Baby On Board

Civitas, 27 September 2010

“For two marks, spell and define ‘pre-eclampsia,’ and a bonus point for anyone who can explain the difference between a breech and normal delivery,” instructs a midwife from a blackboard to a small class of two pregnant girls and a young boy who would otherwise be sat outside the headteacher’s office (the absentees were either suffering from morning sickness or male and in a maths lesson). 
 

Whilst the scenario, envisaged by the National Institute for Health and Clinical Excellence (NICE) and teaching unions, is more likely to be a spectacle of softly spoken community midwives reassuring girls in their third trimester that the odd Bacardi Breezer during the first few weeks of pregnancy was unlikely to have caused lasting damage to their unborn baby, neither antenatal alternative sits well in a classroom just a corridor away from the conventional curriculum (that is, unless you’re propped up by a V-shaped pregnancy pillow).  The Egyptians believed that a floating womb caused hysteria in women and, though eventually proven wrong, fast forward 5000 years and I think their theory resonates amongst those opposed to guidelines recently proposed by the NHS advisory board. Floating antenatal classes in schools borders on hysterical.
 
These plans, based on anecdotal evidence, are part of a wider package to tackle complex social factors complicating pre- and post-pregnancy.  The case for better provision is clear: babies born to the under 20s are ‘at greatest risk of being stillborn or dying within the first six weeks of birth’.  Perhaps not coincidentally, mums-to-be in areas of high deprivation in England are ‘five times more likely to die during pregnancy or after childbirth than women in more affluent areas’.  It’s commonsensical that a sound knowledge of appropriate nutrition pre-pregnancy, of labour mid-assistance from an overzealous midwife and of feeding routines post-pregnancy reduces the risk of complications.   Action should be taken to boost attendance at informative antenatal classes, especially amongst mums-to-be sitting their GCSEs, just not on school sites.
 
Attendance at antenatal classes is particularly low amongst expectant teenagers, not least because turning up in expandable-waist school uniform attire isn’t de rigueur.  It’s thought young mums-to-be are reluctant to recognise their pregnancy (that is, until their stomachs extend for miles, they waddle from class to class and have inexplicable cravings for gherkins).   Instead of relocating costly clinics, surely a more sustainable and appropriate proposal would be to overcome the stigma of teenage pregnancy within an environment specifically established for motherhood? After all, they’ll be no hiding the baby from intimidating elders once it’s crying for milk every half hour.
 
Pregnant teenagers need better antenatal provision and the rest need better sex education.  So, before our schools begin to resemble local family practices, better research into the alternatives available needs to be done. We should tackle the problem at hand, rather than relocating it.