her child (39,40). More important than factual accuracy is the capacity for self-reflection and emotionally engaged narration. Interventions like the PL can offer critical support during this period of identity transformation. Through psychoeducation and attachment-based approaches, the program promotes sensitive maternal responses and reinforces self-efficacy (41). By encouraging mothers to share their stories as daughters, it also opens space for intergenerational healing and improving family relationships. Ultimately, the healthcare professional, through sustained interaction with the adolescent, becomes an essential intersubjective anchor during times of identity change. Temporality Temporality is a core structure of human experience, where past, present, and future are continuously and intentionally interconnected. Unlike chronological time, phenomenological temporality highlights how time is subjectively experienced, shaping consciousness and identity. It is a dynamic process in which the present is never isolated, but embedded in past memories and experiences (retention) and oriented toward future expectations (protention) (22,42). Our results show that multiple factors shape the lived experience of time. Both adolescence and pregnancy are phases rich in protention, yet each mother experiences them differently. Some mature rapidly and view the recent past as a path of growth, which empowers them to envision the future—here, retention supports protention. Others aim to stabilize the present, wanting their child to remain small and their caregiving role to continue. This desire reflects a compensatory effort to freeze the present in response to a future that feels uncertain or distressing. Spatiality Another key dimension for understanding the results and guiding interventions is spatiality. In phenomenology, space is not merely a physical or objective backdrop, but a subjective experience shaped by the individual’s perception and relationship with the world. Building on this, Messas (22) introduces the center-periphery model to describe how consciousness organizes spatial experience. The center holds what is most present and meaningful, while the periphery contains less defined, background elements. For some mothers, the arrival of a baby reorganizes this inner space: the child becomes the central focus, while personal goals are temporarily pushed aside. Socioeconomic conditions deeply influence how maternal space is organized. In Brazil, limited public childcare — reaching only 39% of children aged 0–3 in 2023 (43) — often leaves mothers solely responsible for caregiving, reinforcing a life centered on the child. Without consistent support from partners or family, many struggle to bring personal or professional goals into focus. Thus, beyond psychosocial support, expanding access to public childcare is essential to help mothers gradually broaden their experiential space and envision new possibilities. Clinical Implications Psychosocial interventions for adolescent mothers should recognize when overwhelming openness to the future occurs, particularly during pregnancy. Providing too much information early on may intensify the sense that there is an unmanageable amount to learn and anticipate, which can contribute to disengagement. A more attuned approach is to offer information gradually and clearly, focusing on pregnancy, childbirth, and postpartum changes in a way that reduces fear, supports bodily awareness, and creates space to process future anxieties.. Regular meetings can also foster continuity, making the future feel more manageable and increase confidence in their parental abilities. After the baby is born, for mothers with limited future prospects, interventions should map realistic opportunities for education and work, tailored to individual contexts. This should be done with respect for each mother’s values and choices, emphasizing a gradual, step-by-step process rather than distant goals alone. A non-judgmental approach should honor each mother's life path, while also creating conditions that support development. In early infancy, it is common that the child occupies the experiential center. Interventions should not aim to shift this focus, but as the child grows, they can help broaden the mother’s peripheral awareness, supporting exploration of new possibilities and expanding relational horizons. Our findings also suggest that physical discomfort can be present during emotional distress, shifting bodily experience from subject to object. Evidence from the literature also points in this direction, with studies linking hyperemesis gravidarum to higher rates of depression and anxiety (44). In this sense, recognizing that symptoms can be metonymic expressions — where the part reflects the whole — can help clinicians view somatic complaints as possible signals of existential distress, not just organic dysfunctions. Such an approach may improve the relationship between practitioners and young mothers by legitimizing their concerns, which in turn can enhance engagement and adherence. However, it is essential that responses to such complaints avoid pathologizing pregnancy itself. The biomedical model often applies a static view of health (26), and technical language used to describe normal pregnancy changes, such as “weight gain”, or “reduced mobility”, can carry an objectifying bias. Rather than empowering pregnant individuals, this language risks alienating them from their own experience, turning their embodied transformations into clinical concerns. Therefore, in periods when bodily experience becomes central and physical complaints are frequent, it is vital to recognize when the experience of the body as an object occurs, without reinforcing a clinical gaze that reduces the body to an object. Limitations This study has relevant limitations to be acknowledged. First, we did not conduct the interviews ourselves and had access only to audio excerpts, limiting their connection to participants’ lived experiences, which is crucial in phenomenological research. Second, we did not interview participants who dropped out of the PL program, hindering our understanding of their motivations and limiting direct insights into areas needing improvement. Third, we were unable to invite participants to review the transcripts and provide feedback on the findings due to logistical challenges, which might have further enhanced the credibility and consistency of the results. Lastly, part of the study took place during the COVID-19 pandemic, which likely influenced participants’ daily lives and access to broader opportunities, and should be considered when interpreting the findings. Conclusions This study explored how adolescent mothers who participated in the PL program experienced pregnancy, childbirth, and early motherhood. The findings indicate that the convergence of adolescence and motherhood, both marked by uncertainty and limited life experience, led participants down divergent developmental paths. Some showed accelerated maturation, embracing multiple identity roles as daughters, mothers, students, and providers. Others, however, anchored their sense of self more exclusively in the maternal role. These results suggest that while psychosocial interventions that strengthen maternal competencies are valuable, they must also support the expansion of other dimensions of life. Confidence in the maternal role, often central in this phase, is crucial, but so is fostering engagement in peripheral aspects of identity to promote a more integrated and expansive biographical trajectory. Declarations Acknowledgements This paper has been supported by QUALab, the Qualitative & Mixed Methods Lab, a collaboration between the Yale Child Study Center, and Centre de Recherche en Epidémiologie Et Santé Des Populations (CESP). This paper has also been supported by the Center for Research and Innovation in Mental Health (CISM), São Paulo. Author Contributions : Author contributions were as follows: D.T.C., E.A.N., D.F., and L.B. contributed to the conceptualization of the study. Methodology was developed by D.T.C., E.A.N., and L.B. Data curation was conducted by D.F. The investigation was carried out by D.T.C., E.A.N., L.A.F., D.F., N.B., A.C., V.N.S., A.A.C.O., F.G.F., G.V.P., E.C.M., A.M., and L.B. Validation was performed by D.T.C., E.A.N., L.A.F., D.F., N.B., A.C., V.N.S., A.A.C.O., F.G.F., G.V.P., E.C.M., A.M. and L.B. Formal analysis was carried out by D.T.C., E.A.N., and L.B. Supervision was provided by E.C.M., A.M. and L.B. Project administration was undertaken by L.A.F., D.F., N.B., A.C., V.N.S., and A.A.C.O. The original draft was written by D.T.C. and E.A.N., and all authors contributed to review and editing, including D.T.C., E.A.N., L.A.F., D.F., N.B., A.C., V.N.S., A.A.C.O., F.G.F., G.V.P., E.C.M., A.M. and L.B. Declaration of conflicting interest : Nothing to declare Funding statement: Debora Tseng Chou and Emilio Abelama Neto received funding from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) to support this research. Ethical considerations: The study was reviewed and approved by the Ethics Committee of the University of São Paulo Medical School (reference number: 2286606) and the protocol was registered in the clinicaltrials.gov platform (NCT04362098) Consent to participate : Written informed consent was obtained from all participants included in the study. For participants under the age of 18, written consent was obtained from a parent or legal guardian. All participants and/or their guardians were informed about the purpose of the research, the voluntary nature of participation and their right to withdraw at any time. Data availability: The data that support the findings of this study are available on request from the corresponding author. 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Mais de 70% das crianças em situação de pobreza não frequentam creche. 02/12/2024. 2024 Feb 12; Mitchell‐Jones N, Gallos I, Farren J, Tobias A, Bottomley C, Bourne T. Psychological morbidity associated with hyperemesis gravidarum: a systematic review and meta‐analysis. BJOG Int J Obstet Gynaecol. 2017 Jan;124(1):20–30. Tables TABLE 1 Domains, Themes, and Representative Quotes Domain/Theme Representative quote 1. Reactions to Discovery of Pregnancy Adolescents reacted with ambivalence I always wanted to get married and be a mother early, but not this early. Adolescents rejected pregnancy At times I didn’t want it. In the very beginning, at times I thought, no, I don’t want this anymore, and then I suffered a lot. Adolescents felt happiness and fulfilment Now I think I’m feeling a mother’s love. How wonderful, such a great feeling. Family and partner’s rejection Regarding my family, when I got the news about the baby, it was chaos. They freaked out. (Interviewee cries) It was horrible. Nowadays, I’m treated very differently at home. Someone I wanted to turn to for support, I just can’t find it - that’s the baby’s father. Family and partner’s support I thought my parents would be really mad, but on the contrary, they were very supportive, especially emotionally. The baby's father was also happy. Happy about the pregnancy, happy about the child. Prejudice and discrimination from society A lot of people, even distant relatives, were making comments, saying I was too young, that it wouldn’t work out, that I was a disappointment. Scarcity of reflections on motherhood I keep thinking about how it will be when I have my child, how I will do things, because being alone is completely different from having a child. Motherhood as profound transformation You change as a person, as a woman. 2. Changes Experiencing the Body The Body in the Foreground of Consciousness I get a little worried, I feel a bit of cramping. I feel very nauseous, I feel really sick. Lived Experiences Manifest in the Body So many changes, both in my body and my mood, everything. As the months went by and I saw my belly growing, I started researching a lot of things, and then I started developing love for him. The Body in the Transition from Pregnancy to Motherhood I want to be able to have the strength to communicate with my baby when the contractions come. TABLE 2 Domains, Themes, and Representative Quotes (Continued) 3. Forming a Maternal Identity Adolescence as a Period of Discovery What comes to my mind when I think about pregnancy, especially at my age, because I’m a teenager, it’s a somewhat difficult topic. From Unpreparedness to a Sense of Capability I was afraid to dress him, afraid I might hurt him. As a mother, I’m even surprised by myself because I thought I wouldn’t make it this far. Revisiting the Experience of Being a Daughter When we have a daughter, we think, ‘Oh my God, why didn’t I listen to my mother?’ And really, everything parents say is true. As a mother, I don’t think I’m an example yet, not as much as my mother. I think she’s an amazing person; she was such a warrior, raising six kids. 4. Transformations in the Experience of Time Pregnancy as Openness to the Future I think what really dominates me is more fear and anxiety. Experience of Novelty Through the Child Every day we discover new things together, things I didn’t even know a baby could do, and they do. Motivation to Build a Better Future I was able to prove to everyone that I was going to make it, I was pregnant with them, and I still passed the school year, finished my studies, even while taking care of them. Desire to Freeze the Present I don’t want time to go by fast because at some point they’ll be my height, they’ll become a teenager and won’t want anything to do with me anymore. 