Social exclusion is the failure of society to provide certain individuals and groups, with the rights and benefits that are normally available to its members. They may be excluded due to a number of factors age, gender, race, educational background, neighbourhood, class and more (Giddens, 2001). Social exclusion can be experienced by anyone, but certain groups have been found to be more susceptible. It is a genuine problem that needs to be addressed properly.
The Social Exclusion Unit (SEU) was set up by the Prime Minister in 1997, to help improve Government action to reduce social exclusion by joining together the solutions and the problems.However due to the multidimensional issues it can be very difficult to measure. Social Inclusion is however about involving everyone in society, making sure all have the same opportunities to work or take part in social activities, regardless of any disability or factor from which they may feel excluded. The group selected to experience is teenage mothers. The focus will be on social exclusion and how this can affect the health and wellbeing of teenage mothers.
Identify strategies that are in place to help provide health care and support to teenage mothers.Explore how this can impact on opportunities available and why it matters in the long term. Compare the findings over a period of time and understand why teenage mothering is commonly seen as both personally and socially undesirable (Holgate, Evans and Yuen, 2006). Discussion Teenage mothers are generally referred to as girls aged under 18 (13-17 inclusive) who are under the legal age of adulthood. In February 2011 the annual conception data for 2009 was published which show that England’s teenage pregnancy rates is steadily falling.
The birth rate for under-18’s has dropped 27% from 1998-2009.These are the lowest rates in nearly 30 years. However England still has the highest rate of teenage pregnancy in Western Europe (Teenage Pregnancy Associates, 2011). Teenage pregnancy often increases health inequalities which can lead to poor long-term outcomes for young parents and their children. Death rates and low birth-weights are higher in children of teenage mothers.
Young mothers are more likely to get post-natal depression and at a higher risk of long term mental illness. They are more likely to smoke and less likely to breast feed.May struggle to complete education and find it difficult to gain employment. Teenage pregnancy can increase child poverty which increases the risk of poor health and living in poor housing (Teenage Pregnancy Associates, 2011).
These factors contribute to young parents and their children facing long-term economic challenges. There is a strong economic argument for preventing teenage pregnancy for every ? 1 the NHS spends on contraception; ? 11 is saved in abortion, ante-natal and maternity costs (Teenage Pregnancy Associates, 2011). Teenage pregnancy also costs the taxpayer in terms of benefits and income support.Teenage parents are often more likely to be allocated social housing. Teenage mothers are also more likely to need support for parenting, budgeting, education, employment and training.
The SEU report Teenage Pregnancy in June (1999) highlighted two policy aims to reduce the rate of teenage conceptions and getting more teenage parents into education, training or employment to reduce their risk of long-term social exclusion. Effective ways to help reduce teenage pregnancy are identified as providing young people with information and choices regarding contraception, sex, and protection against sexually transmitted infections.Access to young-people centered contraceptive services. Early intervention to help prevent teenage mothers getting pregnant again too quickly and support for education and employment. The reality of bringing up a child often alone and usually on a low income is misunderstood by teenagers and they are often quite unprepared for it.
They do not know how easy it is to get pregnant and how hard it is to be a parent (Social Exclusion Unit, 1999). Young mothers during pregnancy and beyond feel isolated from their friends, have no social life and experience limited emotional support.Holgate, Evans and Yuen (2006) identify the importance of support groups and projects to increase self-confidence and self-esteem. Gaining the opportunity to self-reflect and the motivation to engage with the new activities helps them to feel more socially included. However encouraging young parents to attend support services is difficult. Young parents often reported feeling judged, intimidated and dissatisfied with the treatment from health professionals, therefore they do not feel comfortable attending support services run by them (Smith and Roberts, 2009).
