(8) There should be strong referral links with relevant agencies.
Many teenage mothers and their partners have additional issues,
such as financial and housing needs that cannot be met by
maternity health services alone. Antenatal care provides an
excellent opportunity to provide information about and
encourage access to other support agencies. Maternity services
should have strong links with these agencies. By raising the
profile of maternity care within these support agencies, young
people already accessing their support can be encouraged to
attend for maternity care.
Some suggestions for improving the relationship between the
support services and the maternity services include:
Agreement regarding local data and information-sharing
protocols between the relevant agencies and children
centres
A specific pathway that incorporates referral (with consent)
to the available services
Arrangements for immediate referral of the teenager to
support services
In units dealing with small numbers of teenagers, a specialist
service may not be viable. Every effort must still be made to maintain
engagement of teenagers with the existing antenatal service.
A small number of poor quality studies have examined the
outcome of specialist teenage antenatal services. Results from
these are contradictory. Some show that antenatal care in schools
improves earlier booking and attendance whilst others show that
a hospital setting improves attendance. Some studies compare
routine GP focussed care and specialist obstetric adolescent care.
Again, there is no strong evidence to recommend hospital care,
but the benefit of providing continuity of care through a specialist
services is recognized. In a questionnaire-based study looking at
teenagers’ attitudes to their antenatal care, those who described
their care as adequate were more likely to have used specialist
teenage antenatal clinics. Compared with routine community
midwifery care, teenagers who have received antenatal care from
a specialist midwife were more likely to have received information
and advice on sexual health screening, income support,
maternity grants and benefits. With regards to pregnancy
outcome, there is little evidence that specialist care has a positive
effect but the studies conducted in this area are poor.