5. Reframing Relationships Child’s centrality in the Mother’s Life I don't think I can do it without her these days. I can't live without her Mother Prioritizes the Child Over Herself I don't care if I don't go out, I don't care if I don't do anything. The important thing is that she's well. Child as an Active Participant in Emotional Support Especially when I'm sad, she always comes to calm me down, hugs me, kisses me, this has been going on since she was very little, since she was 9, 10 months old Care Dynamics in Family Relationships It brought my family and his father's family closer together, it brought me and my mother closer together because we used to fight a lot. It brought everyone together as we were very separate. TABLE 3: Theoretical constructs, and empirical domains and themes Theoretical Construct a Empirical Findings From This Study Domain Themes Embodiment Coexistence of the experiences of body-as-subject and body-as-object Reactions to the discovery of pregnancy Adolescents reacted with ambivalence Adolescents rejected pregnancy Adolescents felt happiness and fulfilment Scarcity of reflections on motherhood Motherhood as profound transformation Changes Experiencing the Body The Body in the Foreground of Consciousness Lived Experiences Manifest in the Body The Body in the Transition from Pregnancy to Motherhood Identity and Intersubjectivity Testing roles and building them with others Reactions to the discovery of pregnancy Family and partner’s rejection Family and partner’s support Prejudice and discrimination from society Forming a Maternal Identity Adolescence as a Period of Discovery From Unpreparedness to a Sense of Capability Revisiting the Experience of Being a Daughter Temporality Subjective experience of time, which shapes consciousness Transformations in the experience of time Pregnancy as openness to the future Experience of novelty through the child Motivation to build a better future Desire to freeze the present Spatiality Dialectics between experiential center and periphery Reframing relationships Child’s centrality in mother’s life Mother prioritizing the child over herself Child as an active participant in emotional support Care dynamics in family relationships a Adapted from Husserl (32) and Minkowski (33) Additional Declarations No competing interests reported. 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PAULO","correspondingAuthor":false,"prefix":"","firstName":"Emilio","middleName":"Abelama","lastName":"Neto","suffix":""},{"id":531583816,"identity":"39a47adc-07e8-488e-9d48-efea2db03c5e","order_by":2,"name":"Lislaine Aparecida Fracolli","email":"","orcid":"","institution":"Universidade de Sao Paulo Escola de Enfermagem, SÃO PAULO, STATE OF SÃO PAULO","correspondingAuthor":false,"prefix":"","firstName":"Lislaine","middleName":"Aparecida","lastName":"Fracolli","suffix":""},{"id":531583817,"identity":"a57a273e-867f-46b9-85f0-492a1c56d732","order_by":3,"name":"Daniel Fatori","email":"","orcid":"","institution":"Universidade de Sao Paulo Instituto de Psiquiatria, SÃO PAULO, STATE OF SÃO PAULO","correspondingAuthor":false,"prefix":"","firstName":"Daniel","middleName":"","lastName":"Fatori","suffix":""},{"id":531583819,"identity":"c2b293d3-f5a3-4ea3-bb40-043767af98b1","order_by":4,"name":"Natalia Becker","email":"","orcid":"","institution":"Universidade Presbiteriana Mackenzie, SÃO PAULO, STATE OF SÃO PAULO","correspondingAuthor":false,"prefix":"","firstName":"Natalia","middleName":"","lastName":"Becker","suffix":""},{"id":531583821,"identity":"fc4adaef-5337-4db8-8370-c85d85cd44b8","order_by":5,"name":"Arthur Caye","email":"","orcid":"","institution":"Universidade de Sao Paulo Departamento de Psiquiatria, SÃO PAULO, STATE OF SÃO PAULO","correspondingAuthor":false,"prefix":"","firstName":"Arthur","middleName":"","lastName":"Caye","suffix":""},{"id":531583822,"identity":"b84bea62-bc3d-4b02-ad57-bbc6c7e3d8fa","order_by":6,"name":"Vinicius Nagy Soares","email":"","orcid":"","institution":"Universidade de Sao Paulo Departamento de Medicina Preventiva SÃO PAULO, STATE OF SÃO PAULO","correspondingAuthor":false,"prefix":"","firstName":"Vinicius","middleName":"Nagy","lastName":"Soares","suffix":""},{"id":531583823,"identity":"eb02eca6-a1f2-484c-972a-65c23d7853f5","order_by":7,"name":"Ana Alexandra Caldas Osorio","email":"","orcid":"","institution":"Universidade Presbiteriana Mackenzie, SÃO PAULO, STATE OF SÃO PAULO","correspondingAuthor":false,"prefix":"","firstName":"Ana","middleName":"Alexandra Caldas","lastName":"Osorio","suffix":""},{"id":531583825,"identity":"c97615bc-57f4-4891-83dc-c19c8e340cdc","order_by":8,"name":"Flávio Guimarães-Fernandes","email":"","orcid":"","institution":"Universidade de Sao Paulo Departamento de Psiquiatria, SÃO PAULO, STATE OF SÃO PAULO","correspondingAuthor":false,"prefix":"","firstName":"Flávio","middleName":"","lastName":"Guimarães-Fernandes","suffix":""},{"id":531583826,"identity":"7d6b4f6d-b662-45a9-bad2-196f27110feb","order_by":9,"name":"Guilherme Vanoni Polanczyk","email":"","orcid":"","institution":"Universidade de Sao Paulo Departamento de Psiquiatria, SÃO PAULO, STATE OF SÃO PAULO","correspondingAuthor":false,"prefix":"","firstName":"Guilherme","middleName":"Vanoni","lastName":"Polanczyk","suffix":""},{"id":531583827,"identity":"88e97448-e6fe-4947-90bf-45ad5661bb1b","order_by":10,"name":"Euripedes Constantino Miguel","email":"","orcid":"","institution":"Universidade de Sao Paulo Departamento de Psiquiatria, SÃO PAULO, STATE OF SÃO PAULO","correspondingAuthor":false,"prefix":"","firstName":"Euripedes","middleName":"Constantino","lastName":"Miguel","suffix":""},{"id":531583828,"identity":"f6d0d872-b33f-4447-9366-ba3185af01a4","order_by":11,"name":"Andrés Martin","email":"","orcid":"","institution":"Yale School of Medicine NEW HAVEN, CONNECTICUT","correspondingAuthor":false,"prefix":"","firstName":"Andrés","middleName":"","lastName":"Martin","suffix":""},{"id":531583830,"identity":"b5be8350-dabb-4dd1-9f16-7a9cbdee236d","order_by":12,"name":"Laelia Benoit","email":"","orcid":"","institution":"Yale School of Medicine NEW HAVEN, CONNECTICUT","correspondingAuthor":false,"prefix":"","firstName":"Laelia","middleName":"","lastName":"Benoit","suffix":""}],"badges":[],"createdAt":"2025-09-27 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11:41:20","extension":"html","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":157463,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7730299/v1/fc63cae3c914bfec3a3741fd.html"},{"id":102785745,"identity":"7b18fc71-d8ec-4224-b79a-5c50242d7433","added_by":"auto","created_at":"2026-02-16 16:09:29","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1150881,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7730299/v1/c5453d6d-618c-4439-93bc-75b9cba97b37.pdf"},{"id":94017896,"identity":"706440eb-1fba-4bfe-b5bd-8d83486262bf","added_by":"auto","created_at":"2025-10-21 11:41:19","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":924317,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementalmaterial1COREQchecklist.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7730299/v1/64c8c8d43f63db950e5c96e3.pdf"},{"id":94017893,"identity":"f187399d-7ec8-4145-a1cb-8734692e113a","added_by":"auto","created_at":"2025-10-21 11:41:19","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":15192,"visible":true,"origin":"","legend":"","description":"","filename":"Supplemental.docx","url":"https://assets-eu.researchsquare.com/files/rs-7730299/v1/acad6015261dee53f96916da.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Motherhood in Adolescence: A Qualitative Study of the Lived Experience of Participants in a Perinatal Home-Visiting Intervention","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe World Health Organization defines adolescent pregnancy as occurring between ages 10 and 19 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). It is a global phenomenon, and births from women aged 15\u0026ndash;19 account for 11% of all pregnancies worldwide (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e), with an estimated prevalence of 16\u0026nbsp;million cases per year (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e), 90% of which occur in low- and middle-income countries (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). These pregnancies are often unplanned (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) and associated with significant challenges across different aspects of life. A recent meta-synthesis (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) analyzing qualitative studies on adolescent motherhood highlighted that this experience can be marked by a lack of preparedness for motherhood, social stigma, frequent absence of partner support, school dropout, loneliness, and emotional distress. Another aspect adolescent mothers face is the complex process of identity restructuring, in which young mothers continuously negotiate their self-perception in relation to their new maternal role alongside their child (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDespite these challenges, some adolescent mothers demonstrate resilience, adapting to their new role through key psychological and social mechanisms. The meta-synthesis also pointed out that self-efficacy and motivation to change one\u0026rsquo;s life trajectory can facilitate adaptation to the maternal role. Factors such as acceptance of the past, a sense of competence in motherhood, and an optimistic outlook were identified as elements that enhance self-efficacy. Additionally, social support from partners, family members, and friends who had also experienced adolescent motherhood played a central role in coping during this period. A key theme in the study was that, for some adolescents, pregnancy represented a time of maturation, the development of a sense of responsibility, and strengthened self-esteem. In other words, motherhood is a period of profound transformation in which adolescents face challenges that can lead to both emotional suffering and personal growth (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eOne strategy designed to support young mothers in this transition is the implementation of home visitation programs, which aim to assist adolescent mothers in adapting to the maternal role while fostering their children\u0026rsquo;s healthy development (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). In Brazil, one initiative is the \u003cem\u003ePrimeiros La\u0026ccedil;os\u003c/em\u003e (PL) program (\u0026ldquo;First Ties\u0026rdquo;), which offers home visits conducted by nurses for adolescent mothers facing adverse conditions. The program supports mother and child from pregnancy until the child reaches two years of age, with the goal of fostering parenting skills, promoting adequate child development, and providing emotional and social support to young mothers (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Evidence suggests the PL program has positive effects not only on infant outcomes \u0026mdash; such as secure attachment (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) and expressive language skills (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) \u0026mdash; but also on parental well-being and maternal behaviors such as reading or singing to the child (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e\u003cp\u003e However, like many home visitation interventions, the PL program faces challenges in participant engagement and retention. High attrition rates are common and can significantly reduce the intended intervention dose. For example, in the Nurse Family Partnership program, implemented across various regions of the United States and internationally, only 35% to 40% of families remained engaged throughout the entire program (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Similarly, both the PL and the Early Head Start program in the U.S. report retention rates around 60% (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Dose adherence is also a concern: in the PL program, participants in the intervention group received, on average, 38 of the 66 planned nurse visits (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThese data raise important questions about how well such interventions align with the lived realities of adolescent mothers. High dropout rates and reduced number of visits may reflect a mismatch between program structure and participants\u0026rsquo; needs and priorities. A deeper understanding of the adolescent motherhood experience is therefore necessary to refine and tailor home visitation models in ways that enhance their relevance and responsiveness. In this context, we go on to explore the lived experience of adolescent mothers, encompassing the period from pregnancy through the first two years postpartum. The overall goal of our study is to inform program adaptations and contribute to more meaningful, engaging, and effective interventions for young mothers navigating early parenthood.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eWe collected qualitative data in the context of a randomized clinical trial (RCT) conducted to evaluate the effectiveness of the PL program for adolescents recruited in 2018 and 2019 in S\u0026atilde;o Paulo city. The study was reviewed and approved by the Ethics Committee of the University of S\u0026atilde;o Paulo Medical School (reference number: 2286606) and the protocol was registered in the clinicaltrials.gov platform (NCT04362098). Full details of the PL protocol are available in previous publications (10,11)\u003cem\u003e.