Health and Sport Committee 5th Report, 2013 (Session 4) Report on Inquiry into Teenage Pregnancy

Health and Sport Committee 5th Report, 2013 (Session 4) Report on Inquiry into Teenage Pregnancy

Health and Sport Committee 5th Report, 2013 (Session 4) Report on Inquiry into Teenage Pregnancy

Health and Sport Committee 5th Report, 2013 (Session 4) Report on Inquiry into Teenage Pregnancy Published by the Scottish Parliament on 19 June 2013 SP Paper 355 Session 4 (2013)

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Health and Sport Committee 5th Report, 2013 (Session 4) CONTENTS Remit and membership Report 1 Foreword 1 Introduction 3 Evidence 6 Structure 6 Different perspectives on teenage pregnancy 7 Teenage Pregnancy Target 8 Factors influencing teenage pregnancy 10 Deprivation 11 Vulnerable groups 12 Low self-esteem 13 Desire for access to social housing 15 Alcohol, drugs and risk taking behaviour 16 Cultural and media influences 16 Links between high rates of teenage pregnancy and health inequalities 17 Policies specifically to address teenage pregnancy 19 Overall policy context 19 Overall progress resulting from policy changes and strategic direction 21 Positive initiatives specifically targeted in area of sexual health and teenage pregnancy 22 Wider policy initiatives 23 Possible limitation of current policy framework 26 Features of the new strategy 31 Targets for reduction of teenage pregnancy 31 Data 33 Clarity on responsibilities 36 Education and other local authority services 40 What role do education services play? 40 Sexual Health and Relationships Education (SHRE) – policy context 41

SHRE in practice – general points 43 SHRE – specific issues 46 Education for young parents 56 Fathers 59 Contraception and provision of sexual health services 63 Community pharmacists 71 Family Nurse Partnerships 75 Possible limitations of FNP 77 Costs and resources 79 Annexe A: Remit and Questions asked in the call for evidence 82 Annexe B: Extract from minutes of the Health and Sport Committee 83 Annexe C: Oral evidence and associated written evidence 86 Annexe D: List of other written evidence 88 Annexe E: Note of visits to The Corner and Menzieshill High School, Dundee; Young Parents' Support Base at Smithycroft Secondary School, Glasgow, and Positive Steps, Oldham 90

Health and Sport Committee Remit and membership Remit: To consider and report on health policy, the NHS in Scotland, anti poverty measures, equalities, sport and other matters falling within the responsibility of the Cabinet Secretary for Health, Wellbeing and Cities Strategy apart from those covered by the remit of the Economy, Energy and Tourism Committee. Membership: Bob Doris (Deputy Convener) Richard Lyle (from 16 May 2013) Mark McDonald (until 14 May 2013) Aileen McLeod Duncan McNeil (Convener) Nanette Milne Gil Paterson Dr Richard Simpson Drew Smith David Torrance Committee Clerking Team: Clerk to the Committee Eugene Windsor Senior Assistant Clerk Rodger Evans Assistant Clerk Rebecca Lamb Committee Assistant Bryan McConachie

HS/S4/13/R5 Health and Sport Committee 5th Report, 2013 (Session 4) Report on Inquiry into Teenage Pregnancy FOREWORD ―Birds and blethers fly‖, as goes the Scots adage. It could well be applied to much of the previous discussion around teenage pregnancy. Our hope is that this inquiry may take us beyond the controversy, hearsay and prejudice that have become so predictable in defining the subject. The reasons for Scotland‘s high teenage pregnancy rate – being in gradual decline in recent years but stubbornly high in a UK and European context – may be culturally complex but are far from insoluble in social policy terms.

We‘ve undertaken to assess the work directed at reducing unplanned teenage pregnancy; and to look at what else can be done to support young people at risk of pregnancy or who have a child very young. The Committee has considered the relationship between teenage pregnancy and poverty, examined the challenges to change in our most deprived communities, asked whether services are being effectively delivered, and tried to highlight those initiatives well regarded but perhaps unsung.

Regarding teenage mums, Anne Houston of Children 1st told us: ―Sometimes, they just hope that a baby will love them and that they can love it and…that will fill a bit of a gap‖. Clearly happiness, confidence and life opportunities, or the diminishment of some or all of these things, matter a good deal. There is a view that efforts to prevent teenage pregnancy should begin as early as possible, pre-school even; the most formative years for those children likely to go on to experience what are usually blandly termed ―poor outcomes‖ in their teens and into early adulthood. Such an approach sits well with the premium value that the Chief Medical Officer has placed upon early-years support and positive intervention.

The young mums who spoke to the Committee said sex education was too biologically focused and not enough about relationships. Research shows a correlation between quality sex education and use of contraception, delay of first sexual experience, and having fewer sexual partners. A head teacher told us: SP Paper 355 1 Session 4 (2013)

Health and Sport Committee, 5th Report, 2013 (Session 4) 2 ―Evidence points out that discussing sexuality and sexual health does not encourage promiscuity or early adoption of sexual behaviour – quite the opposite‖. Schools, health services and all those who engage with young people have a role here.

The Minister for Public Health said he wishes to see more shared ventures between health boards and local authorities in order to tackle teenage pregnancy across Scotland. The poet Emily Dickinson wrote: ―[a] mother is one to whom you hurry when you are troubled‖. The trouble with a good deal of the debate concerning teenage mothers – and indeed fathers – has been the hurried tendency to indulge in either moral admonishment or pessimism of the what-can-be-done sort. It needn‘t be so. Duncan McNeil Convener Health and Sport Committee

Health and Sport Committee, 5th Report, 2013 (Session 4) 3 The Committee reports to the Parliament as follows— INTRODUCTION 1. Scotland has a higher rate of teenage pregnancy than most other western European countries. Chart 1: Percentage of all live births to mothers under 20 years, Scotland and Western Europe, 2009 Source: The Scotland and European Health for All Database, Scottish Public Health Observatory, 2012. *2007 data; ** 2008 data 2. Although, as the report will go on to explore, high levels of teenage pregnancy are associated with deprivation and poverty, Scotland‘s high levels do not reflect its levels of poverty in relation to other western European countries.

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