Youth Support  A Multi facetted service … Project s CON F WEBS PTSD BRIDG E BOOKS YSH Out- reach Teen Parent

Youth Support  A Multi facetted service … Teen Parent

Looking Back  30 years ago started professional work with adolescents  20 years ago study cohort began  Youth Support arose from this

A Positive Outcome

Early Work The first study was produced in Concerns and issues at that stage fell into the following categories –

Rates and Reasons Statistical analyses compared teen fertility to that of older women With time this shifted to comparisons across cultures

Why?  Somewhere buried in the argument surrounding contraception and the young – many of the ‘real’ issues got lost –  It’s not just sex and it’s not just contraception.

Scientific Phase  Physical risks, antenatal care and the lack of it and whether young mothers could be as good parents as older women  It shouldn’t be allowed Higher Perinatal Mortality Increased level of Prematurity and Low birth Weight Poor Antenatal Care

Humanitarian Phase  A Culture of Poverty  In 1986 and in 1987 International Medical Women’s Federation meeting in Sorrento, Italy presented paper entitled ‘ Teenage Pregnancy - a culture of poverty’  it was with dismay that I found myself writing about the same subject ten years later in 1997 …  now in the new millennium - nothing has changed.

A Culture of Poverty  Governments repeatedly talk of policies to ‘reduce teenage pregnancy rates’..  Attacking the symptom instead of the disease of deprivation and poverty Poor housing Overcrowding Unemployment

Family Life  Typical pregnant girl is a member of a large single parent family 70% do not live with both natural parents 16% have no mother 65% have no father.  20% of girls in care.

Disadvantage  Disadvantaged circumstances influence prevalence of :-  dietary inadequacy  antenatal anaemia  perinatal mortality and low birthweight

A Spiral of Deprivation  Early pregnancy can result in a spiral of social deprivation

Why does the situation persist?  So why does the situation persist and the problems repeat from generation to generation ?  after 15 years - 10% still have no housing  Training and work opportunities are poor

Baby Fathers  Baby fathers fade out of the picture

Family Patterns  A third of pregnant schoolgirls are following in the pattern of their mothers - that means that two thirds do not.  Hence it is not so much teenage pregnancy that forms the cycle of trans-generational repetition - but the deprivation that fosters early childbirth.

Deprivation  Pregnancy  what is the mechanism whereby deprived circumstances lead to pregnancy? Emotional psychological issues are the vehicle.

Deprivation  Low Self Worth  Deprivation lowers self worth, expectations and instils a sense of inability to achieve a positive future - parenthood restores self image raises expectations and provides a tangible achievement - a baby

The Self Esteem Study  A self esteem measure  A 'deprivation score' looking at life experiences  A 'sexual' scale estimating degree of sexual experience or sexual trauma

Self Esteem  Pregnancy partially protects the individual from threats to self worth but the effect is temporary

Why is pregnancy such a potent source of self value?  In pregnancy a girl identifies with the ideal mother which she never had and can never be.

Alternative Value System ... Seen from the young girl's viewpoint, pregnancy may not be so undesirable. Certainly it brings heartache and hardship, the extent of which should not be underestimated, but for under- privileged girls with little education and non existent job prospects, motherhood is a fulfilment.

Repetitive Patterns  Why do girls ‘repeat’ their pregnancy experiences?  Girls with multiple relationships can progress from one relationship to another and repeat the experience without seeming to ‘learn’ from the previous situation

Recovery from trauma IMPACT LATE RESOLUTION EARLY STAGE

Pregnancy as a Maturation Experience. The pregnant girl can identify with the foetus and concretise her experience of the ‘inner child’ in her developing baby; this allows her another chance to be ‘loved this time’ by the ‘ideal’ mother. There are situations where pregnancy seems to afford an opportunity for ‘psychic growth’ maturation and personal development.

Long Terms Study 15+ years

Patterns of Relationships 50% of girls had only one significant relationship in their lives.

Care system  Girls in the care system had more pregnancies  Their boyfriends stayed around for shorter periods.

Children in Care Girls who had been in care had more of their children removed and fared worse on every parameter researched

Children – Problems in Care  Their children had more problems at five, ten and fifteen years. First born males fared worst.

Youth Support House YSH Teen Parent

Reason for Admission  Pregnant 21%  Parenting difficulties 97%  Mental Health problem 40%  Learning disability 9%

Past History Residents  Abuse Physical abuse -79% (54) Sexual abuse - 64%(20) Incest 30% (4) Self Harm 35%  Substance abuse Drugs 35% Alcohol 28%  Crime and violence History of criminal activities 41% Prostitution 14%

Residential Children  Neonatal Problems –Died3 –SIDS (cot death)2 –Foetal Alcohol8 –Drug withdrawal7

Children - 91% Abused  Nature of abuse emotional81 neglect83 failure to thrive65 sexual abuse14  Presentation bruising45 burn7 fracture7 head injury6 suffocation4 munchausen6

Prognosis - Adult Factors Residents Rehabilitated Together % of total % Rehabilitated All cases Violent Partner Abused Learning Disability 9 38 Alcohol Drugs In care crime History of violence Self harm Personality Disorder Prostitution Severe PD:Psychopathic 26 9