\u003c/em\u003eQuantitative data from this RCT were under analysis at the time of writing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe recruited nulliparous adolescents aged 14 to 19 years, between 8 and 16 weeks of gestation, from a low socioeconomic status (classes C, D, E according to Associa\u0026ccedil;\u0026atilde;o Brasileira de Empresas de Pesquisa, ABEB (15)), and living in S\u0026atilde;o Paulo, Brazil. Recruitment took place between May 2018 and November 2019, after participants had started prenatal care in the public primary healthcare system. Eligible pregnant adolescents received an informational leaflet about the program and provided their contact details to the research coordinator. The coordinator then contacted them by phone or at the clinic to explain the methodological details, address any questions, and obtain consent. \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTrained psychologists conducted interviews with the adolescents at four time points: during pregnancy, and at 3, 12, and 24 months postpartum. Researchers conducted individual interviews in person, at the research center, and audio-recorded them. Participants received the following open-ended instructions:\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003eDuring pregnancy: \u0026ldquo;We would like you to talk for 5 minutes about your pregnancy, your future child, and yourself as a mother.\u0026rdquo;\u003c/li\u003e\n\u003cli\u003eAt 3, 12, and 24 months: \u0026ldquo;We would like you to talk for 5 minutes about your child, yourself as a mother, and your relationship with your child.\u0026rdquo;\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eParticipants spoke freely for 5 minutes. If prolonged silence occurred, the interviewer used a prompt such as: \u0026ldquo;Please continue\u0026rdquo; or \u0026ldquo;Feel free to talk.\u0026rdquo; It was clarified to participants that their responses would have no bearing on the nature or content of the intervention provided.\u003c/p\u003e\n\u003cp\u003eInterviewers were all female psychologists and post graduate students who had no prior relationship with participants and were not involved in home visits. They also did not participate in data analysis or in preparing the study results. To capture spontaneous narratives while minimizing participant burden, we chose a five-minute free speech interview format, in which adolescent mothers spoke uninterrupted about their thoughts and experiences. Short, unstructured speech samples have shown strong validity in diverse and vulnerable populations, including adolescents (16) and caregivers from low-income backgrounds (17). Even brief samples can yield rich emotional and relational data while reducing fatigue (18). Also, free speech formats are less directive and less influenced by interviewer input, enabling more natural and authentic expression (16). Overall, this method offers a practical, ethically sensitive, and scientifically grounded way to capture the lived experiences of adolescent mothers.\u003c/p\u003e\n\u003cp\u003eInterviews with 72 participants of the intervention group were fully transcribed and anonymized. Three researchers (DTC, EAN and LB), all psychiatrists and native Portuguese speakers conducted data analysis. DTC and LB are female, EAN is male, and LB is a mother, demographic characteristics that informed our reflexivity. To ensure thematic saturation, we chose to code all available interview material. Although the total number of interviews (223) may appear high for a qualitative study, each interview was relatively short. Moreover, participants often provided brief responses, with long pauses, and found it challenging to elaborate, which further justified the inclusion of the entire dataset in the analysis. For reference, we found that the average word count per interview was 496, ranging from 105 to 1,014 words (the average number of words spoken by a young Brazilian in five minutes is about 530 (19). \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe focused on participants from the intervention group, as the qualitative approach is not suitable for comparative results. We conducted the analysis of the transcribed interviews using thematic analysis (20) informed by phenomenology (21,22). This method was chosen due to the large number of short interviews with lower individual depth, making it suitable for capturing common themes and patterns across participants. The short nature of the reports, however, did not prevent descriptions of rich experiences during pregnancy and motherhood. Thus, we carried out the analysis by coding all transcripts line by line, generating initial themes, which constituted general units of meaning. Throughout the analysis, we prioritized those that contained reports of the participant\u0026rsquo;s experiences. Based on these, we organized the content into the five domains described in the results section. Our approach is informed by a phenomenological perspective, which seeks to understand the experiences and personal meanings of the lived reality being studied (23), in this case, how adolescent girls experienced pregnancy and the transition to motherhood. \u003c/p\u003e\n\u003cp\u003eTwo researchers (DTC and EA) independently coded all transcripts in Portuguese and developed an initial codebook. Three team members (DTC, EA and LB) then discussed their interpretations and reached consensus through triangulation, refining the initial domains and themes. Subsequently, quotes were translated into English, and the thematic structure was further reviewed and refined in collaboration with the broader research team, involving all authors in the final interpretive process. We used Microsoft Word for coding and theme development; no software was used in the analysis. This study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) (24), with its criteria systematically addressed throughout the methodology section and included as \u003cstrong\u003eSupplemental Table 1. \u003c/strong\u003e\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eOf the 83 participants enrolled in the intervention arm, 72 (87%) took part in at least one interview. 69 interviews were conducted during pregnancy, 36 at 3 months postpartum, 56 at 12 months, and 62 at 24 months, for a total of 223 interviews. The sociodemographic characteristics of participants can be found in \u003cstrong\u003eSupplemental Table 2.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFrequent themes in the interviews included general accounts of pregnancy and motherhood routines, with few personal details. Participants also frequently described what their child could do (such as crawling, playing, or laughing) or their child\u0026rsquo;s characteristics (such as being intelligent, energetic, or affectionate). While these insights are interesting, they fall outside the primary focus of this article. Therefore, we have chosen to center our results on lived experiences related to pregnancy and motherhood. We identified five key domains, which we will describe below: (1) \u003cem\u003eReactions to the Discovery of Pregnancy\u003c/em\u003e; (2) \u003cem\u003eChanges Experiencing the Body\u003c/em\u003e; (3) \u003cem\u003eForming a Maternal Identity\u003c/em\u003e; (4) \u003cem\u003eTransformations in the Experience of Time\u003c/em\u003e, and (5) \u003cem\u003eReframing Relationships\u003c/em\u003e. We provide a summary of domains, themes, and representative quotations in \u003cstrong\u003eTables 1 and 2.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eINSERT TABLE 1 ABOUT HERE\u003c/p\u003e\n\u003col start=\"1\" type=\"1\"\u003e\n \u003cli\u003e\u003cu\u003eReactions to the Discovery of Pregnancy\u003c/u\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eWe identified different patterns to how the adolescents received the news of their pregnancy. These reflections illustrate how motherhood is not merely an isolated event but a transformative process that involves reorganizing how one experiences the world.\u003c/p\u003e\n\u003cp\u003eMany participants expressed \u003cem\u003eambivalence\u003c/em\u003eas they navigated the reality of impending motherhood. Their reactions often fluctuated between concern and happiness, reflecting the complex interplay of personal aspirations, social expectations, and life circumstances, as illustrated by the quotes: \u0026quot;At the same time, I didn\u0026rsquo;t want to have a child, but I did.\u0026rdquo; and \u0026ldquo;I was scared and happy at the same time\u0026rdquo;.\u003cem\u003e\u003cbr\u003e\u003c/em\u003eAlthough ambivalence was the predominant reaction, some participants expressed complete \u003cem\u003erejection\u003c/em\u003eof the pregnancy, often linked to intense psychological distress, as reflected in: \u0026quot;It affected my mental health a lot. That\u0026rsquo;s when I attempted suicide.\u0026quot;\u003c/p\u003e\n\u003cp\u003eIn contrast, some participants described pregnancy as a long-awaited source of \u003cem\u003ehappiness\u003c/em\u003eand personal \u003cem\u003efulfillment\u003c/em\u003e: \u0026quot;It was a dream come true. Thank God.\u0026quot;\u003c/p\u003e\n\u003cp\u003eThe initial reactions of those around the young women also varied widely. Some families responded with \u003cem\u003erejection\u003c/em\u003e, which led to conflicts within the household. In some cases, the child\u0026rsquo;s father also failed to provide support, further compounding the young mother\u0026rsquo;s challenges: \u0026quot;Well, my pregnancy has been complicated because I\u0026rsquo;m not with the baby\u0026rsquo;s father, and my mother doesn\u0026rsquo;t accept it either.\u0026quot;\u003c/p\u003e\n\u003cp\u003eHowever, most families were described as a\u003cem\u003esource of support\u003c/em\u003efor the adolescents, helping them feel that it was possible to get through this period: \u0026quot;And despite the pregnancy at this age being a bit complicated, it has been a little easier for me because of my family\u0026rsquo;s support, my parents\u0026rsquo; support. Even though my situation is very difficult, knowing I have my parents makes my pregnancy feel safer.\u0026quot; and \u0026quot;Knowing that I have my parents\u0026rsquo; love is what keeps me going.\u0026quot;\u003c/p\u003e\n\u003cp\u003eIn a few cases, the baby\u0026rsquo;s father was described as the one who wanted the child and that was very happy with the pregnancy news: \u0026ldquo;He (partner) ended up being really happy when it happened, and I was happy too\u0026rdquo;.\u003c/p\u003e\n\u003cp\u003eParticipants also described society\u0026rsquo;s reactions to adolescent pregnancy, which were often marked by\u003cem\u003eprejudice and discrimination\u003c/em\u003econcerning the pregnancy itself and the educational status that she would be able to achieve in life: \u0026quot;Some people called me crazy, totally out of my mind for getting pregnant so young.\u0026quot;, \u0026quot;Because I was still in school I faced a lot of prejudice. Everyone would say, \u0026lsquo;Oh, now it\u0026rsquo;s over, you won\u0026rsquo;t study anymore\u0026rsquo;\u0026quot;\u003c/p\u003e\n\u003cp\u003eIn these interviews conducted during pregnancy, one striking observation was the\u003cem\u003escarcity of reflections\u003c/em\u003eon what motherhood would actually entail. While some participants briefly mentioned their hopes of raising their child well, encouraging them to study and become a good person, such future-oriented reflections were relatively rare. Instead, the predominant themes were uncertainty, hesitation, and a lack of concrete expectations. Many young women struggled to articulate what they envisioned for themselves as mothers, often pausing for long periods or expressing an inability to imagine what lay ahead. Their words illustrate this: \u0026quot;Wow, I\u0026rsquo;m going to be a mother, how am I going to manage?\u0026quot;,\u0026quot;I keep thinking about how it will be when I have my child, how I will do things, because being alone is completely different from having a child.\u0026quot;\u003c/p\u003e\n\u003cp\u003eDespite the wide range of initial reactions to the pregnancy, all participants described\u003cem\u003eundergoing a profound transformation,\u003c/em\u003enot only in anticipation of the baby\u0026rsquo;s arrival but even more so after childbirth. Regardless of whether they initially faced the news with joy, ambivalence, or distress, they consistently portrayed motherhood as a pivotal experience that reshaped their daily lives, relationships, and identity. Across the interviews, the perception of motherhood as a deeply life-altering experience was a recurring theme: \u0026quot;Once you realize you are carrying a life, everything shifts.\u0026quot;, \u0026quot;After he was born, my whole world changed.\u0026quot;\u003c/p\u003e\n\u003col start=\"2\" type=\"1\"\u003e\n \u003cli\u003e\u003cu\u003eChanges Experiencing the Body\u003c/u\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003eThe Body in the Foreground of Consciousness\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDuring pregnancy, bodily transformations were visible, and physiological changes were deeply felt. Even before the baby existed physically in the world, their mother\u0026rsquo;s body was the place where new life manifested, in corporeal dimensions that changed: \u0026quot;You put on clothes that used to fit, and now they don\u0026rsquo;t anymore,\u0026quot; and in discomfort such as nausea and abdominal pain. The account of one participant, who had conflicting relationships with her family, revealed how these tensions translated into physical discomfort in her abdomen: \u0026quot;Every time I argue, I feel pain in the lower part of my belly, every time. It\u0026rsquo;s horrible, like little stabs.\u0026quot;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cbr\u003e\u003c/em\u003e\u003cstrong\u003eLived Experiences Manifest in the Body\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe feeling of being unprepared for motherhood was not limited to an idea or representation but could be experienced as a perception of physical immaturity. \u0026quot;Whether we like it or not, teenage pregnancy is very difficult. Because my body is still not fully developed, I don\u0026rsquo;t have a woman\u0026rsquo;s body yet to carry a life inside me.