1. Lyndsey Anderson, Nicola Adams, Rachael Baldock, Julie Bambridge, Kathryn Belfer and Alice Brandolini. Teenage Pregnancy

2. Learning Outcomes Teenage pregnancy demographics and statistics. Key issues facing pregnant teenagers. Key issues facing midwives who care for pregnant teenagers. Local and national strategies that support address the holistic needs of pregnant teenagers.

3. Demographics of Teenage Pregnancy Depravation in relation to teenage pregnancy. Recurring pregnancies. Father’s age vs. Mother’s age. Scottish teenage pregnancies in 2008. (iSD. 2009)

4. Demographics Continued

5. Key Issues Facing Pregnant Teenagers “For some young women having a child when young can represent a positive turning point in their lives, for many more teenagers bringing up a child is incredibly difficult and often results in poor outcomes for both the teenage parent and the child...” Teenage Pregnancy Strategy Beyond 2010 – (Department of Children, Schools and Families, 2010)

6. Key Issues Continued Should I keep my baby? Abortion issues. I am concerned about parents reaction. Emotions. Support and guidance. Will the father support me? Father’s involvement for child. Support for father.

7. Key Issues Continued Will I be able to continue smoking? Infant death rates vs. Smoking. Teenage smoking. Will I suffer from depression? Difficulty in diagnosis. What support is out there for me? Study by Ank De Jonge 1999/2000.

8. Key Issues Continued Do I have to attend antenatal groups? Reluctant/unable to attend. Will I still attend school? Problems facing teenagers out of education for any length of time. Will I get help with money and housing? Not knowing what’s available. Will my friends still want to be around me? Isolation/ loneliness.

9. Key Issues Facing Midwives “ Young parents and their babies have poorer access to maternity services and experience worse outcomes than older mothers and fathers.” Getting Maternity Services Right for Teenage Mothers and Young Fathers. (Department of Health, 2009) Midwives must provide adequate support to teenage mothers and young fathers. How to adapt to parenthood. To prevent undesirable outcomes. To educate them.

10. Key Issues Continued Late diagnosis of pregnancy. Average gestation at booking, and reasons why. Challenges to midwife – less time available to provide information and support. Mental health problems. Post natal depression due to home life, housing issues etc. Challenges to midwife – must be able to identify mental health problems and act accordingly to offer support and referral if necessary.

11. Key Issues Continued The role of the father. Feeling excluded and overwhelmed. Challenges to midwife – Include father as much as he wants to be. Influential on mother = health promotion? Encourage him to support mother.

12. Key Issues Continued Contraception. Around 20% of teenage mothers have further pregnancies before the age of 18. Challenge to midwife – clear, concise education on contraception in postnatal period. Referral to family planning clinic if necessary. Confidentiality. Teenagers may not want parents knowing (particularly in under 16s). Challenge to midwife – Confidentiality always applies in practice, but must be able to recognise when child protection becomes an issues and referral is required. Accessibility. Reluctance or inability to attend maternity services. Challenge to midwife – Ensure ease of access.

13. Local Strategies for Pregnant Teens

14. National Strategies Teenage Pregnancy Strategy Beyond 2010. Original aims to work with the cause and effect of teenage pregnancy. A target of halving under 18s conception rates by 2010 using rates from 1998 as a base year. To increase the number of teenage parents in education, training or employment to reduce long-term social exclusion. Results. Seven key evidence based factors.

15. Conclusion Teenage pregnancy demographics. Pregnant teenagers’ issues. Midwives’ issues. Nationally and local strategies. NICE guidelines.

16. Any Questions?

17. References/ Bibliography AMICA., (2010) Pregnancy Crisis. http://www.amicapregnancycrisisedinburgh.co.uk/ (Accessed 10 October 2010) Brook ., (2010) Abortion. http://www.brook.org.uk/pregnancy/abortion (Accessed 13 October 2010) De Jonge, A., (2001) Support for Teenage Mothers: A Quantative Study into the Views of Women about the Support the Received as Teenage Mothers. Journal of Advanced Nursing. 36(1), pp 49-57. DSCF., (23 April 2010) About the Teenage Pregnancy Strategy. http://www.dcsf.gov.uk/everychildmatters/healthandwellbeing/teenagepregnancy/about/strategy/ (Accessed 28 September 2010) DoH., (November 2009) Getting Maternity Services Right for Teenage Mothers and Young Fathers. Nottingham. DoH., (February 2010) Teenage Pregnancy Strategy Beyond 2010. Nottingham. DoH., (2008) Teenage Parents: Who Cares? A Guide to Commissioning and Delivering Maternity Services for Young Parents. Nottingham. DoH., (2007) Multi-Agency Working to Support Pregnant Teenagers: A Midwifery Guide to Partnership Working with Connexions and Other Agencies. Nottingham. Egan, S., (22 September 2010) Family Nurse Partnership Board Meeting. Http://www.nhslothian.scot.nhs.uk/aboutus.ourorganisation/nhsboard/meetings/boardpaper/board_paper_100922_05-011.pdf (Accessed 30 September 2010)

18. References/Bibliography Cont. Ehiri, J., (2009) Maternal and Child Health: Global Challenges, Programmes and Policies. 1sted, London, Springer. Fatherhood Institute., (2010) Fatherhood Institute Research Summary: Young Fathers. http://www.fatherhoodinstitute.org/index.php?id=13&cID=575 (Accessed 01 October 2010) iSD Scotland., (2009) Sexual Health – Teenage Pregnancy. http://www.isdscotland.org/isd/2071.html (Accessed 01 October 2010) National Institute for Health and Clinical Excellence., (September 2010) Pregnancy and Complex Social Factors. http://guidance.nice.org.uk/CG110/QuickRefGuide/pdf/English (Accessed 04 October 2010) Pregnancy Concerns., (03 July 2010) Teenage Pregnancy. http://pregnancyconcerns.info/teenage-pregnancy/linking-family-planning-and-teenage-pregnancy-problems/ (Accessed 04 October 2010) Royal College of Midwives., (Autumn 2009) National Teenage Pregnancy Midwifery Network. http://www.rcm.org.uk/college/standards-and-practice/national-teenage-pregnancy-midwifery-network/ (Accessed 04 October 2010) Thomson, S., (2010) The Complexities of Supporting Teenagers in Pregnancy. British Journal of Midwifery. 18(6), pp368-371. Tommy’s., (2010) Teenage Pregnancy Health Campaign. http://www.tommys.org/Page.aspx?pid=749 (Accessed 10 October 2010)