The Sunday Times

September 26th, 2010

Please, sir, bin the antenatal class and try shaming gymslip mothers

Imagine a classroom full of 14 or 15-year-olds in a large comprehensive school. “Why, Chenelle,” asks the teacher angrily in front of the class, “did you miss maths and English this morning? I know you were in the building.”

“I couldn’t help it, miss, could I?” replies Chenelle self-righteously. “I was at the school antenatal clinic upstairs, wasn’t I? “Oh,” says the teacher apologetically. “Okay. Well that’s all right then. Sorry.”

Preposterous though this sounds, it is precisely what was recommended last week by the National Health Service quango Nice — the National Institute for Health and Clinical Excellence. A new Nice report about improving antenatal care advised health commissioners to set up antenatal clinics in schools and children’s centres in areas with a high rate of schoolgirl pregnancy.

Nice explains that some teenage mothers are embarrassed in ordinary clinics with older women and are afraid of being sneered at in their GP’s waiting room, or feel medical staff are judgmental: pregnancy would be so much more convenient and non-judgmental at school. Discussing US experiences of antenatal care in school, Nice described with enthusiasm some American programmes that offer healthcare after birth as well as before and also daycare for babies to enable the gymslip mums to return to school.

How the jaw drops. Soon no doubt there will be a recommendation for birthing pools in the school gym, with the attendance of schoolgirl birthing buddies. The fact that this idiocy is well-meaning only makes it worse.

Having antenatal clinics in schools sends out precisely the wrong message not only to schoolgirls — and to schoolboys, too — but also to everyone else.

It suggests that having a baby when still a schoolgirl is perfectly all right and normal. Teachers, mentors, social workers, nurses and doctors will not be judgmental. They won’t embarrass a girl in any way with hints that her behaviour might be selfish and irresponsible, not to mention antisocial. She won’t be taught at school about the life chances of babies born to such mothers. They will be protected from any adults who might take such an embarrassing line by the warm and accepting attitude from one and all at school. It is a schoolgirl’s licence to breed at the expense of the rest of society.

Even worse is the message sent to the rest of the class. Those girls who have not yet given in to the temptation, or to the passing impulse, to have a baby will see that they will receive every encouragement if they do. They certainly won’t be told, for fear of stigmatising anyone, that the babies of girls giving birth under the age of 20 (as the Nice report points out) are at considerably higher risk of stillbirth, neonatal death and perinatal death than babies born to women of 20-34. In plain English, having a baby in one’s teens is risky for the baby — something girls ought to be told and aren’t.

Meanwhile, those boys who tend to get girls into trouble, as people used to say, will see that now it is no trouble at all — rather the reverse. It will be even easier to be nothing more than a babyfather. None of the schoolchildren will be taught, for fear of embarrassing any irresponsible girls, that having a baby without a father is almost certainly to condemn it and you to a life of disadvantage and swells the numbers of the unemployable.

Almost more surprising is the message the Nice recommendation appears to be sending about the law. It really would be very odd if schools were to decide to be cosily unjudgmental about underage sex. After all, the age of sexual consent is 16. Before that age a girl who gets pregnant cannot have given consent legally and therefore whoever impregnated her has broken the law — a law that is in large part there to protect children against paedophilia. Any underage girl — like any woman — is entitled to the best of antenatal care, but to offer that care to underage girls in a state-supported place of education is to give out a very subversive message.

Is Nice recommending that teachers and schools condone underage sex? Does it accept that it is “normal” and should be accepted in schools as normal? The other pupils might well assume so, just as they will certainly assume that teachers condone irresponsible sex and irresponsible pregnancy. There is something decadent about this kind of thinking. It helps to promote, by normalising it, one of the gravest social problems we face — the birth of children into deprivation of every kind, which is hard if not impossible to put right later and which causes misery, unemployment, crime and social unrest.

Of course, if a teenager is pregnant, however irresponsible she may be, she is entitled to maternity care. Such girls are highly likely to have problems and should therefore be identified and followed up by social workers, midwives, doctors, social services and the NHS.

The numbers of young mothers-to-be are quite small and concentrated in deprived inner-city areas. It should not be impossible to target them individually, assigning a midwife to each girl. According to the Office for National Statistics, 8,300 girls under 16 got pregnant in 1997; in 2007 it was much the same — 8,200. More of these girls have abortions now, so today’s figure of babies born is about 38% of those conceived: 3,157 or so. As for girls under 18, the number of conceptions has hardly changed between 1997 and 2007, at about 43,000. Fewer come to term: about 21,500. Those are not enormous numbers compared with babies born overall — 699,000 in 2007. Surely dedicated services could be found for this small number of extremely vulnerable schoolgirls, without intruding upon their schools and schoolfriends.

This Nice recommendation is a perfect paradigm of the flawed thinking behind so many of the best-intentioned policies of the welfare state. Where there is a problem — in this case that pregnant schoolgirls don’t always get good antenatal care — a solution is imposed that makes things worse. Any inadequacy in antenatal care for these girls should be made good by the existing agencies whose job it is.

The real problem is schoolgirl pregnancy, and here what is needed is precisely what Nice wants to do away with: social disapprobation, moral judgment, stern lectures from teachers, funny looks from older women and all the rest, to discourage girls from irresponsible motherhood — all the internal, personal disciplines of a big society, which welfarism has always sought to undermine.