Teenage pregnancy issues and the sexual health of young people – expectations of foster carers

Introduction

There may be occasions, hopefully rare, when a young woman placed with you becomes pregnant. Your preparation and training will have already made you aware of the need to be accepting and supportive of the young woman in your care and help ensure, in consultation with the child’s social worker and birth parents (as appropriate), that she makes the decision about her pregnancy which best suits her needs and respects her wishes and beliefs. If she decides to proceed or not proceed with the pregnancy you need to feel confident about giving the appropriate information and support about the health and other services available to her and about maintaining her education at secondary school or college and meeting her educational needs.

You won’t be alone in supporting her as the young person’s social worker and your supervising social worker will continue to play key roles, though their roles may be more to help you in your crucial support and enabling role. How far the young person’s birth parents and wider family will be involved will depend on the circumstances of them becoming looked after and advice and direction from the young person’s social worker, but in many situations it is hoped the young person’s family will also play an important role.

The following section on promoting the sexual health of looked after young people is also relevant to carers caring for young men.

Promotion of the sexual health of young people placed with foster carers

As part of the corporate parenting role Children and Families has a responsibility to ensure that all young people in its care receive high quality sex and relationships education and that they have information and the confidence to access contraception and sexual health services.

Carers and Social Workers are encouraged to attend the training day provided on sexual health and relationships for Looked After Children.

Young parents are also to be provided with the appropriate support and guidance in parenting and sustaining their education.

This section is based on Children and Families Young People & Sexual Health Policy on providing information and referring young people to Contraception and Sexual Health Services, which can be obtained by your supervising social worker. Please see appendix for guidance for foster carers

Provision of education on sex and relationships by foster carers

In consultation with a young person placed with you and their social worker and your supervising social worker, you have a responsibility to provide appropriate information and support to promote their positive sexual health.

You should support young people to develop their assertiveness and negotiating skills to help them resist any pressure to have early and unwanted sex. A young person’s parents may express wishes about their child’s sex education, which should be taken into account, but your over-riding concern must be to safeguard a young person’s health and welfare.

You can take young people to sexual health services as part of a wider sex education programme and accompany them to a clinic if you consider the young person to be at risk of unprotected sex and is concerned about visiting the clinic.

You can provide information on contraception options but as you are not a health professional you should not give advice. The health professionals will provide advice directly to a young person.

You should be aware that schools are required to provide sexual health education as part of the curriculum for all children and young people. School programmes on sexual health are based on national and local guidelines and take place both at primary and secondary level. If not automatically notified by a child’s school, you should try to find out when sexual health programmes are being introduced so that children and young people attend. Information regarding sexual health education in schools can be obtained from the Head Teacher or Personal Social Health Education (PSHE) Co-ordinator at school. Looked after have a dedicated teacher within schools and you should link with that person to explore the delivery of sex and relationships education.

Contraception advice and information

You should explain to young people that they have the right to confidential contraception and sexual health advice and services, even if they are under 16 years old or on a Care Order (comply with 'Fraser guidelines').

If a young person asks, you should encourage them to seek sexual health and contraception advice and direct them to local services if it appears that the young people are, or are thinking about becoming sexually active, if you feel that by doing so you are protecting them from unplanned pregnancies or sexually transmitted infections. This includes under 16s, gay, lesbian, transgender and bi-sexual and unsure young people.

You should provide information about the sexual health clinics where young people can get advice and or treatment for sexually transmitted infections if you feel that by doing so you are protecting them from infections.

If considered necessary, you should provide details of free pregnancy testing and pregnancy counselling services. These services will also provide confidential support to young women in the decisions they may need to make as a result of the test.

You can accompany them to appointments or drop in clinics if that is helpful.

You can provide leaflets and posters about local services alongside information about other relevant community services, which are provided free at Health Promotion tel: 01273 545403.

If you would like to provide condoms and arrange or carry out a pregnancy test, you should consult the young person’s social worker and your supervising social worker.

A disclosure by a young person of underage sex is not necessarily a reason to breach confidentiality, but you should clarify the confidentiality situation with your supervising social worker before any education, support or referral to services is provided.

Support to young parents

 Brighton and Hove NHS City Teaching Primary Care Trust and the City Council are developing specialist services for young parents to prevent them from becoming excluded from opportunities as a result of early parenthood.

You must ensure that a young woman who is pregnant and planning to keep her baby attends antenatal appointments with the community midwife at your local surgery. If there are difficulties with this please refer to the Teenage Pregnancy Community Midwife who can provide direct support and who can also take the young parent/s around the labour ward.

Terminations of pregnancy - young people are able to have a termination confidentially under 16 if the doctor considers they meet the Department of Health Fraser guidelines of competency which relate to matters of contraception. Before you start working with young people on sexual health confirm the boundaries of confidentiality with your supervising social worker

All young parents will be referred to the specialist ealth visitor for teenage parents.

For young parents who may want some additional support about self-care, child birth, breast-feeding, you should refer the young parent to CHOICES antenatal group which is a specialist drop-in support group for young parents.

You must refer all school aged young mothers to the Teenage Pregnancy Reintegration Officer (TPRO) who will provide them with support in sustaining their education during pregnancy and work with the young parent post delivery, to re-enter education/training and develop a childcare package. Teenage Pregnancy Advisors (PAs) provide the same service for young parents aged 16 – 18, and can also help with housing and benefits.

Specialist learning opportunities are being developed across Brighton and Hove and information is available from the PAs and RO, along with any information on childcare placements and paying for child-care.

Please see the list of telephone numbers and addresses of specialist services.

Maintaining a young woman’s education

This section is based on the Council’s The Education of Looked After Children and Young People A Handbook for Corporate Parents, already referred to in the chapter on the education of looked after children on page 50, which your supervising social worker can obtain if you wish.

Background

Britain has the highest rate of pregnancies in Europe. Brighton and Hove has a high rate of teenage pregnancy, nationally it is in the top 20%. Various areas of Brighton and Hove have higher incidences, for example Hangleton, Whitehawk and Moulsecoomb. Education can be disrupted through pregnancy. Looked after young women in year 11 over the last few years have missed considerable amounts of school and entry to GCSEs. Teenage pregnancy occurs in all social groups.

What must happen if a looked after young woman becomes pregnant?

• the young woman’s foster carer and social worker must ensure that the young woman is supported to remain in education
• the young woman may wish to receive support from the pregnancy support groups run by Children and Families' family centres
• the designated teacher for looked after children in the secondary school attended must support the young woman and liaise with the local Alternative Centre for Education (ACE).

Home tuition

If a young woman placed with you becomes pregnant and is attending school, in consultation with the young woman and their social worker you should refer her to the Teenage Pregnancy Re-Integration Officer who will arrange home tuition for her if this is appropriate.