Welsh Teens: Pills and Pregnancy

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:00:04. > :00:09.Had unprotected sex the night before? This pill may get you off

:00:09. > :00:18.the hook. Free soon from all Welsh pharmacies. Even to under-16s. Some

:00:18. > :00:22.see it as a good thing. Young girls who do not have money and worries

:00:22. > :00:28.about going to the doctors, they can just go there and they do not

:00:28. > :00:35.have to pay for it. Others aren't so sure. Sex, sexuality is a human

:00:35. > :00:38.activity. It has consequences. is better than nothing. But still a

:00:38. > :00:48.high chance of you getting pregnant. I think handing pills out over the

:00:48. > :01:08.

:01:08. > :01:18.counter is just encouraging kids to I can feel it! Charlotte is 15 and

:01:18. > :01:20.

:01:20. > :01:24.five months pregnant. It just kicked me! Oh my God! It kicked me.

:01:24. > :01:26.Her friend Nikita isn't much older and has her own baby. Nikita's

:01:26. > :01:36.supporting her friend and today, along with grandmother Shirley,

:01:36. > :01:37.

:01:37. > :01:41.they've come to Swansea's Singleton hospital for Charlotte's check up.

:01:41. > :01:48.They are going to send me for tests to see how the growth of the baby

:01:48. > :01:54.is. She is a bit worried. They say it is normal in youngsters and even

:01:54. > :02:04.in fourteen-year-old. She was only �6 when she was born so probably

:02:04. > :02:07.

:02:07. > :02:10.the baby will be a bit small but I am sure she will be all right.

:02:10. > :02:17.She's one of about 400 girls under 16 who get pregnant in Wales every

:02:17. > :02:22.year. I knew straight away I was pregnant. They can go on holiday

:02:22. > :02:32.together. There will only be eight months between them. What's the

:02:32. > :02:41.

:02:42. > :02:51.advice? Gas and air! Seriously. It kills. It is not difficult to think

:02:51. > :02:58.about contraception but it is not 100% anyway so you could use the

:02:58. > :03:06.morning-after pill but it is not always 100%. You could use condoms

:03:06. > :03:14.and they are not 100%. They could get damaged or split. You can have

:03:14. > :03:20.a Rodda Mach can snap. You can even be pregnant before you have had it

:03:20. > :03:22.in and it takes seven days to get used to your body. Charlotte's

:03:22. > :03:27.struggles with contraception have left her with an unplanned

:03:27. > :03:37.pregnancy but not an unwanted baby. She lives with her grandparents in

:03:37. > :03:38.

:03:38. > :03:43.Mansleton, Swansea. These things happen. She is not the first and

:03:43. > :03:51.she will not be the last. I was worried in the beginning because of

:03:51. > :03:56.her age. I thought that perhaps she would miss out on her teenage years.

:03:56. > :04:04.But as the weeks are going on, I am looking forward to it. We will help

:04:04. > :04:07.are all we can. But I think she'll make a good mother. Kita and

:04:07. > :04:09.Charlotte's babies were unplanned. The Welsh government wants to cut

:04:09. > :04:12.down on the number of unintended teenage conceptions. It's one of

:04:12. > :04:16.the aims of its sexual health strategy. Emergency contraception

:04:16. > :04:23.is to be made more widely available. The so-called morning after pill,

:04:23. > :04:27.if taken soon after sex, can prevent pregnancy. It's been

:04:27. > :04:30.available from pharmacies over the counter at �26 a pill. Over the

:04:30. > :04:40.last ten years more and more chemists have been providing it

:04:40. > :04:43.

:04:43. > :04:47.free, under a Welsh government scheme. You are the pharmacist here.

:04:47. > :04:52.If I was to come in as a woman wanting emergency contraception,

:04:53. > :04:56.how would you deal with they? would be given to pieces of

:04:56. > :04:59.information to start with. One would be that you can obtain

:04:59. > :05:03.emergency contraception from us and the second thing would be that you

:05:03. > :05:07.have to answer a number of questions, some of which will be

:05:07. > :05:11.personal. If you are agreeable to that, someone would call me and I

:05:11. > :05:21.would come and have a word. The whole process would occur within a

:05:21. > :05:26.

