Pregnancy

Although youth pregnancy rates may be declining in some parts of Canada, pregnancy among youth can have serious impacts on the health of both the youth and child. Pregnant youth need supports to make healthy decisions around pregnancy options and to meet the financial, academic, physical, mental and social challenges that arise from pregnancy.

Approximately 50% of street involved youth become pregnant.

Poverty is connected to a lack of family support, lack of food and limited prenatal care.1

The consequences of poverty on the health of children are numerous and can place a newborn at risk for a lifetime of health problems.2 Infants of poor mothers are at risk for premature birth, intrauterine growth restriction, and death. Later on, children are at risk for learning problems, behaviour problems, and poor school achievement.2

JESS’S STORY…

I woke up this morning and saw I finally got my period. I’m pretty happy about that ‘cause I was starting to get worried. It’s very light, which is a good thing ‘cause I don’t have any cash to buy tampons. It’s been a rough couple of months and I’m so tired, sleeping on a different couch every night is starting to wipe me out. It’s not helping that I have to get up and pee during the night. I wonder if the free clinic can check me for a bladder infection.

Confirming Pregnancy

Lack of education and experience can make it hard for youth to notice the symptoms of pregnancy early on. This can be magnified for street involved youth because of the stress of unstable living and financial circumstances.

Confirming a pregnancy early is important because it may:
  • prompt people to seek early medical care
  • support understanding and accessing pregnancy options
  • enable people to take actions that benefit the health of the pregnancy like taking prenatal vitamins, avoiding alcohol and substances and eating a healthy diet

 Service providers can ask these specific questions if pregnancy is suspected:

  • When was your last period? Was it normal for you?
  • Do you usually get regular periods (typical  is between every 23-36 days)?
  • Are you sexually active? Do you use birth control (hormonal contraception and/or condoms)?
  • Do you use your birth control correctly and consistently? (e.g., have you had any sex without a condom?
  • Do you have any symptoms of pregnancy?

Good to know

 In practical terms, it’s more likely that a pregnancy test will be positive if a client reports a missed period, forgetting or not using birth control or that they suspect they’re pregnant. If someone reports pregnancy symptoms but a pregnancy test is negative, it’s important they see a health care provider to check for other health concerns.

 The most common signs and symptoms of early pregnancy are:

  • A missed period, especially if it’s been more than a week
  • Nausea with or without vomiting (“morning sickness”), typically during the first 6-12 weeks of pregnancy and is often worse in the morning but can occur any time of day
  • Breast tenderness, swelling, heaviness, tingling, or soreness
  • Increased frequency of urination
  • Irregular bleeding – some people have irregular bleeding on and off or bleeding around the time that one would expect their period
  • Food cravings and food aversions
  • Mood changes
  • Lightheadedness
  • Bloating
  • Constipation
  • Heartburn
  • Lower back pain.
  • Nasal congestion.
  • Uterine cramping.

Good to know

 Bleeding in early pregnancy that is heavier than a typical period or accompanied by pain may be a sign of miscarriage or ectopic pregnancy. If this occurs, it is important that the person goes to a healthcare provider.

Pregnancy Tests

Pregnancy tests test for the pregnancy hormone, human choronic gonadotropin (hCG), which can be measured in blood or urine. Pregnancy can also be detected through ultrasound.

The blood test is done at the laboratory. It can detect hCG as early as 6-12 days after ovulation and are are generally more sensitive than the urine test.

Urine pregnancy tests can be done in the home, doctor’s office, or laboratory. A urine pregnancy test is usually done after missing a period. If the test is done too soon, the result may not be accurate. If the test is negative and the period does not come, the test should be repeated in one or two weeks.

If a home pregnancy test is done, make sure to follow the instructions on the kit carefully and that it hasn’t passed its expiry date. Use a first-morning urine sample because that is when the level of hormone is highest.

