Pregnancy

Approximately 50% of street involved youth become pregnant. Pregnancy among these youth is an important issue because it offers challenges for both parent and child. Poverty is connected to a lack of family support, lack of food and limited prenatal care.1

The early consequences of poverty on the health of children are numerous and many times 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. Whereas children are at risk for learning problems, behaviour problems, and poor school achievement.2

 Jess’s story below is a common one for young people on the streets. The stress of unstable living and financial circumstances, in addition to their lack of education and experience, make it hard to notice the symptoms of pregnancy early on. Once pregnancy is detected they often lack the supports needed to make healthy decisions around pregnancy options.

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

Confirming a pregnancy early is important because it may prompt people to seek early medical care, understand their pregnancy options, including taking actions that benefit the health of the pregnancy. These actions include taking folic acid/prenatal vitamin, avoiding alcohol and/or 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

 If a person reports a missed period, involvement in sexual activity, imperfect/no use of birth control, and suspicion of pregnancy, these are signs that a pregnancy test could be positive.

 The most common signs and symptoms of early pregnancy are:

  • A missed period, especially if it has been more than a week.
  • Nausea with or without vomiting (“morning sickness”). This is typical 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.

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.

 Other common signs of early pregnancy are:

  • 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.

Pregnancy Tests

Pregnancy tests test for the pregnancy hormone, human choronic gonadotropin (hCG), which can be measured in blood or urine. The blood test can detect hCG as early as 6-12 days after ovulation. Urine tests are generally less sensitive than the blood 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. There are three methods of EC: two types emergency contraceptive pills (ECPs); and Copper IUD.

 The ECP works best if taken within first 24 hours but can be used up to 5 days. Levonorgestrel ECPs can be bought at a pharmacy without a prescription, or found at many family doctors, walk in clinics or Sexual and Reproductive Health Clinics A newer type of ECP, ulipristal acetate is also available by prescription. The Copper IUD needs to be inserted into the uterus by a trained health care provider. It can be inserted up to 7 days after unprotected sex. Youth should be encouraged to call their local clinic to see if this is offered.

 A person should do a pregnancy test if their 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

If an unintended 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

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

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

Abortion

In Canada, abortion is legal. Generally, most providers allow people to self-refer. Young people may face barriers to care due to lack of information regarding choices or access to services

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

For prenatal information and support, see: https://www.healthyparentshealthychildren.ca/ 
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, see: http://www.nafcanada.org/ 
For information on abortions in Alberta, see: www.kensingtonclinic.com
 https://myhealth.alberta.ca/health/pages/conditions.aspx?Hwid=tw1040
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.