:05:26. > :05:34.By the autumn, every pharmacy in Wales should have joined the scheme

:05:34. > :05:38.supplying free pills. This is a private room. We have to have a

:05:38. > :05:41.private room to be part of the scheme. The Welsh government says

:05:41. > :05:44.pharmacies have a key role in the strategy to reduce unwanted

:05:44. > :05:54.pregnancies. They are open for longer and are often more

:05:54. > :05:54.

:05:54. > :05:59.convenient than NHS centres. We are available outside office hours.

:05:59. > :06:03.Pharmacy services are available over seven days a week. Timeliness

:06:03. > :06:10.is important in this context because emergency contraception is

:06:10. > :06:15.only useful for up to 72 hours. There is a difference in

:06:15. > :06:22.effectiveness over that period of time. The sooner the client

:06:22. > :06:25.accesses the services, the better. If the pharmacist is satisfied

:06:25. > :06:28.after a 20-minute consultation, they can supply the pill even to

:06:28. > :06:31.girls as young as 13. It's a confidential service, so parents

:06:31. > :06:38.don't have to be informed. Steve Newbury's been part of the scheme

:06:38. > :06:43.now for two years. The majority of clients that I have seen have been

:06:44. > :06:51.older than 16. Probably two clients out of more than 200 clients who

:06:52. > :06:55.have access the scheme here would be under 16. How to help teenagers

:06:55. > :07:05.make the right choices about when to have a baby is an important

:07:05. > :07:08.

:07:08. > :07:11.issue for everyone. What about another baby? What contraception?

:07:11. > :07:14.Projects like this in Barry help teenage mums after they've given

:07:14. > :07:24.birth. There's lots of advice, a creche and a very supportive

:07:24. > :07:28.atmosphere. Tamara Davies is a 16- year-old single mother. I was only

:07:28. > :07:36.with the baby's dad for one month. When I found out I was scared and

:07:36. > :07:44.shocked. After its Hunkin, the next day I was excited but still a bit

:07:44. > :07:49.scared at the same time. I was not on anything because I was only with

:07:49. > :07:55.the baby's dad for one month and we were not doing anything. I was

:07:55. > :07:58.going up the doctors to go up -- a go on the pale and we slept

:07:58. > :08:04.together the once and that was when it occurred so by the time I'd got

:08:04. > :08:12.to the doctor up it had already occurred. Amy Burnett was pregnant

:08:12. > :08:20.at 17 and that was also unplanned. I was three-and a-half months and I

:08:21. > :08:27.found out. When I found out, it happened really quit after that. It

:08:27. > :08:35.was shock. I was working and I worked until I was about eight

:08:35. > :08:42.months. I had a massive bump but it went really quick. Amy's life has

:08:42. > :08:45.changed since she's had Brandon. You have times when you ask him to

:08:45. > :08:50.go to sleep and you just want to get everything done and you have to

:08:50. > :08:55.leave it until they are asleep and then you can get everything done.

:08:55. > :09:05.But until then it is just, do my dishes, do my foot and you have to

:09:05. > :09:06.

:09:06. > :09:10.feed them first but I am used to it now. A lot of the goals I work with

:09:10. > :09:13.our children having children and they lose a lot of their self-

:09:13. > :09:18.confidence and self-esteem when they find themselves pregnant and

:09:18. > :09:22.quite often the circumstances that they find themselves in leaves them

:09:22. > :09:25.very vulnerable. We want to help support them and are better

:09:25. > :09:33.equipped they are themselves, the better they are able to develop

:09:33. > :09:37.their children. They are very often not supported adequately. Perhaps

:09:37. > :09:43.their partner, with whom they are having a baby, does not say with

:09:43. > :09:47.them. Perhaps their family are not able to support them as adequately

:09:47. > :09:57.as they need. Not everybody has an unplanned pregnancy but mistakes

:09:57. > :10:09.

