Teenage Mothers and Young Fathers |
By John Lawrence15th October 2010The number of teenage pregnancies in the UK is the highest in Europe. Terminations are also high and those who have their babies often are involved with Social Services. This fifth annual conference on the early years of life, staged and organized by the Centre for Emotional Development in Brighton, was as, “ a study day…looking at what it means to be a teenage mother or young father and how best to understand and be of help as a professional person working within this field.” The day attracted a wide range of practitioners working with young parents and children. Dr Leslie Ironside, not only chaired the discussions, but also provided acute observations in response to the speakers. The actively participating audience widened and deepened understanding of the issues as the day progressed. Kate Billingham, Project Director of the Family Nurse Partnership (FNP) Programme opened the day with an upbeat overview of a service that aims to reach ‘difficult to reach’ young mothers and fathers. Agencies offering such work frequently describe clients with whom they have attempted work, as ‘failing to engage’. It is usual policy for helping agencies to place responsibility for the client’s engagement with the client, whose reluctance is often seen as due to a want of ‘motivation’. The FNP are turning this view on its head by placing the responsibility for engaging the client with their service, with themselves, via the nurse practitioner. The nurse continues to visit, even though the client’s response is negative or defensive. If the nurse is able to prove that s/he is committed, then the client will likely be won over, enabling work to begin. The FNP originating in the United States and now fast achieving government recognition and backing in the UK, offers an intensive prevention programme for young parents which runs from pregnancy until the child is age two years. Ms Billingham said that they can benefit children and families who usually have the poorest outcomes; improve antenatal health, child health and development and parents’ economic self-sufficiency. The nurse practitioner visits a family and conducts ‘structured conversations’ and also activities to improve self-efficacy, change behaviour and build attachment. The object then is to lead the parents to developing a new story of themselves and a new understanding of their lives. This will provide improving relationships with their infant, the other parent and their wider family, whilst also helping them to access wider services. Kate Billingham said that the FNP has had consistently good results and outcomes across three scientific trials in the United States. The audience was impressed and interested, especially since many had come from work settings where, although to reaching out to clients, none had encountered a ‘We are responsible for the client’s engagement’ approach before. Margot Waddell then read her paper entitled, ‘Why Teenagers Have Babies’. Although Dr Waddell placed much emphasis on her ‘key’ concepts of containment, the Oedipal configuration and the ability of a developing young child to tolerate the inclusion of a third party, the audience in the discussion made little reference to them. This was likely because only a minority of the audience felt at home or sufficiently familiar with these ideas. Also, having just had a Power Point presentation, the participants were perhaps not ready to attend to a closely argued paper. Dr Waddell’s paper was, however, very rich in ideas and detailed examples from counselling with teenage mothers. She showed from a psycho-analytic view what might miscarry, or be missing internally, when speaking, as Kate Billingham did, of young parents having had little experience of being effectively parented themselves. Dr Waddell described failures in emotional containment, non resolution of Oedipal conflicts, and there being no available means in the family for the infant or growing child to overcome and then to tolerate the presence of a third party. She said that whilst these unresolved issues and conflicts might remain dormant during a child’s ‘latency’ period, they can break out afresh and often dramatically, in adolescence and take on further poignancy when the adolescent becomes a parent. Professor Joan Raphael-Leff provided the material for the third presentation, entitled, ‘Adolescence as a Second Chance’. This presentation was aimed at providing training and insight for practitioners working with pregnant teens and very young parents. Unfortunately, Professor Raphael-Leff was unable to attend, and Dr Ironside presented her material. Like Kate Billingham, she also emphasized that teenage clients are notoriously difficult to engage, but argued that it could be achieved through emotional understanding, validating the young parent’s importance, naming conflicts and helping the parent become curious about their own and their baby’s feelings. Professor Raphael-Leff stressed that the adolescent mother has to cope with negotiating herself through her adolescence, as well as negotiating the new experience of and learning about becoming a parent. She included material aimed at treating maternal disturbance, particularly depression and persecutory anxiety, which has implications for the unborn child. She said that availability of fathers is important, not only to the child, but also to the young mother. In addition, children who have lived in poverty and deprivation, with attendant school problems and delinquency, are more likely to become teenage parents. Early on in the day, the conference established that teenagers over 16 who have completed their secondary education present few problems when they have babies. Of course, young motherhood is not new and not abnormal, but problems arise when young parents are socially disadvantaged, under educated, emotionally immature, and come from dysfunctional families. Being raised in such circumstances usually means that the young parents have had little experience themselves of being effectively parented and cared for. Dr Ironside then showed Wasp, a short film, made by Andrea Arnold in 2002. It highlighted in dramatic vignette form, the difficulties of a young single mother, desperate to have some life and excitement, coping alone with three young children. When she is out with her children near to her flat, a young man turns up that she used to know. She denies that the children are hers and agrees to meet him later in the pub. She leaves the children outside in the pub car-park and as darkness falls, the kids scavenge around for food. Then youngest child is nearly stung in the mouth by a wasp. The film makes the important point that teenage single mothers, and fathers, need support so that they can participate in teenage life. The final presentation on ‘Young Fathers’ was given by Adrienne Burgess of The Fatherhood Institute, She offered statistics concerning this often elusive client group, including that 25 percent of young dads are under 20 and that they are generally more disadvantaged than young men in the wider population. Importantly, Ms Burgess stressed that when young fathers express disinterest in their children, it is mainly associated with financial insecurity or confusion and anxiety about how to take care of babies or children. Nevertheless, most want very much to stay connected to their children. Ms Burgess said that research in 2002 found that young fathers were often ignored, marginalised or made uncomfortable by professionals. A later study showed that they appear to be perceived as having a poor parenting capacity, by professional who know very little about them. In other words, they are often targets of professional prejudice. In the Family Courts, the interest group Fathers for Justice, make a similar point. She said that the young mother’s perception of support from her baby’s father is linked to a good birth experience and a more positive adjustment to motherhood. When involvement with the father decreases, a teenage mother’s parenting stress increases. However, involvement of fathers has a good effect on children that include fewer behaviour problems in the child, both early in life and at school. She stressed that it is vital is for professionals to assess a young father and not to ignore him. Also fathers, often as much or more than young mothers, are much in need of clear and accurate information. Not having good information leaves fathers alone with their fearful assumptions and feelings of embarrassment or exclusion. The Fatherhood Institute collates and publishes research on fathers, helps shape national and local policies, lobbies for changes in law and is a provider of training and publications on ‘father-inclusive’ rather than ‘father-blind’ practice. Ms Burgess’s presentation gave rise to much lively discussion and impassioned contributions (mostly from men) from the audience. So why do teenagers have babies? Some to fill emptiness, some in the hope of guaranteeing unconditional love from their offspring, some to stop feeling like a baby themselves, some in rivalry with their still young (and still sexually active) mothers? All of these, but I noticed, that no-one, at least no one I remember, spoke of marriage, which for pregnant women provides security and support for the mother’s dependent needs. In response to Margot Waddell’s paper there was discussion about the centrality to the teenage mother of her mother, on whom she will seek to depend. What was less noticed though was how often nowadays teenagers look neither to the family, nor to their partners (much less spouses), but to the welfare state to provide a dwelling and an income. Recently on BBC radio, a panellist on the ‘Any Questions’ team commented, “As a society, we are abolishing marriage and substituting the welfare state.” In my work for the Family Courts, where I see families and children, the teenager looking to gain a home and benefits upon the birth of the baby has been common enough to be the norm. This has suggested to me that another reason why teenagers have babies is to provide them with a role and also a route to independent living that they might not otherwise have. John Lawrence Psycho-analyst. |
