NHS Health Scotland

 

Evidence
 

Information and support are avaialble to enable young people to make early and informed choices following conception.

Link through the outcomes (3a)

Early identification, and provision of support and advice for young women who have conceived will enable greater access to information and more awareness of choices and sources of support available throughout pregnancy. This will enable them to make earlier informed decisions and increase early access to appropriate integrated health and social care services including, where appropriate, effective contraception (LARC). This will contribute to improved health and social outcomes for young women and, where appropriate, their offspring.

Summary

Supporting early informed choices

  • Pregnant young women are less likely to access services early in pregnancy. Late engagement with services is associated with poorer health outcomes for mothers and their offspring and, in relation to abortion services, can result in reduced choices for young women. (1)

  • No highly processed evidence was identified about how best to support professionals to recognise early teenage pregnancy or effective ways of supporting young people to make early informed choices following conception.

Accessing antenatal services

  • Young women experience a large number of personal and service barriers to accessing antenatal care. There is promising evidence that specialist services which emphasise early initiation of care and a multi-faceted community based service, including home visits by trained lay advocates, increase early booking. (1)

  • There is good evidence that antenatal classes designed for young people, home visiting and assistance with transport costs, specialist antenatal services and continuity of care for young women help young people maintain contact with services. There is inconsistent evidence about the most appropriate additional services and limited evidence about what additional information is needed to support young women. (1)

  • NICE Clinical Guideline 110 provides a number of recommendations to improve access to and contact with antenatal services among pregnant women aged under 20. This includes service organisation, training for healthcare staff, care provision and information and support for women. (2)

Access to contraception following abortion

  • NICE Public Health Guidance 51 includes recommendations about the provision of advice and effective contraception in abortion services for young people and CMO (2015) 19 letter (3) recommends targets for the provision of advice about effective contraceptive (LARC) for women, particularly vulnerable women prior to discharge from abortion services in Scotland.

HIIA Note:

The evidence includes research on the views of and programmes targeting pregnant young women.

References:

  1. National Collaborating Centre for Women’s and Children’s Health. Pregnancy and complex social factors: a model for service provision for pregnant women with complex social factors. Commissioned by the National Institute for Health and Clinical Excellence. London: Royal College of Obstetricians and Gynaecologists; 2010.Available at: http://www.nice.org.uk/guidance/cg110/evidence (accessed 3 June 2015).

  2. National Collaborating Centre for Women’s and Children’s Health. Pregnancy and complex social factors: A model for service provision for pregnant women with complex social factors. Clinical Guideline 110. Available at: http://guidance.nice.org.uk/CG110 (accessed 3 June 2015).

  3. CMO letter (2015) 19. Health Promoting Health Service: action in secondary care settings. Edinburgh: Scottish Government; 2015.Available at: http://www.sehd.scot.nhs.uk/cmo/CMO(2015)19.pdf (accessed 3 June 2015).