Young parents reportedly under-use NHS services as they feel stigmatized, lack confidence and find the content irrelevant. Confirming the importance of specialist antenatal clinics and support services that address young parents’ individual needs are required in the UK (Smith and Roberts, 2009). There are only a few providers of support available for teenage mothers, Sure Start is a government run project aiming to give children the best possible start in life by improving childcare, early education, health and family support services.Outreach and community developments to target disadvantaged areas with the goal of reducing child poverty. Sure Start Children’s Centers, aim to provide a variety of advice and support for parents and carers. They bring all the different support agencies together to offer a range of services all in one place.
Their services are available from pregnancy through to when your child starts school. Local health clinics arranged by health visitors are also a great opportunity to sign post information to young parents regarding playgroups and services available to them.Healthcare professionals have a responsibility to be supportive and understanding to teenage mothers. Ensuring advice and education is given using a non-judgmental approach to promote independence.
Much of the sexual health service provision for young people focuses on access in schools. Sutton, in her paper on sexual health promotion in schools, views the school nurse role as vital for reducing the pregnancy rates in the UK (Sutton, 2001). This is supported by Crouch (2002) who suggests that school nurses might play a significant role in meeting the Government’s ‘better prevention’ agenda.Perry (2002) highlights the importance the role of the midwife could play in educating for prevention and birth control and helping to deal with the psychosocial implications of early age pregnancy. Smith (1997) also suggests that nurses that are involved in adolescent healthcare can help to reduce sexual transmitted diseases by focusing on disease prevention and health education and providing easy access to confidential healthcare services, promoting sexual health and addressing high risk sexual behavior.Nurses are in an ideal position to assume a key role to help fight to prevent teenage pregnancy, given their presence in local health clinics, general practice surgeries, care facilities and schools.
Healthcare providers with access to new evidence about the consequences of adolescent childbearing will have a clearer focus on providing competent, successful and compassionate care to pregnant and parenting young people. The complexity of implementing effective sexual healthcare services to meet the needs of young people is widely acknowledged.The National Sexual Health and Relationship Strategy recognises and advocates the provision of appropriate sexual health services for meeting the needs of the socially excluded. That requires careful consideration of the potential impact of ethnicity, deprivation and socio-economic influences.
It also advocates the importance of recognising and implementing more effective ways of dealing with stigmatization and discrimination relating to HIV and sexuality (Department of Health, 2001).These are ongoing issues relating to young people and therefore cannot be ignored. The UK government has demonstrated its support in terms of funding for teenage pregnancy strategies. This has allowed for the implementation of research and training programmes not only for setting up services but also for preparing healthcare practitioners as well as teachers and youth workers to enable them to provide efficient support, sexual health promotion, education and counseling to all groups of young people and specifically targeting pregnant adolescent and young adult females.
The National Sexual Health Advisory Committee strategy for sexual health is aimed at monitoring media campaigns, advocacy interventions and literacy. In addition it highlights the potential benefits of using the barrier method of contraception with other methods to improve protection against STDs and unintended and unwanted pregnancies (Hermiston, 2004). Given that early sexual initiation is an important factor any strategy that can delay the onset would seem appropriate. Abstinence is also a method of contraception that may appeal to some teenagers.Planned Parenthood (2012) highlights abstinence as a behaviour that prevents pregnancy and sexually transmitted infection, as well as being safe, easy and convenient. Sex and Relationship Education (SRE) involves learning about the stages of human growth and maturity, gaining an understanding of sexuality, reproduction and sexual health and what contraception means and gaining an awareness of the services provided to support and advise on sexual health.
It also involves acquiring an understanding of the reasons for delaying sexual activity and the possible consequences of engaging in early sexual activity (Department for Education, 2010).While some aspects may raise some concerns for parents and teachers, these areas are crucial for supporting young people in their development. Knowledge about these different issues will enable young people to seek clarifications in order to avoid confusion and acting on mythical notions regarding sex and sexuality and given the acquired understanding would help them to express their concerns, ask questions and seek guidance and support. The DfE issues guidance for schools to develop their own policies for implementing SRE and encourages them to involve parents.The guidelines also recommend that it should apply equally to both genders whatever their circumstances.
