"Someone to talk to and Someone to listen" - Supporting young pregnant women and young parents in school

4. Supporting young people disclosing a pregnancy in school

"Scary! One of the most scary things I went through…"

Assessing wellbeing and planning to meet identified needs in the context of the young person's support network and unique circumstances, as well as their strengths and vulnerabilities, is enabled by the GIRFEC National Practice Model. A multi-agency approach to supporting young people around pregnancy, including disclosing of pregnancy is important. Each young person's situation will be unique and different supports will be required depending on their situation.

"We need some guidance, something that helps us to understand what is coming next, what to expect…"

All members of staff in school should be aware that a pregnancy disclosure could be made to them. Whilst they do not need to be experts, they should be able to direct the young person to the relevant person at school who can offer the initial help and support they need. It is important that the young person has the time and space they need to talk about the situation at their own pace. Listening and providing a non-judgemental, warm and positive response to the young person will help them feel more confident as they are guided through this time.

"I don't understand why some people are so cold-hearted about it."

"It would be good to hear someone saying something nice [about you being pregnant], even just simple congratulations. But nobody does."

When there are consistent, predictable and secure relationships, young people will feel more confident about disclosing pregnancy, that their rights will be respected and that any support they need will be in place for their next steps, without fear of stigma and discrimination. The young parent's voice should be at the heart of decision making about the support that they need.

The role of the School Nurse

School Nurses are health professionals with enhanced educational qualifications in health and development of school age children and young people. School Nurses may have a key role in supporting young people in school, during pregnancy and parenthood. School Nurses can be an important link between health and education services, supporting and enhancing the health and wellbeing of children and young people.

Family Nurse Partnership

The Family Nurse Partnership (FNP) is a licensed programme, originally developed in the USA, in which specially trained nurses work with first-time young mothers to develop their parenting capacity and support them to make positive choices for themselves and their children. It also seeks to support these families using strength based approachesto achieve their short- and long-term goals and aspirations. Mothers aged 19 and under across Scotland are offered the FNP programme. Family Nurses have a key role in supporting first time young mothers and are an essential part of the support around the young parent and can provide support and advice to the school. Visits are offered weekly to fortnightly from early pregnancy until the first child reaches 2 years of age.

Where a young person does not have a Family Nurse the Health Visitor will be the named person.

Pregnancy Options

This resource focuses on supporting young people who have decided to continue with their pregnancy ensuring they remain supported to continue with their education into parenthood. Young people who disclose their pregnancy to school and who choose other options will also be supported throughout.

Some young people will have already considered their options and made a decision about their pregnancy, whereas others will not. Young people are more likely to seek help with decisions about their pregnancy options from family and health professionals, some young people may seek support in schools. Regardless of where the young person seeks support with their pregnancy options, the school will need to provide ongoing emotional support to the young person.

Taking account of individual circumstances and experiences in childhood, it is important to recognise some young people may require additional care, support and help. By working collaboratively, agencies can ensure a safe space for the young person, putting them at the centre of decision making.

An open and supportive conversation about pregnancy options will help young people to make an informed decision.

Not all young women will disclose a pregnancy to their school, particularly if they decide not to continue with the pregnancy. If a young woman has disclosed to her school, she should continue to receive support around her health and wellbeing, should she need or wish to in line with GIRFEC.

Where a school is aware of a young person choosing to have an abortion, support should be provided to welcome them back into school. Support may also be required for the partner, particularly if the relationship has broken down.

Although they have made a decision not to continue with their pregnancy, some young women may still be vulnerable to pregnancy or may wish to become pregnant again. It will be important to be aware of the needs of these young people and for multi-agency partnerships and to ensure the plan around the child (GIRFEC) engages the right support from the right people at the right time.

If the young person is considering adoption, their midwife will support them in those discussions and in any planning and engagement with other agencies where required.

Final decisions are never made until after the baby is born – only discussion and planning take place during pregnancy. Considerable personal support will be required for the young woman if adoption takes place and reintegration back into school life may take considerable time and must be treated with sensitivity.

Young people can access more information about adoption at the CoramBAAF website.

Confidentiality and Information Sharing

Organisations supporting young people around pregnancy must work in partnership with them when considering and sharing information necessary to promote, support or safeguard their wellbeing.

Education staff have responsibilities to protect all children from risk of harm and where staff are concerned that there is potential or actual risk of significant harm to either an unborn baby, child or young person they must notify the statutory agencies as outlined within the National Guidance for Child Protection in Scotland 2021 (to be published in summer 2021).Consent is not required or appropriate because the information must be shared in order to protect the child. Where appropriate, agreement and understanding about the sharing of information may be helpful in engaging individuals in the process.

The needs, feelings, views and wishes of the young person should be taken into account and documented. They may also need additional support to understand and communicate.