Good to know

 If there has been unprotected sex (e.g., without a condom or birth control), using emergency contraception (EC) can help prevent pregnancy. EC will NOT end a pregnancy. It’s important to take a pregnancy test if a period does not come within three weeks of using EC, or if the period is much lighter than normal. For more information on ECPs, click here. (https://myhealth.alberta.ca/HealthTopics/sexual-reproductive-health/Pages/emergency-contraception.aspx)

Pregnancy Options

Once a pregnancy has been confirmed, a person has three options.
  • Continuing with the pregnancy and choosing to parent
  • Continuing with the pregnancy and choosing adoption
  • Ending the pregnancy and choosing abortion

Parenting

There are many resources that offer support to pregnant people choosing to go on to parent.

In addition to maintaining a healthy pregnancy, responsibilities for those who choose to parent include:

  • Planning for meeting the basic physical, emotional, medical, social, and developmental needs of the child
  • Preparing for lifestyle changes such as changes to daily routine or recreational activities
  • Learning about healthy parenting
  • Choosing childcare options if the parent(s) will be in school or at work
  • Accessing supports

Adoption

Adoption is where a person continues the pregnancy then places the baby for adoption by another family. This is usually done through a licensed adoption agency.

In Canada each province has its own rules and regulations regarding adoption.

Often the pregnant person can be part of choosing the adoptive family and what type, if any, information is shared and contact with the baby and adoptive family is continued.

In Alberta, more adoption information can be found at: https://www.alberta.ca/adoption.aspx

Abortion

An abortion is a medical procedure to end a pregnancy. In Canada, abortions given by specially trained doctors are legal and are quite safe. Accessing abortion may differ between provinces. In Alberta, people can self-refer for abortion, they don’t need to get someone else’s permission for an abortion, they don’t need to be a certain age and the cost is covered by provincial health care. There are 2 types of abortion:

  • Medication abortion (up to 9 weeks). Medicine stops development and makes the uterus squeeze. The pregnancy comes out through the vagina over the next day or so at home.
  • Surgical abortion (up to 20 weeks). In a clinic, the person gets medicine to lessen discomfort and the doctor uses tools that remove the pregnancy.

Most abortions happen during the first 12 weeks of pregnancy. 

To find a provider in Alberta, see www.ahs.ca/abortion.

To find a provider in other places in Canada, see https://choiceconnect.ca/ or https://www.actioncanadashr.org/resources/services

Healthy Pregnancy

Supporting youth who remain pregnant have a healthy pregnancy can support healthy development of both the youth and the baby.

To maintain a healthy pregnancy, a youth needs:

  • Basic needs met like safety, food, clothing, housing, transportation, medicine, school, sleep
  • Ongoing medical care including STI testing & treatment, prenatal vitamins, management of health challenges, including mental health concerns
  • Safe, supportive relationships
  • Supports to reduce tobacco use, abstain from alcohol and substance use
  • Regular exercise
  • Prenatal education
  • Supports meeting their developmental tasks of adolescence

For prenatal support, groups and classes see:
https://www.birthandbabies.com/ (Calgary Zone)
http://nrvcl.ab.ca/programs-and-services/pregnancy-beyond/(Airdrie and area)
https://www.albertahealthservices.ca/findhealth/Service.aspx?id=1568 (Calgary)
For a resource for those experiencing pregnancy and street involvement, see: http://streetworks.ca/pdfs/pregnancy-book-inside.pdf
For more information about pregnancy, labour, birth and new parenting, see:
http://healthyparentshealthychildren.ca/
www.myhealth.alberta.ca
https://www.pregnancyinfo.ca/
For more information on adoptions, see:  www.adoption.ca
For more information on abortion in Canada, see: http://www.nafcanada.org/ 
For information on abortions in Alberta, see:
www.kensingtonclinic.com
ahs.ca/abortion

1Shah, S., Bernstein, J., Moore, A. M., Thompson, G., Sohail, S., Ford-Jones, L., & Vandermorris, A. (2017). Three hundred babies born to underhoused mothers in Toronto—understanding the problem and how we can help. Paediatrics & child health, 22(5), 282-284.
2Larson, C. P. (2007). Poverty during pregnancy: Its effects on child health outcomes. Paediatrics & Child Health, 12(8), 673-677.