The SRE programme should have learning at pre-pubertal stage, learning at the transitional stage of puberty followed by appropriate learning from then on. This strategy will ensure that girls understand the physiological process of menstruation and that they are prepared and supported for the associated emotional and psychological effects. The school SRE policy should raise awareness among all the pupils about STDs and their prevention.At an appropriate stage there should be a component of learning about safer sex. Additionally the school should provide explanation regarding the moral and personal dilemmas associated with abortion and the potential psychological impact that can result from the experience.
Another recommendation is that the delivery of the programme should be staged from primary school level onwards. There is also a recommendation that a suitable environment should be established to encourage young people to articulate their values, levels of respect, perceived responsibilities, and relationships with their parents, peers and teachers. They should feel comfortable to openly discuss their perceptions.This may help to gain a better insight of their views in order to answer questions, clarify any misconceptions and address their particular concerns by providing appropriate guidance and support.
Professionals who coordinate these sessions should be well informed and experienced in working with young people in order to address the different issues at a level that makes sense to the age range and varied backgrounds of the individuals present.Studies should be conducted to explore the factors that influence sexual risk behaviours and the impact of drugs and alcohol on adolescent sexual behaviours and risk-taking. Other important factors that still need further research are the influencing and inhibiting factors associated with the health seeking behaviours of adolescents and young adults and the impact of ethnicity, deprivation and socio-economic factors on sexual health. BBC News (2010) highlights how young people everywhere are becoming bombarded with sexual messages via magazines, social networking sites and music videos.Concerns over the effects of sexualisation being imposed on young people are an issue that is becoming increasingly worrying to parents.
The impact of the family structure, parenting style to which the adolescent is exposed and the natures of the interaction or communication between the mother and child have a strong influence on sexual behaviour. Additionally, the social norms, cultural and religious influences, peer and media influences to which they are exposed in the community environment may have equally strong influences.Therefore these factors need to be considered when implementing services to support young people. The UK Teenage Pregnancy Strategy aim is to not only reduce the rate of teenage pregnancy but also to promote the social inclusion of teenage mothers and their families. It advocates between relevant governmental, health and education departments to work towards achieving effective service provision for young people. These strategies are primarily designed to target high risk groups.
The principles embedded to form the basis for better sex education, including guiding and supporting parents to discuss sex and relationships with their teenage children. Other important elements are to ensure provision of better support for teenage mothers, including measures to enable them to resume their education. This proves critical for their future career opportunities, when education becomes disrupted by pregnancy and childbirth.Consideration is also given for the provision of effective and safe childcare facilities to help and support teenage mothers. The needs of teenage fathers are also addressed.
Where possible supported housing may be provided to ensure additional security for the adolescent mothers and their babies. Such initiatives and programmes are clearly highly beneficial for young teenage mothers and fathers and for the parents and guardians but coverage is patchy. Standardisation of certain key services across the UK is urgently needed.ConclusionThe health and wellbeing of young people has always been a complex matter.
Risk taking behaviours in young people are not a new phenomenon. The culture of alcohol consumption, drug taking, crime, violence and sex is a reality for young people in today’s world. However, the discussions highlight that the short- and long-term consequences of early age sexual activity present difficulties for the young person, their family and society. Adolescent childbearing is commonly associated with negative long-term effects for the mothers.These include future adolescent births, adverse socio-economic conditions, fractured education and poor earning capacity.
Evidence of negative health consequences is well documented in policy documents, academic publications and research reports with increased risks identified for the both the pregnant mother and her child. Along with this the psychological impact of early pregnancy amongst young people, which often includes stress, depression and sometimes suicide.Current government policy highlights the need to improve understanding and change behaviour. It aims to improve teenage pregnancy prevention through education and access to contraception. Sex education and adolescent-focused healthcare are key to addressing this problem. Teenage pregnancy is not an issue that is going to go away and the best way forward is to recognise the complexity of the issue.
Highlighting the need for a different approach to encompass the nature of sexual relationships and behaviour in today’s world (Leishman and Moir, 2007).
