Review finds non-targeted methods to prevent unplanned pregnancy don't work
Increased vulnerability due neglect and abuse, the absence of a supportive adult in their lives and a lack of mainstream effective sex and relationship education due to placement moves, are some of the reasons identified by children's charity Coram as to why standard sexual health education may need re-thinking for care experienced young people, to reduce unplanned pregnancy.
The findings have emerged from a review of academic papers and research from 2000 to 2014 undertaken by experts from The University of Manchester and Lancaster University to ascertain how best to improve outcomes of this vulnerable group of young people.
The review found that non-targeted methods to prevent unplanned pregnancy did not help to prevent unplanned pregnancy and childbirth for young people with experience of care leaver due to the following reasons:
- increased vulnerability due to pre-care experiences (such as abuse or neglect) contributing to a higher likelihood of mental health problems;
- increased chances of missing out on effective mainstream sex and relationship education due to placement moves;
- the absence of a supportive adult in their lives;
- being more likely to choose to continue with an unplanned pregnancy due to a desire for a loving attachment in their lives
Debbie Fallon, lead author from The University of Manchester's School of Nursing, Midwifery and Social Work, said: "For me, one of the key messages of this review is the paucity of publications that focus on interventions that aim to prevent unwanted pregnancy in looked after young people. That is not to say that good work is not taking place - but if it is, we all need to know about it. It is therefore vital that interventions are evaluated and published so the good practice can be shared and costly mistakes avoided."
Karen Broadhurst, co-author and Professor of Social Work Lancaster University, said: "The findings from the review are helpful in thinking about where we might start in developing and testing pilot projects that aim to help young people avoid an unplanned pregnancy, make positive choices about partners and be better prepared for parenthood. There are some excellent initiatives in the US and we can learn from the evaluation of the initiatives we have described in our report, to develop bespoke programmes in the UK."
Professor Broadhurst referred to her related on-going research funded by the Nuffield Foundation, which included interviews with 72 birth mothers. "40-50% of these women had a care background, and 100% were either in care or on the edge of care. Interviews revealed the complexity of factors associated with early unplanned transition to motherhood which included young women finding themselves in highly coercive relationships with older men where domestic violence was a feature of their daily lives."
Director of Operations at Coram, Renuka Jeyarajah-Dent said: "The context of this review is a situation in which young people who have been in care are falling pregnant, some repeatedly so, (British Journal of Social Work (2015) 45, 2241–2260 while at the same time reduced teenage pregnancy overall suggests that the messages about sex education and healthy choices are showing great success.
"There are few examples of evidenced programmes to prevent pregnancy for young people who have been in care. The report concluded that the lack of published evidence of effective unplanned pregnancy programmes in the UK means that successes cannot be replicated and mistakes are likely to be repeated. It also found that the results which have been published are not necessarily evaluated in a robust manner.
"However, our review also identifies models where programmes have been successfully tailored for the needs of care leavers, mainly in the US. Now we have to think about what could be adapted from these, applying our increased understanding of the issues so that vulnerable young people get a better level of support and can make educated choices about what's right for them."