\u0026quot; On the other hand, participants who had positive experiences and accepted their pregnancy described taking pleasure in the changes in their bodies and the early development of affectionate feelings toward their future child: \u0026quot;It\u0026rsquo;s going to be a wonderful feeling, it already is! Carrying a life inside me, watching my body change.\u0026quot;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe Body in the Transition from Pregnancy to Motherhood\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the transition from pregnancy to motherhood, the experience of continuity between the two stages was not always present: \u0026quot;When I hold him in my arms, sometimes I stop and think: I can\u0026rsquo;t believe he came out of me. Because, how is it possible, right? A baby like this came out of me\u0026hellip;\u0026quot; This statement reveals the difficulty of integrating pregnancy and motherhood as part of the same experience. The maternal body, which previously housed the baby, now finds itself separate from the child, generating feelings of surprise and unfamiliarity.\u003c/p\u003e\n\u003cp\u003eChildbirth emerges as a crucial event in this transition, acting as a process through which the body adapts to separation from the baby. Some women describe this moment as marked by intense pain, closely linked to feelings of fear and vulnerability: \u0026quot;During his birth, the only thing I could think about was that I was going to die because the pain was unbearable.\u0026quot;\u003c/p\u003e\n\u003cp\u003eFollowing the birth, physical closeness remained intense through breastfeeding. Some participants described this experience as an act of giving their own body to nourish the child, despite pain and discomfort: \u0026quot;Wow, I suffered so much while breastfeeding in the first two weeks because he actually tore off a little piece of my breast.\u0026quot;.\u003c/p\u003e\n\u003cp\u003eINSERT TABLE 2 ABOUT HERE\u003c/p\u003e\n\u003col start=\"3\" type=\"1\"\u003e\n \u003cli\u003e\u003cu\u003eForming a Maternal Identity\u003c/u\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003eAdolescence as a Period of Discovery\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAdolescence is inherently characterized by exploration, change, and the shaping of aspirations. Becoming a mother during this period did not close off that openness but rather introduced new variables to be navigated alongside existing dreams and uncertainties. As one participant expressed, \u0026quot;It\u0026rsquo;s a little difficult because of my age, where you\u0026rsquo;re just starting to achieve things, starting to explore the world. Then you look to the side and see that there\u0026rsquo;s a responsibility there.\u0026quot;\u003c/p\u003e\n\u003cp\u003eFor some, the arrival of a child became part of this ongoing process of discovery, reshaping their expectations but not necessarily limiting their sense of possibility. For others, the weight of new responsibilities brought feelings of apprehension, as they adjusted to an unanticipated shift in their path.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFrom Unpreparedness to a Sense of Capability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMany participants reported difficulties in caring for their newborn during the first days of life: \u0026quot;During the first week when I got home, I would look at him and feel like I wasn\u0026rsquo;t capable of taking care of him on my own.\u0026quot; The perception of the newborn\u0026rsquo;s fragility led to fear of accidentally harming the baby while performing basic caregiving tasks: \u0026quot;And when he was born, everything was so new. I was even afraid to bathe him because newborns are slippery, their skin is so delicate, and I was scared I might drown him.\u0026quot;\u003c/p\u003e\n\u003cp\u003eHowever, after a few months, many developed a sense of confidence in their ability to care for their child, were surprised by how much they had learned and integrated this confidence into their sense of identity: \u0026quot;I am a completely different person today. I stopped being a girl, I became a woman, a mother, a homemaker, totally different from who I was before she arrived.\u0026quot;, \u0026quot;I think I have gone beyond what I expected from myself.\u0026quot;\u003c/p\u003e\n\u003cp\u003eMotherhood in adolescence often led to significant shifts in daily habits and priorities, prompting some young mothers to adopt a greater sense of responsibility. For many, the arrival of a child reshaped their routines, influencing how they spent their time and what they valued. As one participant reflected, \u0026quot;When I got pregnant, I used to go to many funk parties, now I stopped going.\u0026quot; Another described a transformation in her attitude toward responsibilities, stating, \u0026quot;I used to be really irresponsible with things, I didn\u0026rsquo;t care about anything. I didn\u0026rsquo;t want to work, I didn\u0026rsquo;t want to do anything.\u0026quot;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRevisiting the Experience of Being a Daughter\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe experience of motherhood frequently led participants to reflect on their relationships with their own mothers. Many reported increased empathy and understanding toward them: \u0026quot;To us, our mothers seem annoying, but when we become one, we realize they only want the best for their children.\u0026quot;\u003c/p\u003e\n\u003cp\u003eSome recognized their own upbringing as a positive reference, and saw their mothers as resilient figures who overcame challenges and imparted valuable lessons: \u0026quot;I want to pass on to him everything I\u0026rsquo;ve learned, everything my mother taught me too.\u0026quot; For others, motherhood also prompted a critical reassessment of negative aspects of their own upbringing, leading them to reflect on cycles of care and behaviors they wished to avoid in raising their own children: \u0026quot;I used to get punched when I was a child for not doing house chores.\u0026quot;.\u003c/p\u003e\n\u003col start=\"4\" type=\"1\"\u003e\n \u003cli\u003e\u003cu\u003eTransformations in the Experience of Time\u003c/u\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003ePregnancy as Openness to the Future\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThroughout the interviews conducted during pregnancy, discussions about the future were abundant. The very expression \u0026quot;expecting a child\u0026quot; encapsulates how this stage of life is often filled with anticipation, centered on what is yet to come. Many participants expressed this sense of looking ahead and making plans. As one participant shared, \u0026quot;We are already starting to make plans ahead, already thinking about what it will be like, what to do.\u0026quot; Another reflected on how pregnancy shifted her perspective, saying, \u0026quot;Oh, I don\u0026rsquo;t know, it\u0026rsquo;s different. You think more about the future, you think that now it\u0026rsquo;s not just you, you have another person to take care of, to feed.\u0026quot;\u003c/p\u003e\n\u003cp\u003eThis openness to the future often manifested as expectations regarding life with the baby. Curiosity also played a role in these expectations, with participants wondering about their baby\u0026rsquo;s characteristics: \u0026quot;And I also feel anxious at the same time to see what my child will be like, if they will look like me, if they will look like their father.\u0026quot; and \u0026quot;I\u0026rsquo;m anxious to know how they are, if I will be able to hear their heartbeat, to know the sex.\u0026quot; However, not all expectations were positive. In some cases, uncertainty gave way to fear, with participants expressing concerns about the unknown aspects of childbirth and parenting. One young mother admitted, \u0026quot;I\u0026rsquo;m scared. I don\u0026rsquo;t know how it\u0026rsquo;s going to be... I\u0026rsquo;m very, very scared.\u0026quot;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eExperiencing Novelty Through the Child\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe experience of moving towards the future continued after the baby was born, a similar experience to the pregnancy, however with different themes. Many participants described how their perception of time became shaped by their baby\u0026rsquo;s rapid development and constant changes. The early months of motherhood were filled with daily discoveries, both for the mother and the child. As one participant observed, \u0026quot;They are discovering the world, each day that passes, a different situation happens, and they are adapting to that situation.\u0026quot;\u003c/p\u003e\n\u003cp\u003eSome mothers looked at their child as the continuity of life goals that they weren\u0026apos;t able to achieve, almost as giving up of their personal plans and living the progression of time and unfolding of plans by proxy, as illustrated by this excerpt: \u0026ldquo;when it comes to my son\u0026apos;s future, I can help him to do what I couldn\u0026rsquo;t do, finish his studies, and when he finishes his studies, start a good college, so that in his future, he can become a much better person than I am.\u0026rdquo;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMotivation to Build a Better Future\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOther participants described how motherhood became a driving force for them to pursue a better future for them and for the child. The responsibility of providing a good life for their baby made education and work more meaningful and urgent. As one young mother explained, \u0026quot;Because for me to be someone in life, to give them a future, I need to at least have my studies.\u0026quot; Another spoke about adjusting her academic goals, saying, \u0026quot;I won\u0026rsquo;t be able to go to college now, but in two years, I will, to set a good example for my child\u0026quot;.\u003c/p\u003e\n\u003cp\u003eSome participants also felt a strong need to prove their ability to succeed despite the challenges of young motherhood. One mother proudly shared, \u0026quot;But I was able to prove to everyone that I was going to make it (study) even with the baby.\u0026quot; The motivation extended beyond education to financial independence, as one participant expressed: \u0026quot;I want to have something to give my child, to have an income.\u0026quot;\u003c/p\u003e\n\u003cp\u003eHowever, despite their motivation, balancing personal goals with childcare responsibilities was not always easy. Many mothers spoke of the overwhelming burden of managing studies, work, and household duties, especially when they lacked external support. One participant illustrated this struggle, saying, \u0026quot;And right now, I\u0026rsquo;m going through a really tough phase because I have to juggle my studies\u0026mdash;I\u0026rsquo;m close to finishing school\u0026mdash;and I\u0026rsquo;m looking for a job. Then, taking care of the baby every day, doing the housework, I take care of everything alone, it\u0026rsquo;s really hard.\u0026quot;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDesire to Freeze the Present\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn contrast to those who were focused on the future, some mothers expressed deep satisfaction with their current stage of life, leading them to wish they could slow time down. For these participants, the present moment with their child was so fulfilling that thoughts of change or planning ahead felt unnecessary. As one mother shared, \u0026quot;As a mother, I\u0026rsquo;m living the best experience of my life.\u0026quot;\u003c/p\u003e\n\u003cp\u003eThis contentment sometimes translated into a desire for time to pass more slowly, preserving their current relationship with their baby. One participant reflected on this feeling, saying, \u0026quot;I feel like they are growing too fast. I wish time would pass more slowly, but unfortunately, life is like that.\u0026quot;\u003c/p\u003e\n\u003cp\u003eThe attachment to the present also led to a reluctance to imagine their child growing up and becoming independent. Some mothers playfully idealized keeping their child close for as long as possible, as one joked, \u0026quot;I already told them that I\u0026rsquo;m not going to let them leave home before they turn forty.\u0026quot;\u003c/p\u003e\n\u003col start=\"5\" type=\"1\"\u003e\n \u003cli\u003e\u003cu\u003eReframing Relationships\u003c/u\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003eChild\u0026rsquo;s Centrality in the Mother\u0026rsquo;s Life\u003cbr\u003e\u003c/strong\u003e For many participants, the arrival of the baby brought about a powerful emotional bond, in which the presence of the child became central not only to their daily routines but also to their identity. This intense connection was often marked by a desire for constant proximity, reflecting how the baby had become a vital source of emotional fulfillment. As one participant expressed, \u0026quot;I can\u0026rsquo;t be without her at all, not even for a little while!\u0026quot; In some cases, this relationship was described as the mother\u0026rsquo;s main purpose in life, with the child representing the core of her existence: \u0026quot;She is everything to me, my reason for living.\u0026quot; Such statements reveal how motherhood, for many, reshaped the way they perceived themselves and the world around them.\u003c/p\u003e\n\u003cp\u003eFor some, the experience of becoming a mother filled an emotional void, offering a renewed sense of wholeness and purpose: \u0026quot;I didn\u0026rsquo;t feel complete without her... Now I feel totally complete, I don\u0026rsquo;t need anything else, anyone else except for her.