:10:09. > :10:11.happen. But supporting teenage mums with projects like this one called

:10:11. > :10:15.Flying Start is expensive. Every pound spent on contraception saves

:10:15. > :10:17.the public purse about ten times as much. The girls here have mixed

:10:17. > :10:23.feeling about the morning after pill. Young girls can go in and

:10:23. > :10:29.they can get it. You do not do it loads of time. You cannot keep

:10:29. > :10:33.doing it but it is for an emergency. It is good for stuff like that.

:10:34. > :10:38.encourages younger people, it is saying that they can have sex

:10:38. > :10:43.without using anything and it does not really matter because

:10:43. > :10:47.contraception is just on hand anyway for afterwards. I think it

:10:47. > :10:57.is better to use other contraception so before actually

:10:57. > :10:57.

:10:57. > :11:01.having sex. Back in Swansea, 15- year-old Charlotte agrees. I think

:11:01. > :11:06.handing pills over the counter is encouraging teenagers to have sex,

:11:06. > :11:13.to be honest with you. Do you think too many teenagers are having sex?

:11:13. > :11:19.Yes, way too many. Why? Because they think they have got to do it,

:11:19. > :11:24.just to get in at school. They think, I slept with that person,

:11:24. > :11:32.you slept with a person. Now, as a teenage mum-to-be, Charlotte feels

:11:32. > :11:36.stigmatised. I have had people call me slag and stuff like that. What

:11:36. > :11:41.do you think when there and say that to you? There are girls who

:11:41. > :11:51.have not got pregnant because they have abortions and everything. When

:11:51. > :11:54.

:11:54. > :11:59.I was with one boy for nearly two years. Do you think you could be as

:11:59. > :12:03.good a mum as anyone else? I will be a better mum than others. People

:12:03. > :12:13.can turn around and say because they are young, they will not be

:12:13. > :12:14.

:12:14. > :12:16.any good at being a mum, they do not know nothing. Well, we do.

:12:16. > :12:18.Catholic Church has watched with growing concern the increased

:12:18. > :12:28.availability of contraception, especially to youngsters under the

:12:28. > :12:35.

:12:35. > :12:40.age of 16, the legal age for sex. The Catholic Church teaches that

:12:40. > :12:46.artificial contraception is not a morally -- morally correct thing to

:12:46. > :12:55.do. When one looks at the introduction of the morning-after

:12:55. > :12:59.pill, which Don and straights that the separation -- demonstrates that

:12:59. > :13:07.the separation between sexuality and sex and responsibility. You are

:13:07. > :13:17.left with something which is devoid of its intention, a recreational

:13:17. > :13:21.

:13:22. > :13:23.activity almost. The church and some other organisations are

:13:23. > :13:26.particularly worried about pharmacists giving the morning

:13:26. > :13:32.after pill to younger girls. I showed Monsignor Reardon the form

:13:32. > :13:35.that pharmacists take girls through before agreeing to provide the drug.

:13:35. > :13:40.Is the farmer missed its -- is the pharmacist's satisfied that it is

:13:40. > :13:45.in the young person's best interest to give treatment? Be concern I

:13:45. > :13:51.would have and the question I would ask his however good the pharmacist

:13:51. > :13:55.is, he or she could quite possibly be meeting this young person for

:13:55. > :14:01.the first time. They are asked to make a judgment on that person's

:14:01. > :14:10.best interests without having a discussion with a parent or a

:14:10. > :14:13.significant adults in that young NHS Sexual Health clinics like this

:14:13. > :14:23.one, and the local GP, have been the places where teenagers have

:14:23. > :14:27.traditionally come to get contraception. The age of people

:14:27. > :14:32.starting to have intercourse seems to get lower and lower and we are

:14:32. > :14:35.seeing those people, younger and younger. Often they don't think

:14:35. > :14:43.about regular contraception until they have already had unprotected

:14:43. > :14:47.sex. At least once. Quite often alcohol is a factor. And they lose

:14:47. > :14:51.their inhibitions and do things they wouldn't normally do and they

:14:51. > :14:55.take more risks with their sexual health when they have had alcohol

