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Teenage pregnancy rates

Introduction

Teenage pregnancy is a significant public health issue in England. Teenage parents are prone to poor antenatal health, lower birth weight babies and higher infant mortality rates. Their health, and that of their children, is likely to be worse than average. Teenage mothers are less likely to finish their education, less likely to find a good job, and more likely to end up both as single parents and bringing up their children in poverty. The children themselves run a much greater risk of poor health, and have a much higher chance of becoming teenage mothers themselves.

What do we know?

The UK still has one of the highest rates of teenage pregnancy in Western Europe, in England in 2013 over 22,800 women under the age of 18 became pregnant, approximately 5,000 of whom were under the age of 16 (ONS, 2015). Only about 5% of under 18 conceptions are to girls aged 14 or under and to include younger age groups in the base population would produce misleading results. The 15-17 age groups are effectively treated as the population at risk.

However, teenage pregnancy rates are at their lowest level for over 20 years. In Reading, effective local delivery of the Teenage Pregnancy Strategy has reversed the previous upward trend. The latest available data for 2013 shows the under-18 conception rate in Reading has been reduced to around 23/1000. This is a reduction of around 52% since 2009.

The under 16 years of age conception rate is low but remains of considerable concern. It is a trend across the country that the proportion of under 16s conceptions resulting in a termination of pregnancy is higher for the under 16s than for the older age group.

Facts, Figures, Trends

Table 1 shows data on; actual number of conceptions, conception rates per 1,000 females in the age group and percentage of conceptions leading to abortion. They cover England, the South East and Reading authority areas. The data are an aggregation over the rolling 3 year periods and are based on the under 16 year olds (aged 13 to 15) female population. The data are based on the number of actual pregnancies which led to either a maternity or a termination of pregnancy by abortion. This data is over a four year rolling period (2008 to 2010 and 2011 to 2013).

The conception rate has consistently been higher to females under the age of 16 years living in Reading compared to the averages across the South East Region and England as a whole. The national trend has continued to reduce from 7.2/1000 in 2008/10 to 5.5/1000 in 2011/13. A similar downward trend has been seen across the South East region (5.8/1000 in 2008/10 to 4.5/1000 in 2011/13). Over recent years the trend for Reading has been following an upward direction. A recent drop in rates has been seen in for Reading (6.9/1000 for 2011/13) which is encouraging, however, we cannot say yet that the overall trend is going downwards. Trends will need to be monitored over the next few years to see if downward trend is observed and can be reported. Rates are similar in Reading to the average of Local Authorities with similar levels of deprivation.

Over the 2008/10 period, the proportion of conceptions to under 16 years olds living in Reading, that resulted in a termination, was slightly lower than what was seen nationally and across the South East Region. Data for Reading from 2009/11 to 2011/13 is not shown due to the small numbers in the data and has been withheld due to patient confidentiality issues.

Table 1: Under 16 conceptions/outcomes

England data

2008/10

2009/11

2010/12

2011/13

2012/14

Number of conceptions

20,153

18,683

17,048

15,155

 

Conception rate per 1,000 women in age group

7.2

6.7

6.1

5.5

 

Percentage of conceptions leading to abortion

61.6

61.1

61.2

60.8

 

South East data

2008/10

2009/11

2010/12

2011/13

2012/14

Number of conceptions

2,641

2,456

2,294

2,042

 

Conception rate per 1,000 women in age group

5.7

5.3

5

4.5

 

Percentage of conceptions leading to abortion

61.4

61.8

63.2

63.3

 

Reading data

2008/10

2009/11

2010/12

2011/13

2012/14

Number of conceptions

52

58

61

50

 

Conception rate per 1,000 women in age group

7.6

8.3

8.6

6.9

 

Percentage of conceptions leading to abortion

55.8

c

c

c

 

c denotes confidential

Source: ONS (2015)

Table 2 shows data on; actual number of conceptions, conception rates per 1,000 females in the age group and percentage of conceptions leading to abortion. They cover England, the South East and Reading authority areas. The data are an aggregation over the rolling 3 year periods and are based on the under 18 year olds (aged 15 to 17) female population. The data are based on the number of actual pregnancies which led to either a maternity or a termination of pregnancy by abortion. This data is over a four year rolling period (2008 to 2010 and 2011 to 2013).