\u0026quot; In particularly strong expressions of this transformation, the sense of self became so closely tied to the presence of the child that the two identities appeared almost fused. As one young mother put it, \u0026quot;Without her, there\u0026rsquo;s no me anymore.\u0026quot;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMother Prioritizing the Child Over Herself\u003cbr\u003e\u003c/strong\u003e Some mothers reported prioritizing their child\u0026rsquo;s needs over their own. As one participant shared, \u0026quot;Everything I do is for her. I even end up putting myself aside a little to do more things for her, and I don\u0026rsquo;t really mind that.\u0026quot; Such accounts reflected a daily routine shaped by the child\u0026rsquo;s needs, with mothers often viewing self-sacrifice as a natural part of caregiving.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eChild as an Active Participant in Emotional Support\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn addition to the central role of the baby in their lives, some participants described the mother-child bond not only as a source of affection but also as a relationship marked by reciprocity. The child was not seen solely as someone in need of care, but also as someone who contributed meaningfully to the mother\u0026rsquo;s emotional well-being: \u0026ldquo;I think she helps me more than I help her.\u0026rdquo;\u003c/p\u003e\n\u003cp\u003eIn these accounts, the children were perceived as emotionally attuned, capable of recognizing the mother\u0026apos;s feelings and offering comfort, even at a very young age. The mother of a one-year-old, for example, described her child\u0026rsquo;s attentiveness: \u0026ldquo;A child who always notices when I\u0026rsquo;m sad. As incredible as it may seem, despite her young age, she notices and gives me affection.\u0026rdquo;\u003c/p\u003e\n\u003cp\u003eThis emotional sensitivity and exchange of care were described as particularly significant during moments of vulnerability. For some mothers, the presence of the child not only provided daily companionship but also symbolized a new beginning. In certain cases, the birth of the child was associated with a break from past difficulties and the possibility of emotional healing: \u0026quot;Even though I became a mother when still young, my daughter was a big way out of my problems.\u0026quot;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCare Dynamics in Family Relationships\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSome mothers described feelings of jealousy over their child\u0026rsquo;s closeness with other family members, often with a light-hearted tone: \u0026quot;Sometimes I get a little jealous of her with my family because she\u0026rsquo;s really attached to them too, sometimes I feel silly jealousy.\u0026quot; These emotions sometimes coincided with a reluctance to delegate caregiving, as some preferred to manage all aspects themselves: \u0026quot;I love taking care of her. I love doing things for her: bathing, changing, everything. I like doing it myself; I don\u0026rsquo;t like anyone else doing it for me.\u0026quot;\u003c/p\u003e\n\u003cp\u003eAs they experienced these sentiments, most mothers reported receiving support, primarily from their own mothers, and occasionally from the child\u0026rsquo;s father. Although paternal involvement was not deeply explored, accounts ranged widely: \u0026quot;Listen, the affection she has for her father, my God, it\u0026rsquo;s huge.\u0026quot; vs. \u0026quot;His father, he\u0026rsquo;s not present in his life, he doesn\u0026rsquo;t really know what he\u0026rsquo;s like.\u0026quot;\u003c/p\u003e\n\u003cp\u003eBeyond the mother-child bond, participants described the baby\u0026rsquo;s birth as positively influencing broader family dynamics. For many, the child\u0026rsquo;s arrival improved relationships within the extended family and, in some cases, served as a unifying presence in previously tense environments: \u0026quot;He brought happiness into the house because where there used to be only fighting, he brought peace.\u0026quot;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn contemporary Western society, adolescence is often seen as a time of openness to novelty and the future (25). It is a key stage for identity consolidation and investment in education and a career. Pregnancy, likewise, is marked by movement, growth, and change (26), qualities that resonate with the inherent indeterminacy of adolescence. This convergence makes the period more prone to anticipation than certainty and may explain the long silences observed during interviews, as motherhood represents a transition into the unknown (27).\u003c/p\u003e\n\u003cp\u003eThe arrival of a child during adolescence introduces a new variable. As shown in the results, this process was marked by the idea that everything changes, though the nature and direction of those changes varied among participants. For many, motherhood was a catalyst for maturation, increased responsibility, motivation to pursue education and work, and a strengthened sense of identity. Caring for the child became a driver of personal growth, fostering agency and self-confidence. The overall positive tone observed in the interviews is noteworthy. It may suggest that feelings of pleasure or capability outweighed the challenges, or alternatively, that some participants were hesitant to delve into more painful topics during the brief interview. Further research is needed to explore this dynamic in greater depth. Nevertheless, these findings align with existing literature, which highlights how adolescent motherhood, despite its challenges, can promote personal development and maturity (5). We believe the PL program\u0026rsquo;s focus on self-efficacy supported this perspective, though the interview question did not directly address the intervention.\u003c/p\u003e\n\u003cp\u003eAt the same time, for some, the maternal role offered emotional security. In these cases, the child served as a solution to past difficulties and became a central organizing presence in the mother\u0026rsquo;s life. Some mothers expressed a desire to maintain the child\u0026rsquo;s dependence, finding purpose in that dynamic. This was sometimes accompanied by anxiety about the child growing up and becoming more independent, as well as discomfort when others received the child\u0026rsquo;s affection, reflecting a desire to remain the primary caregiver and emotional anchor. These mothers often saw their child as emotionally attentive, sometimes even comforting them when they were sad. Paradoxically, while desiring to maintain the child\u0026rsquo;s dependence, some perceived the child as more emotionally mature than they actually were. This dynamic may relate to emotional parentification, where the child assumes excessive emotional responsibility within the family (28), potentially affecting their development. Although this role reversal may foster certain caring abilities, it can also result in emotional overload and long-term relational difficulties (29).\u003c/p\u003e\n\u003cp\u003eSome participants also voiced hopes that their children would achieve goals they had not, such as completing school or becoming \u0026ldquo;a better person.\u0026rdquo; While common in parenting (30), these aspirations may also reflect a vicarious pursuit of progress. The child\u0026rsquo;s development becomes not just a goal but a symbolic continuation of the mother\u0026rsquo;s own interrupted paths. Rather than pursuing certain ambitions directly, some mothers appeared to invest in their child\u0026rsquo;s success as a way to fulfill postponed trajectories.\u003c/p\u003e\n\u003cp\u003eThus, adolescent motherhood can take on diverse meanings. For some, it sparks growth, encouraging maturity, education, and work. For others, it marks a stabilizing endpoint that interrupts the exploratory nature of adolescence. In such cases, motherhood becomes the central experience around which identity forms. While this profile has also been noted in adult women, such as in Sharon Hays\u0026rsquo; concept of Intensive Motherhood (31), it may be even more pronounced in adolescence, when few other roles have yet been formed.\u003c/p\u003e\n\u003cp\u003eUnderstanding these experiences from a phenomenological perspective can help health professionals and researchers design interventions that broaden these young women\u0026rsquo;s life possibilities. We go on to consider participants\u0026rsquo; accounts through key phenomenological categories to deepen insight into how adolescent mothers experience and navigate motherhood. Importantly, we do not assume that adolescent motherhood corresponds to a specific psychopathological structure. Rather, we describe common aspects that appeared in participants\u0026rsquo; narratives, recognizing that these can reflect characteristics that are intrinsic to adolescence and to the perinatal period. In this sense, we refer to the phenomenological \u0026ldquo;conditions of possibility\u0026rdquo; (22): the basic structures that shape human experience. Classic authors such as Husserl (32,33) have emphasized how dimensions like temporality, spatiality, embodiment, identity, and intersubjectivity are not just contents of experience but the very ground that allows it to unfold. Approaching adolescent motherhood through these categories offers a framework that links subjective narratives with clinical understanding that informs practical recommendations. In \u003cstrong\u003eTABLE 3\u003c/strong\u003e we integrate these theoretical constructs with our study\u0026rsquo;s empirical findings.\u003c/p\u003e\n\u003cp\u003eINSERT TABLE 3 ABOUT HERE\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eEmbodiment\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThe maternal body is the first environment where new life emerges, a space of transformation. Participants described a wide range of sensations during pregnancy, from visible changes to discomforts like nausea and pain. These heightened bodily sensations stood in contrast to the usual transparency of the non-pregnant body. In daily life, the body often functions invisibly, responding to intention without drawing attention, serving as both a medium for action and a spatial anchor. Phenomenology refers to this as the experience of the \u0026quot;body-subject\u0026quot; (21). However, this seamless relationship shifts when the body becomes an object of awareness \u0026mdash; felt in its mass, weight, and limitations \u0026mdash; as in illness or physical discomfort (34).\u003c/p\u003e\n\u003cp\u003ePregnancy is a paradigmatic moment where these two experiences, body-subject and body-object, coexist. Bodily changes such as the growing belly and altered movement bring the body into focus. Yet for some, the pregnant body remains a means of intentionality and agency. When pregnancy is welcomed, the body may be experienced as powerful, a vehicle for realizing life goals (26). In our study, however, many adolescents experienced unplanned pregnancies and expressed ambivalence. Their narratives often centered the body as an object, marked by nausea, pain, and sudden changes. In these cases, the body became external, even burdensome, perhaps more accessible than confronting emotional and social complexities. For many, the feeling of \u0026ldquo;my body is unprepared\u0026rdquo; was more vivid than recognizing a lack of readiness for motherhood. In moments of family conflict, often intensified after revealing the pregnancy, participants reported somatic symptoms, like abdominal pain. This focus of the conscience on the body happens unintentionally and pre-reflectively: the body becomes a point of focus, offering concrete contours in the face of overwhelming emotional complexity.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eIdentity and Intersubjectivity\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eIdentity forms through the interplay of personal history, bodily experience, and the surrounding world. It is not fixed, but dynamic, shaped by time, space, and cultural context. Spatially, identity reflects one\u0026rsquo;s felt sense of ownership and orientation in the world. In adolescence, identity is especially fluid, marked by cycles of exploration and commitment (35). It requires integrating past experiences, future aspirations, and shifting roles within family, peers, and broader society (36). At a stage of life characterized by minimal responsibility and identity fluidity, the abrupt shift toward motherhood introduced tension and uncertainty. However, through childbirth and early caregiving, feelings of insecurity gradually gave way to the formation of a maternal identity.\u003c/p\u003e\n\u003cp\u003eThis identity first takes shape during pregnancy through imagined representations of the baby and deepens postpartum through interaction. Maternal identity is relational and develops gradually until a personal style of mothering is formed (37). For adolescent mothers, this evolution overlaps with their own identity formation, demanding a reconfiguration of roles and expectations. While disorienting, this process can also catalyze growth and deeper bonding with the child (38). Literature describes three phases in this transformation: an initial disorientation and loss of prior identity; the emergence of a revised self that integrates motherhood; and finally, a deepening of emotional capacities such as empathy and responsibility. This process may also confront the mother with emotional and psychological limits, as idealized views of motherhood clash with lived experience (36).