Enhancing young people's pregnancy loss and fertility awareness and knowledge via schools: a way forward

Pregnancy and infant loss, in the form of miscarriage, stillbirth or early neonatal death, occurs in 20-25% of all pregnancies. Despite its prevalence and associated physical and psychological impacts, there remains a lack of public awareness and understanding of pregnancy loss, including amongst people of reproductive age. Drawing on evidence from a preliminary review of peer-reviewed and grey literature, we make the case for enhancing pregnancy loss and (in)fertility awareness, specifically focusing on young people in second-level education. We situate our work within reproductive health and reproductive justice frames, recognizing the impact of social factors on people's reproductive lives, and the need for multi-level interventions to enable people to fully realize their reproductive rights and goals. Although schools provide an important setting to learn about and discuss topics relating to sexual and reproductive health-including pregnancy loss and fertility-current evidence suggests that this is not happening, despite young people's desire to engage in such conversations. While there are barriers to addressing sexual and reproductive health issues within schools (including lack of access to teacher training, continuing professional development, appropriate and engaging resource material, teacher discomfort and lack of confidence), it is important that interventions are developed in collaboration with all relevant knowledge users, including young people themselves. This will help to ensure that any interventions developed are relevant, acceptable, feasible and effective. Further research is needed to explore how education around pregnancy loss and fertility can be best delivered within school settings.