Pregnancy clinics in schools

By Dr. Ananya Mandal, MDSep 23 2010

According to the National Institute for Health and Clinical Excellence (NICE), pregnant women under 20 often felt excluded from antenatal care in hospitals. Teachers have thus welcomed the proposal to set up antenatal clinics in schools to care for pregnant teenagers. The services would provide advice on nutrition, staying healthy while pregnant, carry out routine tests and monitor the pregnancy while in the latter stages classes may be provided to prepare the woman for the birth.

One of the major reasons for this proposal was that Britain has the highest teenage pregnancy rates in Western Europe, the guideline said. Around 40,000 women under the age of 20 give birth each year, out of a total of around 700,000. It is not known how many women do not attend antenatal services. Also teenagers and young women are more likely to have complications including giving birth prematurely and have small babies. The guideline said that young women should be offered appointments where their partner can be present if they wish and with or without parental involvement.

Dr Gillian Leng, Nice Deputy Chief Executive said, “Expectant mothers need support throughout their pregnancy yet some groups of women do not access, or continue to maintain contact with traditional antenatal care services because of issues such as domestic violence, teenage pregnancy or not having English as a first language…They might feel scared, overwhelmed, judged, unable to communicate, or may be physically stopped from attending appointments. Although these women represent a small proportion of those having babies in the UK each year, they and their unborn children deserve the same level of care as anyone else.”

According to Christine Blower, general secretary of the National Union of Teachers, many pregnant teenagers run a risk of abandoning their education. “If antenatal care in school can both keep girls in education and ensure that they and their babies are healthy, it should be welcomed,” she said.

Russell Hobby, general secretary of the National Association of Head Teachers also feels this is a “natural set up”. “Schools are trusted hubs within their communities. We already do similar things to this. We have social workers based in schools,” he said. But schools should not be forced to have antenatal clinics, he added.

Dispelling the underlying fear Mary Bousted, general secretary of the Association of Teachers and Lecturers said antenatal classes would not encourage teenagers to get pregnant. “It will simply provide a service which will help ensure the health of mothers and their babies. It is a perfectly good suggestion.”

Rhona Hughes, chairman of the guideline development group pointed out that no British schools were currently providing antenatal classes but it was a “common pattern of care” in the US. She said: “It would not be appropriate for many teenagers, 18, 19, and 20-year-olds, but we did find examples in the literature of good practice where clinics were held in schools and young women were more likely to access care.” She noted that teenagers can “feel embarrassed going to clinics where there are older women”, and can feel like an outsider.

Norman Wells, Director of the campaign group, Family Education Trust however said, “Bringing antenatal classes onto school premises runs the risk of normalizing teenage pregnancy and of increasing the very problem it was intended to address…Schools exist to assist and support parents in the education of their children, not to be the panacea for every social ill…The more that schools are called on to shoulder the burden of problems created by a permissive society, the more they will lose their focus on imparting knowledge and teaching children to think in a rational and logical way.”