:14:55. > :15:00.but then, afterwards, obviously they seem to find out when they

:15:00. > :15:03.realise there's a problem, they seem to find died where they can

:15:03. > :15:06.then obtain emergency contraception. Some clinicians are concerned that

:15:06. > :15:14.the pharmacy scheme will mean that the pills will get emphasised over

:15:14. > :15:20.other methods. The pale as emergency contraception is likely

:15:20. > :15:25.to be preferable to do absolutely nothing if someone had unprotected

:15:25. > :15:31.sex and doesn't want to be pregnant. But there are still a very high

:15:31. > :15:37.chance, compared to all the other things. The device that beats these

:15:37. > :15:43.polls by a long way is there copper coil which can be fitted also until

:15:43. > :15:48.at least five days after the intercourse, maybe even longer.

:15:48. > :15:52.This device has and effectiveness of at least 99% if it is used as

:15:52. > :15:55.emergency contraception and then they can carry on using it for the

:15:55. > :16:00.next five or 10 years, because that's how long they would last if

:16:00. > :16:03.they would like to keep it. With the morning after pill there is a

:16:03. > :16:12.one in 20 chance of getting pregnant compared with a one in 100

:16:12. > :16:18.chance with the emergency IUD. People have always said I didn't

:16:18. > :16:22.know that. It works really well, doesn't it? I am concerned that

:16:23. > :16:24.message does not get out. Pharmacists can't fit the more

:16:25. > :16:30.effective longer acting contraceptivies like the IUD but

:16:30. > :16:39.say they are trained to promote them. We think about the type of

:16:39. > :16:45.contraception that the client needs on an ongoing basis. Part of the

:16:45. > :16:53.process is to establish, not just their need today, but whether

:16:53. > :17:00.appropriate provision has been made into the future. Back in Swansea,

:17:00. > :17:04.it's an important day for Charlotte. She's come for a scan. She's been

:17:04. > :17:11.worried her baby's not growing fast enough but she's also keen to know

:17:12. > :17:17.if it's a boy or a girl. This is the scan I was worried about the

:17:17. > :17:23.most because this is where they can tell if the spine and everything is

:17:23. > :17:28.OK, everything is growing. When they said about the baby's growth,

:17:28. > :17:33.it really scared me but they says it's common with first babies,

:17:33. > :17:36.anyway. People's first babies. It really scared me. Sheering

:17:36. > :17:45.everything is fine or just to reassure us you, so I am really

:17:45. > :17:52.glad. It's going to be had bring up a child on her own, yes. I was

:17:52. > :18:02.young, 17. But then I was married and had a partner. It made it

:18:02. > :18:04.

:18:04. > :18:08.easier then. So what about Charlotte's partner? Will the

:18:08. > :18:15.father be with you through this? don't know. Would you like him to

:18:15. > :18:24.be with you? In some ways yes, other ways, no. Why not? He doesn't

:18:24. > :18:30.deserve to be a father. Is he not interested? No. In the ways you

:18:30. > :18:35.would like him to be there, why would you like him to be there?

:18:35. > :18:42.It's every mother's dream to have both parents there for their child.

:18:42. > :18:47.The baby's forehead, his face. would you like best of all? If I

:18:47. > :18:52.had a girl, I would like to bring it to dancing, singing lessons,

:18:52. > :18:58.whatever she wants to do. Everyone has had a chance in life. I want

:18:58. > :19:03.them to go to college. And eventually have kids of their own

:19:03. > :19:10.when they are old enough. Not as young as you. Maybe wait until they

:19:10. > :19:17.are a little bit older. Finally, Charlotte is getting the news she

:19:17. > :19:27.has been waiting to hear. We are about 98% accurate, so I can tell

:19:27. > :19:37.you I think this baby is probably a girl. Oh God! Everyone said it was

:19:37. > :19:37.

:19:37. > :19:39.a girl. Emergency contraception is a last line of defence. The BMA,

:19:39. > :19:49.which represents family doctors, welcomes the pharmacy scheme, but

:19:49. > :19:50.

