Supporting Young People in Care with Sexual Health and Contraception – Guidance for Foster Carers

This guidance is based on the Children and Families' Sexual Health Policy.

There is national and local evidence that young people in care are two and a half times more likely to become pregnant as a teenager than other young people.

• 1 in 10 young people are affected by a sexually transmitted infection – which if untreated can cause chronic infection, disease and infertility.

Carers should be supported in their work with young people and should attend the sexual health training day for foster carers

SOME BASIC PRINCIPLES TO REMEMBER:

The welfare of the child/young person is most important issue and must be at the forefront of all actions taken

• Young people should be kept safe and must be protected from abuse

• The Sexual Offences Act 2003 states that children under the age of 13 years do not have the capacity to consent to sex and anyone involved in sexual activity with a child under 13 is liable to prosecution – presumed consent cannot be a defence. Sexual intercourse with a child aged 12 or younger is classified as rape

• Young people have the right to education about sex and relationships which informs them when their behaviour is risky – as well as information on how to access sexual health and contraception

• Young people in care have the same right to confidentiality from services as other young people unless it compromises the rights of others or themselves or places others or themselves at risk of harm.

• Disability does not necessarily preclude sexual young people from sexually fulfilling relationships or risk taking behaviours

CARERS CAN:

• Support young people to raise their self esteem, increase their range of interests and leisure activities and improve assertiveness skills and abilities to help them resist peer pressure and delay sexual activity.

• Attend the sexual health training day for foster carers and keep up to date by accessing information via appropriate websites, journals etc.

• Encourage young people to talk about sex and relationships as long as the carer feels reasonably prepared and confident and the environment and privacy level is appropriate

• Offer an open and positive view of difference and diversity and support sexual self acceptance in a framework of minimising risky behaviour

• Help the young person to understand the links between alcohol and substance use and the increased vulnerability to sexual risk taking behaviours.

• Help young people to be more aware of the impact of sexual activity and the responsibilities of early parenthood.

• Ensure young people have knowledge of appropriate sexual health clinics and services.

• Seek advice from the supervising social worker if feeling unsure about keeping information confidential. An assessment should be made taking into consideration the welfare and well being of the young person & their right to privacy, balanced with the extent of personal vulnerability and their need for protection from harm.

• Be as clear as possible with young people about the boundaries regarding keeping information confidential

• Report immediately any suspicion of abuse to the child’s social worker or to the duty social worker if not available, and to their supervising social worker.

• Accompany young people to sexual health/contraception service/clinics when appropriate.

• If attended the training day – keep a small supply of condoms for ‘emergency’ situations, but encourage the young person to access services for regular free supplies of condoms via the C Card scheme.

• Support young women to access emergency hormonal contraception (the morning after pill) as soon as possible following unprotected sex. The pill is effective for up to 72 hours post sex – but is more effective the sooner it is taken – don’t wait – even at the weekend it is free from participating chemists (see handbook) and from the out of hours GP service.

• Carry out a pregnancy test at home – although this is better done by a nurse at the clinic when options and health implications can be fully discussed. Some young people may be reluctant to go to the GP/clinic at first and a home test will then be useful

• Support pregnant young women, helping them to access the specialist teenage pregnancy health and education services in the City.

• Support a young person who wishes to terminate her pregnancy. The GP or family planning clinic can refer to the appropriate counselling and termination services. The young person’s right to confidentiality should be upheld unless it is deemed necessary to breach this – applying the principles set out above.

CARERS SHOULD NOT:

• Talk freely about their own sexual activity – this can leave the child and sometimes the carers feeling unsafe and can blur boundaries. It is best to discuss your intentions with your supervising social worker if you feel a limited amount of self disclosure may aid your support of the young person

• Give advice to young women on which form of contraception to use – you can provide information but the type of contraception has to be based on individual health profile and implications and should only be undertaken by a family planning trained nurse or doctor.

• Break the young person’s right to confidentiality if there is no good reason to do so.

• Keep information confidential if the young person’s behaviour puts themselves or others at risk of serious harm.
• Carers should know and advise the young person that it is illegal for any adult in a caring role to have a sexual relationship with a young person for whom they have responsibility if the young person is under the age of 18.

Advice provided by the Nurse Consultant Children in Care