Teenage Pregnancy Research Report - 3p Consulting

Pregnancy health and accessing antenatal carePoor obstetric and maternal outcomes for teenagersand their children are documented internationally andnationally. Obstetric and medical risks for pregnantteenagers include pre-term labour, urinary tract infections,anaemia, pre-eclampsia, high rate of caesarean sections,pre-term birth and low birth weight infants resulting inincreased mortality and morbidity of mother and child.There is now consensus among researchers that therisks for adverse birth outcomes for teenagers are linkedto socio-economic status and to the level of medical carethat teenagers receive during their pregnancy rather thanas a result of their young age. 11 Risky lifestyle factorsand irregular or no antenatal care to monitor the physicalhealth of the mother and baby contribute to poor outcomesof babies to teenage mothers. For example, in Tasmania11.6% of teenage mothers reported using drugs during theirpregnancy. Similarly, smoking is associated with low birthweight that is in turn associated with stillbirth. In Tasmaniathe self-reported smoking rate for teenage mothers is34.9 per cent as compared to 23.9% of all mothers andsmoking is a key preventable cause of low birth weight andpreterm birth. 12 Low birth weight (LBW) babies (less than 2500 grams) are more likely to die in the first year of life andare more susceptible to chronic illness later in life, such asheart and kidney disease and diabetes.Regular monitoring during the antenatal period meansthat most of the medical risk factors that lead to increasedmortality and morbidity rates for teenagers can bemanaged. Understanding that many pregnant teenshave pre-existing poor general physical health has meantthat service providers have focused on encouragingteenagers to access regular antenatal care, to makelifestyle changes, such as stopping smoking, and tofocus on nutrition as the avenue to lowering morbidityand mortality outcomes.However, there are a number of barriers that pregnantteens experience when accessing mainstream servicesand medical care, including poor communication on thepart of health professionals, overly complex systems, alack of knowledge about what is available, multiple staffand a lack of self-confidence on the part of the youngpeople. 13 In response, a number of alternative servicedelivery models have been trialled to help overcomethese barriers, such as youth-specific antenatal services,outreach and community-based services such as homevisiting.An explanation for the marginal successes that targetedservice models have had on changing pregnant teens’behaviours is contained in the evaluation report of the UKSure Start Plus program and has its basis in the particularneeds and circumstances of pregnant teenagers. 14 SureStart Plus is an on-going UK Government pilot initiative tosupport pregnant young women and young parents under18 years of age. The core aims set out at the beginning ofthe program were to:• Improve the social and emotional wellbeing ofpregnant young women, young parents and theirchildren;• Strengthen the families and communities of pregnantyoung women and young parents;• Improve the learning of pregnant young women,young parents and their children; and• Improve the health of pregnant young women, youngparents and their children.Sure Start Plus programs were established in areas withhigh levels of poverty and social deprivation and theseareas were selected because they were among those60