:19:50. > :19:54.has reservations. Pharmacists are trained very well to give the

:19:54. > :19:59.Tablet. The difference is what the GPs are trained to do is to look at

:19:59. > :20:08.the whole person, not just one aspect of it or one part of it, but

:20:08. > :20:10.the broadest aspect of their health. Pharmacists say they are more

:20:11. > :20:13.accessible than GPs. They will discuss ongoing health problems and

:20:13. > :20:20.will suggest patients contact their doctors if necessary. But GPs still

:20:20. > :20:23.aren't convinced. One thing you have to remember is that a GP's

:20:23. > :20:28.surgery is like a mini hospital these days so when somebody sits

:20:28. > :20:32.down with me and says, I need the morning after pill, I can explore

:20:32. > :20:36.with them many other aspects of their health, for example, we can

:20:36. > :20:40.talk about their ongoing contraceptive needs. Perhaps why

:20:40. > :20:45.they are not on a regular contraception or the last type they

:20:45. > :20:49.were wrong failed. Maybe we could start them on something you or

:20:49. > :20:53.refer them if necessary. We can look perhaps if they are seeking to

:20:53. > :20:58.become pregnant in the future, we can talk to them about health

:20:58. > :21:06.issues so, generally speaking, when people come to see the GP, it isn't

:21:06. > :21:09.usually just about the thing. Welsh government has identified our

:21:09. > :21:13.high rates of teenage pregnancy as a public health priority in its

:21:13. > :21:16.latest sexual health action plan. We've established that providing

:21:16. > :21:24.free morning after pills through pharmacies will cost the Welsh NHS

:21:24. > :21:26.up to �300,000 a year. And we've uncovered evidence suggesting that

:21:26. > :21:36.this kind of scheme has little effect on teenage pregnancy rates,

:21:36. > :21:39.bringing into question the cost- effectiveness of the policy. This

:21:39. > :21:49.research looked at Bridgend where the scheme was first introduced ten

:21:49. > :21:59.

:21:59. > :22:01.These findings came as no surprise to some academics who have been

:22:01. > :22:09.studying the situation in England, where some parts have adopted a

:22:09. > :22:13.similar scheme and some haven't. found, contrary to what people were

:22:13. > :22:18.hoping, the introduction of the morning after pill for young people

:22:18. > :22:21.didn't have any effect in terms of reducing teenage pregnancy rates.

:22:21. > :22:27.There have been around two dozen studies on other countries saying

:22:27. > :22:32.the same thing. So what could be the reasons? One of the hypotheses

:22:32. > :22:36.is that access to the morning after pill leads to an increase in sexual

:22:36. > :22:40.risk-taking behaviour. Another possibility that increasingly

:22:40. > :22:47.doctors are suggesting is that some forms of emergency birth control

:22:47. > :22:52.are less effective in preventing pregnancy than was once thought.

:22:52. > :22:57.This professor's research suggests something else. We found that there

:22:57. > :23:00.was a 12% relative increase in sexual infections amongst under

:23:00. > :23:06.sixteens in the areas with emergency birth control free of

:23:06. > :23:10.charge at pharmacies, compared to other areas. If the pharmacies

:23:10. > :23:13.scheme increases S T Dees by encouraging risky behaviour, it

:23:13. > :23:23.comes as no surprise to those of the morning against the whole

:23:23. > :23:27.

:23:27. > :23:33.direction of government policy. and sexuality, reduced to a mere

:23:33. > :23:41.biological thing, to a recreational activity, is something which has

:23:41. > :23:49.become very, very casual and, again are separated from aspect of

:23:49. > :23:59.intimacy, of love, and its role in the growth and the maturing of a

:23:59. > :24:01.

