Termination of pregnancy

Young women who are Looked After may be at risk in the same way as the general population to becoming pregnant. Whilst every effort is made to educate young people about safe sex, if a young person who is in care does become pregnant, they will need help and support in order to make the right decision for them. This page looks at the process if the young person makes the decision to terminate the pregnancy.

If a young women who is Looked After becomes pregnant, the ultimate aim should be to ensure that they have the appropriate advice and support to enable them to make the decision that is best for them. Teenage pregnancy and termination of pregnancy are very emotive subjects, however as professional adults we are required to put our own views to one side and provide impartial support. This support should then continue once the young person has made their decision. Young people have the right to:

see the health visitor (children in care)
emotional support before, during and after the decision making process
privacy and confidentiality
encouragement and help in telling their parents where possible and appropriate
Most importantly, it should not be assumed that the young woman wishes to have a termination

If the young person is to have a termination, appropriate practical arrangements must be made to support her before, during and after the operation. The private room within the Princess Elizabeth hospital should be used.

After the operation, the young woman should be offered support, advice and counselling after the termination to ensure they are able to make informed choices about future sexual relationships, sexual health and contraception. Unless there is very good reason the social worker will respect the views of the young person with regard to who should know about the termination.

Young women over 16 who are looked after

If the young person is over the age of 16, in law they are able to make their own decision and give consent for a termination.

In such instances two registered medical practitioners are required to sign the application form.

The young person's privacy and confidentiality should be respected, with only those who need to know being involved in the process.

Young women under the age of 16 who are looked after

Both the looked after status and the competence of the young person play a role in determining who can consent to a termination if the young person is under 16.Separate consideration must also be given under child protection procedures as to the lifestyle / sexual activity that led to the pregnancy.

Fraser Competence If a young woman is deemed to be Fraser competent, then they can give their own consent. Based on the principle of Gillick competence , the Fraser guidelines relate specifically to contraceptive advice. In the case of terminations, the decision as to whether a young person is Fraser competent is that of the two medical practitioners who sign the application form.

If the doctors are satisfied that the criteria are met, then if the young person does not want their parents told then this should be respected.

The ultimate decision as to whether the termination goes ahead is that of the consultant who carries out the procedure.

Children who are accommodated If the child is not deemed Fraser competent and is voluntarily accommodated then the decision rests with the parents.

Children subject to a community parenting order

If the child is under a community parenting order and not deemed Fraser competent then the local authority share parental responsibility. Negotiation needs to take place with the parents (unless there are reasons not to contact the parents) as to who will give consent, bearing in mind at all times the young person's right to confidentiality and privacy.If the local authority is required to give consent, this must be given by the Director of Services for Children and Young People (or above), with this being clearly recorded.

Actions

Task	Responsible Officer	Record	Timescale
If a young woman indicates that she considers they may be pregnant ensure that they are taken to, or visit, their GP or another local service for a pregnancy test.	Social worker/foster carer/care staff worker	Confidential part of child's file	As soon as possible.
If pregnancy is confirmed young woman to have access to unbiased pregnancy advice on options - keeping baby, termination or adoption. Referral and or appointment could be made with Health Visitor (Children in Care)	Social worker/foster carer/care staff worker and health visitor (children in care)	Confidential part of child's file	As soon as possible
Young woman to be accompanied to appointment if so chooses	Worker, carer, friend or family	Confidential part of child's file	As soon as possible
Young woman encouraged to discuss with parents as appropriate	Health service and social worker if appropriate	N/A	As soon as is appropriate
If young woman is considered not to be competent to make an informed choice legal advice is to be sought	Social worker	Legal meeting minutes	As soon as possible
If young woman makes choice to have a termination, (and departmental consent is required) report to be prepared for permission from Director Children's services, (or above). The report should include (a) options that have been explored (b) independent advice that has been made available, (c) views of the relevant medical practitioners (d) consent to a termination, (e) support that will be available before and after the termination	Social worker	Confidential part of child's file	As soon as information is available
Plan support for young woman prior to and following termination	Social worker	Confidential part of child's file	Prior to termination.

Termination of pregnancy

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