\u003c/p\u003e\n\u003cp\u003eSome participants reflected on their own mothers, highlighting how past maternal models shape current caregiving, whether through repetition or differentiation. Pregnancy often signals a symbolic shift from daughter to mother, inviting a reevaluation of childhood experiences and one\u0026rsquo;s place in the generational chain (39). These reflections offer an opportunity for identity reconstruction.\u003c/p\u003e\n\u003cp\u003eThis narrative process plays a crucial role in shaping the relationship with the new child. Research indicates that a mother\u0026apos;s ability to reflect on and coherently narrate her own experiences of being mothered \u0026mdash; regardless of the relationship\u0026rsquo;s quality\u0026mdash; is associated with secure attachment in her child (39,40). More important than factual accuracy is the capacity for self-reflection and emotionally engaged narration.\u003c/p\u003e\n\u003cp\u003eInterventions like the PL can offer critical support during this period of identity transformation. Through psychoeducation and attachment-based approaches, the program promotes sensitive maternal responses and reinforces self-efficacy (41). By encouraging mothers to share their stories as daughters, it also opens space for intergenerational healing and improving family relationships. Ultimately, the healthcare professional, through sustained interaction with the adolescent, becomes an essential intersubjective anchor during times of identity change.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eTemporality\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eTemporality is a core structure of human experience, where past, present, and future are continuously and intentionally interconnected. Unlike chronological time, phenomenological temporality highlights how time is subjectively experienced, shaping consciousness and identity. It is a dynamic process in which the present is never isolated, but embedded in past memories and experiences (retention) and oriented toward future expectations (protention) (22,42).\u003c/p\u003e\n\u003cp\u003eOur results show that multiple factors shape the lived experience of time. Both adolescence and pregnancy are phases rich in protention, yet each mother experiences them differently. Some mature rapidly and view the recent past as a path of growth, which empowers them to envision the future\u0026mdash;here, retention supports protention. Others aim to stabilize the present, wanting their child to remain small and their caregiving role to continue. This desire reflects a compensatory effort to freeze the present in response to a future that feels uncertain or distressing.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eSpatiality\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eAnother key dimension for understanding the results and guiding interventions is spatiality. In phenomenology, space is not merely a physical or objective backdrop, but a subjective experience shaped by the individual\u0026rsquo;s perception and relationship with the world. Building on this, Messas (22) introduces the center-periphery model to describe how consciousness organizes spatial experience. The center holds what is most present and meaningful, while the periphery contains less defined, background elements. For some mothers, the arrival of a baby reorganizes this inner space: the child becomes the central focus, while personal goals are temporarily pushed aside.\u003c/p\u003e\n\u003cp\u003eSocioeconomic conditions deeply influence how maternal space is organized. In Brazil, limited public childcare \u0026mdash; reaching only 39% of children aged 0\u0026ndash;3 in 2023 (43) \u0026mdash; often leaves mothers solely responsible for caregiving, reinforcing a life centered on the child. Without consistent support from partners or family, many struggle to bring personal or professional goals into focus. Thus, beyond psychosocial support, expanding access to public childcare is essential to help mothers gradually broaden their experiential space and envision new possibilities.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Implications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePsychosocial interventions for adolescent mothers should recognize when overwhelming openness to the future occurs, particularly during pregnancy. Providing too much information early on may intensify the sense that there is an unmanageable amount to learn and anticipate, which can contribute to disengagement. A more attuned approach is to offer information gradually and clearly, focusing on pregnancy, childbirth, and postpartum changes in a way that reduces fear, supports bodily awareness, and creates space to process future anxieties.. Regular meetings can also foster continuity, making the future feel more manageable and increase confidence in their parental abilities.\u003c/p\u003e\n\u003cp\u003eAfter the baby is born, for mothers with limited future prospects, interventions should map realistic opportunities for education and work, tailored to individual contexts. This should be done with respect for each mother\u0026rsquo;s values and choices, emphasizing a gradual, step-by-step process rather than distant goals alone.\u003c/p\u003e\n\u003cp\u003eA non-judgmental approach should honor each mother\u0026apos;s life path, while also creating conditions that support development. In early infancy, it is common that the child occupies the experiential center. Interventions should not aim to shift this focus, but as the child grows, they can help broaden the mother\u0026rsquo;s peripheral awareness, supporting exploration of new possibilities and expanding relational horizons.\u003c/p\u003e\n\u003cp\u003eOur findings also suggest that physical discomfort can be present during emotional distress, shifting bodily experience from subject to object. Evidence from the literature also points in this direction, with studies linking hyperemesis gravidarum to higher rates of depression and anxiety (44). In this sense, recognizing that symptoms can be metonymic expressions \u0026mdash; where the part reflects the whole \u0026mdash; can help clinicians view somatic complaints as possible signals of existential distress, not just organic dysfunctions. Such an approach may improve the relationship between practitioners and young mothers by legitimizing their concerns, which in turn can enhance engagement and adherence. However, it is essential that responses to such complaints avoid pathologizing pregnancy itself. The biomedical model often applies a static view of health (26), and technical language used to describe normal pregnancy changes, such as \u0026ldquo;weight gain\u0026rdquo;, or \u0026ldquo;reduced mobility\u0026rdquo;, can carry an objectifying bias. Rather than empowering pregnant individuals, this language risks alienating them from their own experience, turning their embodied transformations into clinical concerns. Therefore, in periods when bodily experience becomes central and physical complaints are frequent, it is vital to recognize when the experience of the body as an object occurs, without reinforcing a clinical gaze that reduces the body to an object.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study has relevant limitations to be acknowledged. First, we did not conduct the interviews ourselves and had access only to audio excerpts, limiting their connection to participants\u0026rsquo; lived experiences, which is crucial in phenomenological research. Second, we did not interview participants who dropped out of the PL program, hindering our understanding of their motivations and limiting direct insights into areas needing improvement. Third, we were unable to invite participants to review the transcripts and provide feedback on the findings due to logistical challenges, which might have further enhanced the credibility and consistency of the results. Lastly, part of the study took place during the COVID-19 pandemic, which likely influenced participants\u0026rsquo; daily lives and access to broader opportunities, and should be considered when interpreting the findings.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study explored how adolescent mothers who participated in the PL program experienced pregnancy, childbirth, and early motherhood. The findings indicate that the convergence of adolescence and motherhood, both marked by uncertainty and limited life experience, led participants down divergent developmental paths. Some showed accelerated maturation, embracing multiple identity roles as daughters, mothers, students, and providers. Others, however, anchored their sense of self more exclusively in the maternal role. These results suggest that while psychosocial interventions that strengthen maternal competencies are valuable, they must also support the expansion of other dimensions of life. Confidence in the maternal role, often central in this phase, is crucial, but so is fostering engagement in peripheral aspects of identity to promote a more integrated and expansive biographical trajectory.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis paper has been supported by QUALab, the Qualitative \u0026amp; Mixed Methods Lab, a collaboration between the Yale Child Study Center, and Centre de Recherche en Epid\u0026eacute;miologie Et Sant\u0026eacute; Des Populations (CESP). This paper has also been supported by the Center for Research and Innovation in Mental Health (CISM), S\u0026atilde;o Paulo.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003eAuthor contributions were as follows: D.T.C., E.A.N., D.F., and L.B. contributed to the conceptualization of the study. Methodology was developed by D.T.C., E.A.N., and L.B. Data curation was conducted by D.F. The investigation was carried out by D.T.C., E.A.N., L.A.F., D.F., N.B., A.C., V.N.S., A.A.C.O., F.G.F., G.V.P., E.C.M., A.M., and L.B. Validation was performed by D.T.C., E.A.N., L.A.F., D.F., N.B., A.C., V.N.S., A.A.C.O., F.G.F., G.V.P., E.C.M., A.M. and L.B. Formal analysis was carried out by D.T.C., E.A.N., and L.B. Supervision was provided by E.C.M., A.M. and L.B. Project administration was undertaken by L.A.F., D.F., N.B., A.C., V.N.S., and A.A.C.O. The original draft was written by D.T.C. and E.A.N., and all authors contributed to review and editing, including D.T.C., E.A.N., L.A.F., D.F., N.B., A.C., V.N.S., A.A.C.O., F.G.F., G.V.P., E.C.M., A.M. and L.B.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of conflicting interest\u003c/strong\u003e: Nothing to declare\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding statement:\u0026nbsp;\u003c/strong\u003eDebora Tseng Chou and Emilio Abelama Neto received funding from the Funda\u0026ccedil;\u0026atilde;o de Amparo \u0026agrave; Pesquisa do Estado de S\u0026atilde;o Paulo (FAPESP) to support this research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical considerations:\u0026nbsp;\u003c/strong\u003eThe study was reviewed and approved by the Ethics Committee of the University of S\u0026atilde;o Paulo Medical School (reference number: 2286606) and the protocol was registered in the clinicaltrials.gov platform (NCT04362098)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e:\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eWritten informed consent was obtained from all participants included in the study. For participants under the age of 18, written consent was obtained from a parent or legal guardian. All participants and/or their guardians were informed about the purpose of the research, the voluntary nature of participation and their right to withdraw at any time.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability:\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThe data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy considerations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e: not applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eGanchimeg T, Ota E, Morisaki N, Laopaiboon M, Lumbiganon P, Zhang J, et al. Pregnancy and childbirth outcomes among adolescent mothers: a W orld H ealth O rganization multicountry study. BJOG Int J Obstet Gynaecol. 2014 Mar;121(s1):40\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eTodhunter L, Hogan-Roy M, Pressman EK. Complications of Pregnancy in Adolescents. Semin Reprod Med. 2022 Mar;40(01/02):098\u0026ndash;106. \u003c/li\u003e\n\u003cli\u003eKirchengast S. Teenage Pregnancies: A Worldwide Social and Medical Problem. In: Laratta R, editor. An Analysis of Contemporary Social Welfare Issues [Internet]. InTech; 2016 [cited 2025 Mar 7]. Available from: http://www.intechopen.com/books/an-analysis-of-contemporary-social-welfare-issues/teenage-pregnancies-a-worldwide-social-and-medical-problem \u003c/li\u003e\n\u003cli\u003eColeman PK. Resolution of Unwanted Pregnancy During Adolescence Through Abortion Versus Childbirth: Individual and Family Predictors and Psychological Consequences. J Youth Adolesc. 2006 Nov 15;35(6):903\u0026ndash;11. \u003c/li\u003e\n\u003cli\u003eTenaw LA, Ngai FW, Lam K. Explore the lived childbirth experiences, challenges following childbirth, and coping strategies of teenage mothers: A qualitative meta-synthesis. Midwifery. 2024 Oct;137:104128. \u003c/li\u003e\n\u003cli\u003eLaney EK, Hall MEL, Anderson TL, Willingham MM. Becoming a Mother: The Influence of Motherhood on Women\u0026rsquo;s Identity Development. Identity. 2015 Apr 3;15(2):126\u0026ndash;45. \u003c/li\u003e\n\u003cli\u003eSmith JA. Identity development during the transition to motherhood: An interpretative phenomenological analysis. J Reprod Infant Psychol. 1999 Aug;17(3):281\u0026ndash;99. \u003c/li\u003e\n\u003cli\u003eLevy M, Duffy M, Pearson J, Akuno J, Oduong S, Yemaneberhan A, et al. Health and social outcomes of HIV‐vulnerable and HIV‐positive pregnant and post‐partum adolescents and infants enrolled in a home visiting team programme in Kenya. Trop Med Int Health. 