:24:01. > :24:09.What is clear is that there are many reasons that teenagers get

:24:09. > :24:14.pregnant. It certainly changes their lives. In a way, to be honest,

:24:14. > :24:19.I think it's the best thing that's ever happened to me. I could have

:24:19. > :24:23.been a bit older when they had a baby, but it gives you a whole

:24:23. > :24:29.different perspective, to be honest with you. Now I realise I have got

:24:29. > :24:35.to grow up and I'm going to be a mother, which means, like, it gives

:24:35. > :24:42.you something to, like, grow up four. You have got a reason to,

:24:42. > :24:47.like, grow up and do well in life and set fact that. -- and stuff

:24:47. > :24:52.like that. We are looking at your choices have to protect yourself

:24:52. > :24:57.physically, emotionally and in the social context of where you are at

:24:57. > :25:01.this moment in time. Some people are babies for different reasons.

:25:01. > :25:05.Because they want to be loved and cared for. There are no other

:25:05. > :25:09.options for them and they think a baby will fill this gap. What were

:25:10. > :25:15.you doing before you became pregnant? Getting drunk every

:25:15. > :25:19.weekend. Before I had the baby. After the baby, it made my life

:25:19. > :25:27.better, even though I can't do as much as I used to. It has made life

:25:27. > :25:32.better. Better because you have become a mother? Yes. I started

:25:32. > :25:41.acting different. When people used to shout at me, I started to shout

:25:41. > :25:43.back. I came out of my shell. became more confident? Yes.

:25:43. > :25:45.Welsh government's sexual health strategy isn't just about supplying

:25:45. > :25:52.contraception. Sex and relationships education play a big

:25:52. > :25:56.part. We don't want you going out there with loaded guns shooting all

:25:56. > :26:03.over the place. We want to make sure you use your gun properly when

:26:03. > :26:05.you should do. Does that make sense? At this school in Barry, the

:26:06. > :26:13.boys like lessons delivered by outside agencies but criticise the

:26:13. > :26:15.curriculum for emphasising sex over relationships. They go straight to

:26:15. > :26:22.the physical part of the relationship, rather than intimacy

:26:22. > :26:28.with each other. They could bring in a young couple, and married

:26:28. > :26:33.couple, stuff like that. I think it a good idea because it shows how

:26:33. > :26:37.you can make it successful, you could build a relationship so you

:26:37. > :26:40.can get to a point way you are both comfortable talking about the

:26:40. > :26:43.sexual part of their relationship. In light of all the evidence we've

:26:43. > :26:45.seen, we wanted to ask the new health minister Lesley Griffiths

:26:45. > :26:48.whether her department still thought the pharmacy scheme was a

:26:48. > :26:51.good way of reducing teenage pregnancies. Our request was

:26:51. > :26:54.declined. A welsh government spokesman said the scheme was "an

:26:54. > :26:59.important aspect of a comprehensive sexual health service but not part

:26:59. > :27:08.of our strategy to reduce teenage conceptions." Some observers say

:27:08. > :27:11.that's not the impression left by her predecessor. The health

:27:11. > :27:15.minister talked about the aim of reducing teenage pregnancy rates

:27:15. > :27:19.and abortions so I was a bit surprised that that was being used

:27:19. > :27:25.as a rationale for this policy and it may be that policy makers are

:27:25. > :27:29.just not aware of the evidence on this issue. Some are calling for an

:27:29. > :27:34.early review to see if the pharmacies scheme is working.

:27:34. > :27:37.teenage pregnancy rate is multifactorial. We can't say it's

:27:37. > :27:42.because of one thing or another thing so making was available, is

:27:42. > :27:48.it part of the solution, will it actually increase good behaviour?

:27:48. > :27:51.Will it change behaviour to make more risky behaviour more common?

:27:51. > :27:55.Will it decrees pregnancy rates, and the evidence at the moment is,

:27:55. > :28:02.actually, there is no good evidence that decreases teenage pregnancy

:28:02. > :28:05.rates. And that, I think, is the fundamental question.

:28:06. > :28:09.pharmacies scheme will be fully rolled out in a few months. About

:28:09. > :28:19.the time Charlotte's little girl is due. And she's getting her room

:28:19. > :28:22.

:28:22. > :28:27.ready. I'm going to put this round to the Mirror. Charlotte has

:28:27. > :28:31.learned from experience, too. wish for a baby too quick. I used

:28:31. > :28:41.to say I can't wait for a baby. You have got to be careful what you

:28:41. > :28:43.