Pregnancy and Parenthood in Young People Strategy

Background, Rationale and Context

Background

Pregnancy in young people is often a cause and a consequence of social exclusion^[32] and should not been seen narrowly as a health challenge. Reducing levels of pregnancy in young people helps to reduce the likelihood of poverty and a recurring cycle from one generation to the next^[19]. The Institute of Fiscal Studies concluded that to significantly reduce levels of teenage pregnancy you cannot concentrate on high risk groups alone; a proportionate universalism approach is needed to ensure the needs of all young people are met^[5]. Universal services^[a], across all agencies, have an important role to play in identifying and supporting the needs of young people. These responsibilities will be strengthened through the commencement of the provisions and duties in relation to the Children and Young People (Scotland) Act 2014^[39]. The Act will further the Scottish Government's ambition for Scotland to be the best place to grow up by placing children and young people at the heart of planning and services and ensuring their rights are respected across the public sector.

The rate of pregnancy (defined as all conceptions i.e. live births and abortions) in young people has been decreasing in Scotland but it is still high compared to other comparable western countries and remains a concern for policy makers and communities (appendix C). Between 2007 and 2013, Scotland experienced decreases in the pregnancy rate in the under 20, 18 and 16 age groups. However, the gap in inequality is increasing. The data shows that young people living in the most deprived areas are 4.6 times more likely to experience a pregnancy and nearly 12 times more likely to continue the pregnancy as someone living in the least deprived areas of Scotland^[20].

This strategy focuses on two particular groups: young people, and young parents.

Young people

Young people can experience a wide range of cognitive, biological and emotional changes as well as unique social transitions^[28] All of these factors can impact significantly upon their health and wellbeing as many behaviours adopted during this time continue into later life. Promoting a holistic approach to health and wellbeing at this transitional stage and empowering young people to improve their own health and address the social determinants of health can help set them on a positive path into adulthood.

Why young people need support from services^[28]:

• Youth is a unique and critical period of life, a major developmental transition from childhood to adulthood.
• Young people experience key biological, cognitive, emotional and social changes which bring challenges and opportunities for both the individual and society.
• Young people are influenced by social, economic and cultural factors which are different to those experienced during the early years.
• Young people are tomorrow's workforce, parents and leaders. Any limitations on the potential of young people in Scotland will impact on their ability to contribute productively as citizens, family members and employees/employers.
• Young people participate in risk-taking and experimentation as they learn to manage new capabilities and greater freedom.
• Common patterns of adult risk taking behaviour start during youth.

Groups who may need extra support are young people:

• who are looked after and accommodated or care leavers
• who have poor attendance at school
• who have low educational attainment
• living in poverty and/or areas of deprivation
• who are disabled
• who have learning disability
• who have experienced abuse and violence
• who are in contact with the justice system
• whose parents had children when they were young
• who are, or at risk of, homelessness

Young Parents

Parenthood can be both exciting and daunting at any age. Young people who are at higher risk of becoming parents tend to have poorer health and social outcomes compared to older parents^[3], and these are generally intensified as a result of becoming a parent. Such disadvantages underlie many of the additional issues that young parents face. Taking action on these issues will impact the inequality that exists between young and older parents. Providing young people with the ability to consider their aspirations and ambitions for the future can increase their opportunities and choices; and help achieve their potential as an individual. Younger mothers who exhibit child nurturing behaviours, such as reading to their child/children, promoting a healthy lifestyle and who provide a secure and stable environment have similar chances of raising children with positive outcomes as older mothers who do the same. Whilst mothers aged 20-24 are relatively advantaged when compared with their younger counterparts, they are still at a significant disadvantage when compared with older parents (25+). Whilst the needs of each young parent will vary and such needs should be considered on an individual basis, there are some groups that professionals should be aware of as requiring additional and likely on-going comprehensive interagency support.

Why young parents need support from services:

• Young parents tend to have poorer perinatal health outcomes (later engagement with services, lower birth weights, less likely to breastfeed, higher infant mortality and higher rates of postnatal depression)^[22].
• Young mothers experience poorer mental health and are at a higher risk of mental health issues, such as postpartum depression in the first three years after giving birth than older mothers. Postpartum depression, if unchecked, can have long-term consequences for both the mother and her child^[26].
• Young mothers also have higher than average feelings of isolation and low self-esteem. Failure to support those with mental health difficulties can have negative effects on parenting practices and can affect the mother's ability to bond with her child. Also, little or no support with daily stress, family difficulties and emotional issues can impede adjustment and development of good coping abilities^[26].
• Young mothers have poorer health behaviours during pregnancy such as higher smoking rates and drug misuse and lower breastfeeding rates^[22].
• Young mothers often experience problems in their relationship with the father of their child; these problems sometimes lead to the involvement of police, legal advisors and social services^[31].
• The circumstances and experiences of young mothers show that they face significant socio-economic disadvantage in terms of lower educational qualifications, lower employment levels and lower income^[3].
• Young fathers have double the risk of being unemployed aged 30, even after taking account of deprivation.
• Young fathers tend not to engage with health and social services as well as young mothers. Highlighting the role of fathers, both as a partner and as a father, helping them to feel welcome to engage with services, is key to improving support for young parents^[31].

Groups who may need extra support are young parents who are:

• living in social/economic deprivation
• homeless or at risk of homelessness
• care experienced young people
• in contact with the justice system
• not engaged with education/employment/training