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Postcards from Scotland

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Posted 02/02/2011

 Slabs of ice like mini Tectonic plates collide and tumble as the ferry crosses the Baltic from Finland to Estonia. In social democratic Finland there is a sense of equity on the streets - people look well and on the roads, medium sized cars predominate. In post Soviet Estonia, the gap in living standards is more evident - in markets and malls, the people look less well and on the roads large 4x4s with tinted glass make their mark.

In Estonia, two women, Sigrid Petaffer (who used to run state orphanages) and Jane Snaith (married to a Brit, hence the surname), run a voluntary organisation to advocate for and support adoption. Children’s homes (orphanages) have been since Soviet times collectors of neglected, abandoned and abused children.

 

With a population of just over a million people, social workers, who only number 178 across the entire country are; “too busy rehabilitating criminals or chopping wood for old ladies” explained Jane, “to attend to children and families”.

 

Estonians have a thirst for alcohol and, like Scotland, one of Europe’s highest rates of teenage pregnancy. Here for a few countries are the rates of live births per 1000 women aged 15 to 19 years:

Netherlands 5

Finland 8

Germany 11

Czech Republic 17

UK 20

Estonia 26

Russia  30

 

“Our children need people in their lives, social skills, not products,” said Jane, “so many mothers have practically no support – they are condemned”. At that the conversation broke off and there was an exchange in Estonian.  Our time had run out but it was agreed that they could squeeze in another half hour. But only after they had topped the credit on the car parking meter outside using wifi and a mobile phone.

 

Super duper technology but virtually no support for struggling mothers.

 

Teenage mothers are a barometer on a society’s well being and an engine for what goes wrong. Teenage age mothers are invariably the children of teenage mums.  Their babies are more likely to have a low birth weight, different health and development conditions, less likely to do well at school and more likely to be entangled in the criminal justice system by the time they themselves have children as teenagers. 

 

Economists have a sanitised way of describing the change brought to society: differential fertility.  It is now common for women who have a degree to have their first child at 34 and then usually only one child. Teenage mothers even if they only have two children will likely become grandmothers when they are 34 years old. So, in the space of one generation in one family another family clocks up two generations.

 

If teenage pregnancy were just a fact of life, like dark skies in February, there would be no point in stirring. But it is not a god given.  What happens in different countries varies a lot; in terms of teenage mothers we are closer to Estonia and Russia than we are to Finland and Holland.

 

So it is possible to improve the barometer rating by having fewer teenage mothers and as a programme called the Nurse Family Partnership demonstrates, it is possible to improve the life chances of teenage mothers and children. Nurses or health visitors are trained and given extra supervision. They make contact with the teenage mother and father if possible, as early in the birth as possible and stick to that mother and form a relationship and continue to support the mother until the baby is two years old. One nurse supports 25 mothers – a demanding but manageable caseload.

 

David Olds from Colorado ran his first Nurse Family Partnership Programme over thirty years ago. There have been three randomised control trials of the programme and each while showing different outcomes paints a similar impressive picture. There is improved parental care: fewer injuries to children and better infant emotional and language development. Mothers go onto have a better life with fewer subsequent pregnancies, greater participation in work and less welfare dependency. At 15 years of age the children have fewer convictions, less substance abuse and less promiscuity.

 

Fortunately we are into year three on a large trial of the Nurse Family Partnership in England and have started one programme in Scotland.

 

Turning the tide on teenage pregnancy is not shifting Tectonic plates; it is moving tiny ice like lumps. The real tectonic plates are our mind set, resignation and lack of organisation.

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