Watchdog calls for pregnancy clinics at school

It wants midwives to be able to go into schools to offer advice to expectant young mothers and carry out health checks.

Pregnant under-20s often feel excluded from mainstream antenatal care or judged by their peers, according to the National Institute for Health and Clinical Excellence (Nice).

Experts behind the guidance, which applies to England and Wales, said services should be tailored to the needs of women in each region, such as providing "one-stop shop" antenatal care in areas with high teen pregnancy rates.

Information suitable for women of a young age should be provided and staff should create opportunities for the baby's father to be involved in antenatal care if the mother agrees.

But last night family campaigners criticised the move.

Norman Wells, director of the Family Education Trust, said: "Bringing ante-natal classes to school premises runs the risk of normalising teenage pregnancy and of increasing the very problem it was intended to address.

"Schools exist to assist and support parents in the education of their children, not to be the panacea for every social ill.

"The more that schools are called on to shoulder the burden of problems created by a permissive society, the more they will lose their focus on imparting knowledge and teaching children to think in a rational and logical way."

The guidance said NHS trusts should commission "antenatal care and education in peer groups in a variety of settings, such as GP surgeries, children's centres and schools".

It added: "Young women aged under 20 may be reluctant to recognise their pregnancy or inhibited by embarrassment and fear of parental reaction.

"They may also have practical problems such as difficulty getting to and from ante-natal appointments."

The chairman of the guideline development group, Rhona Hughes, said no British schools were currently providing ante-natal classes but it was a "common pattern of care" in the United States.

She added: "It would not be appropriate for many teenagers, 18-, 19-, 20-year-olds, but we did find examples in the literature of good practice where clinics were held in schools and young women were more likely to access care."

She added that teenagers can "feel embarrassed going to clinics where there are older women", and can feel like an outsider.

The deputy chief executive of Nice, Dr Gillian Leng, said the services should be focused in schools where there was a teen pregnancy problem.

Louise Silverton, deputy general secretary of the Royal College of Midwives (RCM), said implementing the guidelines would require extra resources and staffing "at a level that it is not clearly available in the current context of cutbacks in NHS spending".

She said: "These important recommendations will require significantly more, rather than less, one-to-one care and time from midwives.

"It is also disappointing that most of the evidence in the guideline comes from a setting outside the UK.

"Consequently, this calls into question the applicability of this evidence to UK-wide services.

"There is also very limited evidence of the acceptability of this research to women and midwives.

"Nevertheless, we are pleased to see the recommendations and believe that it is a step in the right direction."