Information sharing decisions must be based not only upon considerations about the safety and wellbeing of the individual, but also the safety of others.

Information can be shared without consent if, for example, a practitioner is unable to gain consent from the individual in time to prevent risk of harm, or if gaining consent could place a child at risk. Every effort should be made to gain consent for issues that are not related to child protection.

It can be beneficial for a young person to have a central point of contact, a person with whom they can discuss the situation. As part of the GIRFEC approach, the young person will have a named person or trusted adult within the school. This is likely to be a member of school staff at their school and someone already involved in offering support. In these circumstances it is important that the central point of contact is someone that the young person feels most comfortable talking to, and this might be someone other than the named person. If the young person has a child's plan, they should also have a lead professional to coordinate, manage and review actions agreed to provide a range of support. The lead professional could be outwith the school, for example their Family Nurse, who works with school staff where they are agreed partners to a plan.

The school's Guidance/Pastoral Team will be key contacts for the young person and their parents/carers; and, if the young person has a child's plan, key partners to the young person's plan where agreed with the young person in order to access support and plan next steps within the school.

Young people may be concerned about confidentiality – particularly if they are under 16 – and should have confidence and clarity about how and when any information sharing takes place to support their wellbeing. In most circumstances, the young person will know what information is being shared, with whom and for what purpose, and their views will be taken into account. This may not happen in exceptional cases, such as where there is a child protection concern.

On occasions when a young woman has not disclosed her pregnancy to her parent/carer it is good practice to encourage the young person to do so. However, it is important to remember that a young person has a right to confidentiality and the school should not share information about a pregnancy with parents or carers without the young person's consent.

Discussing with the young person why they fear a negative reaction may help identify their anxieties and support them in communicating the news to their parents/carers. The right to confidentiality and safeguarding of the young person must be respected at all times, whilst ensuring their safety where there are child protection concerns.

More detailed information is available at: Resource for Professionals: Key Messages for Young People on Healthy Relationships and Consent

Collaborative Planning

Through multi-agency working, organisations can provide the young person with the tailored support that is required. A key component of GIRFEC is a single plan or planning process which covers all aspects of a young person's wellbeing and circumstances. Pregnancy and pre-birth planning for school should have the young person at its heart in the context of their own circumstances, strengths and vulnerabilities. They should have ownership of their plan and be able to express what they need with the support and advice of the professionals and trusted adults around them. Assessment and planning should be delivered through the GIRFEC National Practice Model^[7].

It is important to recognise that young people may experience a range of mental, emotional, social and physical issues that could affect their ability to continue to engage, or engage meaningfully with learning during pregnancy. They may also result in the young person wishing to leave school altogether.

These issues could include:

• having mixed feelings about the pregnancy
• anxiety and/or depression
• bullying and/or perceived bullying by other students
• discrimination and judgement.
• conflict with the father of the baby (particularly if he is in the same school)
• conflict with family
• disruption at home
• financial worries
• housing worries
• physical health worries and symptoms

Bullying and Young Parents

Bullying of any kind is unacceptable and must be addressed quickly whenever it arises.

'Respect for All: The National Approach to Anti-bullying for Scotland's Children and Young People^[8][1]' provides the framework for all anti-bullying work in Scotland.

We know that young people's mental, emotional, social and physical wellbeing and attainment can be severely impacted by bullying. To support them it requires approaches that are holistic, preventative, and supportive. Young parents can experience bullying because of the stigma and judgement that is still associated with young parenthood.

Teachers should be aware of the increased possibility of bullying in relation to a young pregnant person or young parent and that this can occur face to face as well as online.

Schools should be cognisant of their anti-bullying practice and approach and ensure young people receive adequate information and guidance around this topic. For those who are pregnant/young parents, this can add to what is already a potentially highly emotional and stressful time.

Coping with loss

Some young people may experience complications in pregnancy or other health issues which may lead to loss of their baby. They will need considerable support through this time. Fellow students, peers and friends may also require support to help them know what do to support their friend if they experience pregnancy complication or loss.

For some young women, a pregnancy may end in a miscarriage. The young woman (and her partner) will require support in such circumstances and should be helped to access more specialist support.

More information for young people can be found at https://www.miscarriageassociation.org.uk/your-feelings/young-people/ and Scottish Care and Information on Miscarriage https://www.miscarriagesupport.org.uk/ and Held in Our Hearts https://heldinourhearts.org.uk/

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Young people who have experienced a stillbirth or a neonatal death will need support from the school as well as other services to support them through this difficult time.

The Stillbirth and Neonatal Death Society (SANDS) and Held in Our Hearts https://heldinourhearts.org.uk/ provides help and support for parents who have suffered bereavement. https://www.sands.org.uk/support-you