2021 June;26(6):640\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eOlds DL. The nurse\u0026ndash;family partnership: An evidence‐based preventive intervention. Infant Ment Health J. 2006 Jan;27(1):5\u0026ndash;25. \u003c/li\u003e\n\u003cli\u003eFatori D, Fonseca Zuccolo P, Shephard E, Brentani H, Matijasevich A, Archanjo Ferraro A, et al. A randomized controlled trial testing the efficacy of a Nurse Home Visiting Program for Pregnant Adolescents. Sci Rep. 2021 July 13;11(1):14432. \u003c/li\u003e\n\u003cli\u003eAlarc\u0026atilde;o FSP, Shephard E, Fatori D, Am\u0026aacute;vel R, Chiesa A, Fracolli L, et al. Promoting mother‐infant relationships and underlying neural correlates: Results from a randomized controlled trial of a home‐visiting program for adolescent mothers in Brazil. Dev Sci [Internet]. 2021 Nov [cited 2023 Apr 26];24(6). Available from: https://onlinelibrary.wiley.com/doi/10.1111/desc.13113 \u003c/li\u003e\n\u003cli\u003eFatori D, Argeu A, Brentani H, Chiesa A, Fracolli L, Matijasevich A, et al. Maternal Parenting Electronic Diary in the Context of a Home Visit Intervention for Adolescent Mothers in an Urban Deprived Area of S\u0026atilde;o Paulo, Brazil: Randomized Controlled Trial. JMIR MHealth UHealth. 2020 July 28;8(7):e13686. \u003c/li\u003e\n\u003cli\u003eHolland ML, Christensen JJ, Shone LP, Kearney MH, Kitzman HJ. Women\u0026rsquo;s Reasons for Attrition from a Nurse Home Visiting Program. J Obstet Gynecol Neonatal Nurs. 2014 Jan;43(1):61\u0026ndash;70. \u003c/li\u003e\n\u003cli\u003eRoggman LA, Cook GA, Peterson CA, Raikes HH. Who Drops Out of Early Head Start Home Visiting Programs? Early Educ Dev. 2008 Aug 1;19(4):574\u0026ndash;99. \u003c/li\u003e\n\u003cli\u003eAssocia\u0026ccedil;\u0026atilde;o Brasileira de Empresas de Pesquisa (ABEP). Crit\u0026eacute;rio de Classifica\u0026ccedil;\u0026atilde;o Econ\u0026ocirc;mica: Crit\u0026eacute;rio Brasil 2015 e atualiza\u0026ccedil;\u0026atilde;o da distribui\u0026ccedil;\u0026atilde;o de classes para 2016. 2015 [Internet]. 2015; Available from: https://abep.org/criterio-brasil/ \u003c/li\u003e\n\u003cli\u003eGreenlee JL, Stelter CR, Hickey E, Burton C, Carlson M, Winter MA. Using the Three-Minute Speech Sample to Examine the Parent-Adolescent Relationship in Autistic Youth: A Qualitative Analysis. J Autism Dev Disord. 2024 June;54(6):2274\u0026ndash;85. \u003c/li\u003e\n\u003cli\u003eKaugars AS, Moody EJ, Dennis C, Klinnert MD. Validity of the Five Minute Speech Sample in families with infants from low-income backgrounds. Infant Behav Dev. 2007 Dec;30(4):690\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eCowles KV. Issues in Qualitative Research on Sensitive Topics. West J Nurs Res. 1988 Apr;10(2):163\u0026ndash;79. \u003c/li\u003e\n\u003cli\u003eMartins VDO, Andrade CRFD. Perfil evolutivo da flu\u0026ecirc;ncia da fala de falantes do portugu\u0026ecirc;s brasileiro. Pr\u0026oacute;-Fono Rev Atualiza\u0026ccedil;\u0026atilde;o Cient\u0026iacute;fica. 2008 Mar;20(1):7\u0026ndash;12. \u003c/li\u003e\n\u003cli\u003eBraun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006 Jan;3(2):77\u0026ndash;101. \u003c/li\u003e\n\u003cli\u003eFulford KWM, Stanghellini G. Values and Values-based Practice. In: Stanghellini G, Broome M, Raballo A, Fernandez AV, Fusar-Poli P, Rosfort R, editors. The Oxford Handbook of Phenomenological Psychopathology [Internet]. Oxford University Press; 2019 [cited 2025 Apr 10]. p. 353\u0026ndash;66. Available from: https://academic.oup.com/edited-volume/27976/chapter/211637198 \u003c/li\u003e\n\u003cli\u003eMessas G. The Existential Structure of Substance Misuse: A Psychopathological Study [Internet]. Cham: Springer International Publishing; 2021 [cited 2025 Mar 10]. Available from: http://link.springer.com/10.1007/978-3-030-62724-9 \u003c/li\u003e\n\u003cli\u003eStanghellini G, Broome MR, Fernandez AV, Fusar-Poli P, Raballo A, Rosfort R. 1Introduction. In: Stanghellini G, Broome M, Raballo A, Fernandez AV, Fusar-Poli P, Rosfort R, editors. The Oxford Handbook of Phenomenological Psychopathology [Internet]. Oxford University Press; 2019 [cited 2025 Sept 19]. p. 0. Available from: https://doi.org/10.1093/oxfordhb/9780198803157.013.106 \u003c/li\u003e\n\u003cli\u003eTong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007 Sept 16;19(6):349\u0026ndash;57. \u003c/li\u003e\n\u003cli\u003eHarter S, Bresnick S, Bouchey HA, Whitesell NR. The development of multiple role-related selves during adolescence. Dev Psychopathol. 1997 Dec;9(4):835\u0026ndash;53. \u003c/li\u003e\n\u003cli\u003eYoung IM. Pregnant Embodiment: Subjectivity and Alienation. J Med Philos. 1984 Feb 1;9(1):45\u0026ndash;62. \u003c/li\u003e\n\u003cli\u003eLundgren I, Wahlberg V. The Experience of Pregnancy: A Hermeneutical/Phenomenological Study. J Perinat Educ. 1999 July 1;8(3):12\u0026ndash;20. \u003c/li\u003e\n\u003cli\u003eMasiran R, Ibrahim N, Awang H, Lim PY. The positive and negative aspects of parentification: An integrated review. Child Youth Serv Rev. 2023 Jan;144:106709. \u003c/li\u003e\n\u003cli\u003eByng‐Hall J. The significance of children fulfilling parental roles: implications for family therapy. J Fam Ther. 2008 May;30(2):147\u0026ndash;62. \u003c/li\u003e\n\u003cli\u003eBrummelman E, Thomaes S, Slagt M, Overbeek G, De Castro BO, Bushman BJ. My Child Redeems My Broken Dreams: On Parents Transferring Their Unfulfilled Ambitions onto Their Child. Scott JG, editor. PLoS ONE. 2013 June 19;8(6):e65360. \u003c/li\u003e\n\u003cli\u003eHays S. The cultural contradictions of motherhood. New Haven, Conn.: Yale Univ. Press; 1996. 252 p. \u003c/li\u003e\n\u003cli\u003eHusserl E, Husserl E. General introduction to a pure phenomenology. The Hague Boston Lancaster: Martinus Nijhoff Publishers, a member of the Kluwer Academic Publishers Group; 1983. 401 p. (Collected works / Edmund Husserl volume 2, Ideas pertaining to a pure Phenomenology and to a Phenomenological Philosophy). \u003c/li\u003e\n\u003cli\u003eMinkowski E, Metzel N, Minkowski E. Lived time: phenomenological and psychopathological studies. Evanston, Ill: Northwestern University Press; 1970. 455 p. (Northwestern University studies in phenomenology \u0026amp; existential philosophy). \u003c/li\u003e\n\u003cli\u003eFuchs T. The Phenomenology of Shame, Guilt and the Body in Body Dysmorphic Disorder and Depression. J Phenomenol Psychol. 2002;33(2):223\u0026ndash;43. \u003c/li\u003e\n\u003cli\u003eBranje S, De Moor EL, Spitzer J, Becht AI. Dynamics of Identity Development in Adolescence: A Decade in Review. J Res Adolesc. 2021 Dec;31(4):908\u0026ndash;27. \u003c/li\u003e\n\u003cli\u003eBailey L. Refracted Selves? A Study of Changes in Self-Identity in the Transition to Motherhood. Sociology. 1999 May;33(2):335\u0026ndash;52. \u003c/li\u003e\n\u003cli\u003eKimura AF. A constru\u0026ccedil;\u0026atilde;o da personagem m\u0026atilde;e: considera\u0026ccedil;\u0026otilde;es te\u0026oacute;ricas sobre identidade e papel materno. Rev Esc Enferm USP. 1997 Aug;31(2):339\u0026ndash;43. \u003c/li\u003e\n\u003cli\u003eMazzini MDLH, Alves ZMMB, Silva MRS, Sagim MB. M\u0026atilde;es adolescentes: a constru\u0026ccedil;\u0026atilde;o de sua identidade materna. Ci\u0026ecirc;nc Cuid E Sa\u0026uacute;de. 2009 Mar 18;7(4):493\u0026ndash;502. \u003c/li\u003e\n\u003cli\u003eStern DN. The Motherhood Constellation: A Unified View of Parent-Infant Psychotherapy [Internet]. 1st ed. Routledge; 2020 [cited 2025 Mar 19]. Available from: https://www.taylorfrancis.com/books/9780429907258 \u003c/li\u003e\n\u003cli\u003eFonagy P, Steele M, Steele H, Moran GS, Higgitt AC. The capacity for understanding mental states: The reflective self in parent and child and its significance for security of attachment. Infant Ment Health J. 1991;12(3):201\u0026ndash;18. \u003c/li\u003e\n\u003cli\u003eBandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191\u0026ndash;215. \u003c/li\u003e\n\u003cli\u003eHusserl E. The Phenomenology of Internal Time-Consciousness. Bloomington: Indiana University Press; 2019. 1 p. \u003c/li\u003e\n\u003cli\u003eFunda\u0026ccedil;\u0026atilde;o Maria Cecilia Souto Vidigal. Mais de 70% das crian\u0026ccedil;as em situa\u0026ccedil;\u0026atilde;o de pobreza n\u0026atilde;o frequentam creche. 02/12/2024. 2024 Feb 12; \u003c/li\u003e\n\u003cli\u003eMitchell‐Jones N, Gallos I, Farren J, Tobias A, Bottomley C, Bourne T. Psychological morbidity associated with hyperemesis gravidarum: a systematic review and meta‐analysis. BJOG Int J Obstet Gynaecol. 2017 Jan;124(1):20\u0026ndash;30. \u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTABLE 1 \u0026nbsp; Domains, Themes, and Representative Quotes\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003e\u003cstrong\u003eDomain/Theme\u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003eRepresentative quote\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 624px;\"\u003e\u003cstrong\u003e1. Reactions to Discovery of Pregnancy\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eAdolescents reacted with ambivalence\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003e\u0026nbsp;I always wanted to get married and be a mother early, but not this early.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eAdolescents rejected pregnancy\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003eAt times I didn\u0026rsquo;t want it. In the very beginning, at times I thought, no, I don\u0026rsquo;t want this anymore, and then I suffered a lot.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eAdolescents felt happiness and fulfilment\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003e\u0026nbsp;Now I think I\u0026rsquo;m feeling a mother\u0026rsquo;s love. How wonderful, such a great feeling.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eFamily and partner\u0026rsquo;s rejection\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003e\u0026nbsp;Regarding my family, when I got the news about the baby, it was chaos. They freaked out. (Interviewee cries) It was horrible. Nowadays, I\u0026rsquo;m treated very differently at home.\u003cbr\u003e\u0026nbsp; Someone I wanted to turn to for support, I just can\u0026rsquo;t find it - that\u0026rsquo;s the baby\u0026rsquo;s father.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eFamily and partner\u0026rsquo;s support\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003e\u0026nbsp;I thought my parents would be really mad, but on the contrary, they were very supportive, especially emotionally.\u003cbr\u003eThe baby\u0026apos;s father was also happy. Happy about the pregnancy, happy about the child.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003ePrejudice and discrimination from society\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003e\u0026nbsp;A lot of people, even distant relatives, were making comments, saying I was too young, that it wouldn\u0026rsquo;t work out, that I was a disappointment.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eScarcity of reflections on motherhood\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003e\u0026nbsp;I keep thinking about how it will be when I have my child, how I will do things, because being alone is completely different from having a child.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eMotherhood as profound transformation\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003e\u0026nbsp;You change as a person, as a woman.\u003cbr\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 624px;\"\u003e\u003cstrong\u003e2. Changes Experiencing the Body\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eThe Body in the Foreground of Consciousness\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003eI get a little worried, I feel a bit of cramping.\u003cbr\u003e\u0026nbsp;I feel very nauseous, I feel really sick.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eLived Experiences Manifest in the Body\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003eSo many changes, both in my body and my mood, everything.\u003cbr\u003eAs the months went by and I saw my belly growing, I started researching a lot of things, and then I started developing love for him.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eThe Body in the Transition from Pregnancy to Motherhood\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003eI want to be able to have the strength to communicate with my baby when the contractions come.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTABLE 2 Domains, Themes, and Representative Quotes (Continued)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 624px;\"\u003e\u003cstrong\u003e3. Forming a Maternal Identity\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eAdolescence as a Period of Discovery\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003eWhat comes to my mind when I think about pregnancy, especially at my age, because I\u0026rsquo;m a teenager, it\u0026rsquo;s a somewhat difficult topic.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eFrom Unpreparedness to a Sense of Capability\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003eI was afraid to dress him, afraid I might hurt him.\u003cbr\u003eAs a mother, I\u0026rsquo;m even surprised by myself because I thought I wouldn\u0026rsquo;t make it this far.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eRevisiting the Experience of Being a Daughter\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003eWhen we have a daughter, we think, \u0026lsquo;Oh my God, why didn\u0026rsquo;t I listen to my mother?\u0026rsquo; And really, everything parents say is true.\u003cbr\u003eAs a mother, I don\u0026rsquo;t think I\u0026rsquo;m an example yet, not as much as my mother. I think she\u0026rsquo;s an amazing person; she was such a warrior, raising six kids.