The Teenage Pregnancy Midwife in Northern Ireland

Teenage pregnancy refers to pregnant women between the ages of 13-19 intended or unintended. Teenage years are a time for acquiring knowledge and skills that will lead to opportunities in careers and lifestyle. Events that limit those opportunities, such as teenage pregnancy are undesirable by our society. In the United Kingdom (UK) teenage pregnancy is considered a taboo entwined with social stigmatisation, alienation and associated with poor social and health outcomes for mother and child. In the UK teenage pregnancy rates have been steadily declining, however, compared to the rest of Europe the UK still has the one of the highest rates. In Northern Ireland 3% of all births are to teenage mothers which equates to 1.8 teenage pregnancies each day. This makes young parents a vulnerable group that need support to tackle the health inequalities that occur when a young woman becomes a pregnant.
This poster analyses one such support in the form of The Teenage Pregnancy Midwife (TPM). The initiative was implemented in 2011 by the Northern Trust and funded by the Public Health Agency (PHA). Its aim is to ensure young mums within the Causeway and Mid Ulster area receive tailored support to have a healthy pregnancy, improve their child’s health and development, plan for their own futures and achieve their ambitions.
An evaluation is conducted annually and submitted to the PHA to monitor outcomes and gain repeat funding. The evaluation includes outcomes from focus groups and individual mother’s experiences. It monitors the number of one to one and group sessions, text messages, telephone calls and interactions via social media. Evaluated benefits have been shown to include continuity of care and carer, increased breastfeed rates and increased confidence of parent craft skills. An additional benefit is that the young parent does not have to live in a Sure Start area to avail of the service. The TPM specifically targets teenage mothers who are pregnant for the second time, pregnant teenagers who do not fit the Family Nurse Partnership (FNP) criteria. One challenge the TPM found on implementation is that she cannot support a young mother who is involved in FNP. FNP is operated by nurses and not midwives, therefore the young mother is missing out on support that the TPM provides. Another challenge found by the TPM was that midwives were not aware that the initiative existed or were unsure how to, or where to refer the young mothers.
Currently, only particular areas within the Northern Trust benefit from the TPM initiative. A team of TPM’s could be put in place throughout the province to ensure all pregnant teenagers benefit from additional support and increased continuity, resulting in better outcomes for mother, father and child. The criteria of the FNP could change to allow the TPM to work alongside them, provide antenatal, intrapartum and postnatal care through a case load model. Workshops could be implemented to promote the initiative ensuring health professional know to complete referrals forms and how to contact the TPM if required. The TPM Initiative is a leap in the right direction to support pregnant teenagers and address the health inequality within this vulnerable group.