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 624px;\"\u003e\u003cstrong\u003e4. Transformations in the Experience of Time\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003ePregnancy as Openness to the Future\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003eI think what really dominates me is more fear and anxiety.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eExperience of Novelty Through the Child\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003e\u0026nbsp;Every day we discover new things together, things I didn\u0026rsquo;t even know a baby could do, and they do.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eMotivation to Build a Better Future\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003eI was able to prove to everyone that I was going to make it, I was pregnant with them, and I still passed the school year, finished my studies, even while taking care of them.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eDesire to Freeze the Present\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003eI don\u0026rsquo;t want time to go by fast because at some point they\u0026rsquo;ll be my height, they\u0026rsquo;ll become a teenager and won\u0026rsquo;t want anything to do with me anymore.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 624px;\"\u003e\u003cstrong\u003e5. Reframing Relationships\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eChild\u0026rsquo;s centrality in the Mother\u0026rsquo;s Life\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003eI don\u0026apos;t think I can do it without her these days. I can\u0026apos;t live without her\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eMother Prioritizes the Child Over Herself\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003eI don\u0026apos;t care if I don\u0026apos;t go out, I don\u0026apos;t care if I don\u0026apos;t do anything. The important thing is that she\u0026apos;s well.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eChild as an Active Participant in Emotional Support\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003eEspecially when I\u0026apos;m sad, she always comes to calm me down, hugs me, kisses me, this has been going on since she was very little, since she was 9, 10 months old\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003eCare Dynamics in Family Relationships\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 437px;\"\u003e\u0026nbsp;It brought my family and his father\u0026apos;s family closer together, it brought me and my mother closer together because we used to fight a lot. It brought everyone together as we were very separate.\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTABLE 3: Theoretical constructs, and empirical domains and themes\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"630\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 164px;\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u003cstrong\u003eTheoretical Construct\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 466px;\"\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Empirical Findings From This Study\u003cbr\u003e\u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u003cstrong\u003eDomain \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Themes\u003c/strong\u003e\u003cbr\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"8\" style=\"width: 164px;\"\u003e\u003cstrong\u003eEmbodiment\u003c/strong\u003e\u003cbr\u003e\u003cem\u003eCoexistence of the experiences of\u0026nbsp;body-as-subject and body-as-object\u003c/em\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 172px;\"\u003eReactions to the discovery of pregnancy\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eAdolescents reacted with ambivalence\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eAdolescents rejected pregnancy\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eAdolescents felt happiness and fulfilment\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eScarcity of reflections on motherhood\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eMotherhood as profound transformation\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 172px;\"\u003eChanges Experiencing the Body\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eThe Body in the Foreground of Consciousness\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eLived Experiences Manifest in the Body\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eThe Body in the Transition from Pregnancy to Motherhood\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 164px;\"\u003e\u003cstrong\u003eIdentity and Intersubjectivity\u003c/strong\u003e\u003cbr\u003e\u003cem\u003eTesting roles and building them with others\u003c/em\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 172px;\"\u003eReactions to the discovery of pregnancy\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eFamily and partner\u0026rsquo;s rejection\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eFamily and partner\u0026rsquo;s support\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003ePrejudice and discrimination from society\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 172px;\"\u003eForming a Maternal Identity\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eAdolescence as a Period of Discovery\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eFrom Unpreparedness to a Sense of Capability\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eRevisiting the Experience of Being a Daughter\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 164px;\"\u003e\u003cstrong\u003eTemporality\u003c/strong\u003e\u003cbr\u003e\u003cem\u003eSubjective experience of time, which shapes consciousness\u003c/em\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 172px;\"\u003eTransformations in the experience of time\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003ePregnancy as openness to the future\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eExperience of novelty through the child\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eMotivation to build a better future\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eDesire to freeze the present\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 164px;\"\u003e\u003cstrong\u003eSpatiality\u003c/strong\u003e\u003cbr\u003e\u003cem\u003eDialectics between experiential center and periphery\u003c/em\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 172px;\"\u003eReframing relationships\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eChild\u0026rsquo;s centrality in mother\u0026rsquo;s life\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eMother prioritizing the child over herself\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eChild as an active participant in emotional support\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 294px;\"\u003eCare dynamics in family relationships\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003csup\u003ea \u0026nbsp;\u003c/sup\u003eAdapted from Husserl (32) and Minkowski (33)\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"child-and-adolescent-psychiatry-and-mental-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"caph","sideBox":"Learn more about [Child and Adolescent Psychiatry and Mental Health](http://capmh.biomedcentral.com)","snPcode":"13034","submissionUrl":"https://submission.nature.com/new-submission/13034/3","title":"Child and Adolescent Psychiatry and Mental Health","twitterHandle":"@IACAPAP","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Adolescent parenting, qualitative methods, intervention, Latin America, parenting, poverty","lastPublishedDoi":"10.21203/rs.3.rs-7730299/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7730299/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eAdolescent motherhood represents a complex period of identity restructuring, characterized by negotiation of self-perception and the balancing of a new caregiving role. As a developmental stage, it can be complicated by a lack of preparedness, social stigma, absence of partner support, school dropout, loneliness, and emotional distress. Aiming to inform more developmentally attuned interventions, we explored the lived experience of adolescent mothers who participated in a perinatal home-visiting program.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eWe recruited 72 adolescents, aged 14\u0026ndash;19, from low-income neighborhoods in S\u0026atilde;o Paulo, Brazil. Most identified as Black or Brown and all were experiencing their first pregnancy. They took part in \u003cem\u003ePrimeiros La\u0026ccedil;os\u003c/em\u003e (\u0026ldquo;First Ties\u0026rdquo;), a nurse-led program that provides psychosocial support from pregnancy through the child\u0026rsquo;s second year. We enrolled participants into a qualitative study based on open-ended interviews during pregnancy and again at 3, 12, and 24 months postpartum, totaling 223 interviews. Using thematic analysis informed by phenomenology, we examined how their lived experiences changed over time.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eWe identified five experiential domains: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) \u003cem\u003eReactions to the Discovery of Pregnancy\u003c/em\u003e, marked by ambivalence and conflicting emotions, including those elicited by social stigma; (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) \u003cem\u003eChanges Experiencing the Body\u003c/em\u003e, with adolescents experiencing their bodies as intensely present, sometimes expressing emotional suffering through physical sensations; (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) \u003cem\u003eForming a Maternal Identity\u003c/em\u003e, with a reshaping of prior adolescent roles into an emerging maternal persona; (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) \u003cem\u003eTransformations in the Experience of Time\u003c/em\u003e, encompassing future-oriented aspirations and or a desire to hold onto the present; and (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) \u003cem\u003eReframing Relationships\u003c/em\u003e around the child, who became a central source of meaning and emotional reciprocity.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eOur findings highlight how existential structures of temporality, embodiment, identity, and intersubjectivity shape the lived reality of adolescent motherhood. Pregnancy and early caregiving intensified bodily awareness and restructured temporal horizons, with some adolescents experiencing an expansion of future possibilities and others a sense of paralysis. Relationships were reorganized around the child as a new experiential center. These insights suggest that psychosocial interventions should be attentive to moments when the future feels overwhelming, provide clear, non-objectifying information, and support continuity in care. A non-judgmental stance that respects each mother\u0026rsquo;s values while gradually broadening life horizons can help strengthen maternal competencies and expand possibilities beyond caregiving.\u003c/p\u003e","manuscriptTitle":"Motherhood in Adolescence: A Qualitative Study of the Lived Experience of Participants in a Perinatal Home-Visiting Intervention","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-21 11:41:15","doi":"10.21203/rs.3.rs-7730299/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-01T14:26:56+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-01T13:02:27+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-27T15:29:28+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"96603053272159329451261833400344464868","date":"2025-11-12T08:59:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"34053389559421422537075906614560102430","date":"2025-10-13T10:56:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"310779160320096051794983468343872704478","date":"2025-10-13T10:52:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"50861369685644125320225251292489165969","date":"2025-10-10T07:30:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"150236093819815432219314730342876156131","date":"2025-10-08T14:52:42+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-08T10:36:38+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-08T10:33:39+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-06T07:23:36+00:00","index":"","fulltext":""},{"type":"submitted","content":"Child and Adolescent Psychiatry and Mental Health","date":"2025-09-27T19:36:36+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"child-and-adolescent-psychiatry-and-mental-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"caph","sideBox":"Learn more about [Child and Adolescent Psychiatry and Mental Health](http://capmh.biomedcentral.com)","snPcode":"13034","submissionUrl":"https://submission.nature.com/new-submission/13034/3","title":"Child and Adolescent Psychiatry and Mental Health","twitterHandle":"@IACAPAP","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"72620217-7ecd-42b8-855d-6a8e95795202","owner":[],"postedDate":"October 21st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-02-16T16:07:28+00:00","versionOfRecord":{"articleIdentity":"rs-7730299","link":"https://doi.org/10.1186/s13034-026-01039-y","journal":{"identity":"child-and-adolescent-psychiatry-and-mental-health","isVorOnly":false,"title":"Child and Adolescent Psychiatry and Mental Health"},"publishedOn":"2026-02-15 15:59:24","publishedOnDateReadable":"February 15th, 2026"},"versionCreatedAt":"2025-10-21 11:41:15","video":"","vorDoi":"10.1186/s13034-026-01039-y","vorDoiUrl":"https://doi.org/10.1186/s13034-026-01039-y","workflowStages":[]},"version":"v1","identity":"rs-7730299","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7730299","identity":"rs-7730299","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}