The conception rate has consistently been higher to females under the age of 18 years living in Reading compared to the averages across the South East Region and England as a whole. The national trend has continued to reduce from 37.0/1000 in 2008/10 to 27.6/1000 in 2011/13. A similar downward trend has been seen across the South East region (30.3/1000 in 2008/10 to 23.3/1000 in 2011/13). Over recent years the trend for Reading has been following the same pattern but at an increased rate. The local rate has reduced from 43.4/1000 in 2008/10 to 31.0/1000 in 2011/13. The drop in rates is testament to the implementation of the local Teenage Pregnancy Strategy and the hard work of local partners across sectors. However, the data in the table below shows that Reading is still higher than national and regional figures.

The proportion of conceptions to under 18 years olds nationally, that resulted in a termination, has remained fairly static over recent years at around 49.6%. Across the South East Region there has been a slight upward trend (50.9% in 2008/10 to 52.2% in 2011/13). Reading has witnessed an upward trend also but at a far higher pace. For the period 2008/10 around 43% of conceptions to those under 18 resulted in an abortion, this increased significantly to 55.7% for the 2011/13 period.

Table 2: Under 18 conceptions/outcomes

England data

2008/10

2009/11

2010/12

2011/13

2012/14

Number of conceptions

107,301

97,684

87,875

78,153

 

Conception rate per 1,000 women in age group

37

34

30.9

27.6

 

Percentage of conceptions leading to abortion

49.7

49.5

49.6

49.7

 

South East data

2008/10

2009/11

2010/12

2011/13

2012/14

Number of conceptions

14,334

13,197

12,088

10,888

 

Conception rate per 1,000 women in age group

30.3

28

25.8

23.3

 

Percentage of conceptions leading to abortion

50.9

51.1

51.9

52.2

 

Reading data

2008/10

2009/11

2010/12

2011/13

2012/14

Number of conceptions

314

282

260

221

 

Conception rate per 1,000 women in age group

43.4

39.7

36.9

31

 

Percentage of conceptions leading to abortion

43

46.1

50.8

55.7

 

Source: ONS (2015)

The chart in figure 1 shows a similar trend analysis for the number of conceptions per 1000 of under 18 year olds (aged 15 to 17) but on an annual basis. It covers a 16 year period from 1998 to 2013. The chart shows a similar pattern as described above from the data in table 2 with rates for Reading been consistently higher than those seen nationally and the fifth least deprived decile. In 2005 the conception rate was around 64/1000 but has consistently decreased since then. Latest available full year data for 2013 now shows that the rate for Reading is now at 23.1/1000, which is below the national average rate (24.3/1000).

Figure 1: Conceptions per 1,000 female population aged under 18 1998 to 2013

image1

The continued reduction in the number of teenage pregnancies and the subsequent increase in the proportion of terminations have resulted in far fewer births to teenage mothers. This is positive in terms of reducing the number of children generally been born into hardship and having a harder start in life. For newborns that are born to teenage mothers/families then support mechanisms will still need to be in place to give them and their families the best start in life.

National & Local Strategies (Current best practices)

  • Quality Criteria for Young People Friendly Health Services  (DoH, 2011) is published guidance that stresses important that all sexual-health-related work is informed by evidence of effectiveness.
  • NICE Guidelines (PH3) (NICE, 2007) gives advices for services intended to reduce sexually transmitted infections and under 18 conceptions.
  • Teenage Pregnancy Strategy: Beyond 2010 is an updated strategy document that focuses on the factors known to reduce teenage pregnancy rates when they are implemented robustly and consistently, with each delivery partner understanding and taking responsibility for their particular contribution to the overall strategy. (DoH, 2010)
  • Reading Borough Council 10 point teenage pregnancy strategy
  • Designated outreach young people's health services have been commissioned in Reading. These are called Juice Points and there are eight currently operating in a range of settings.
  • A young people's health website is in place
  • A local pharmacy scheme is in place to provide access to free emergency hormonal contraception.
  • A sexual health out-reach nurse has been commissioned to provide targeted sexual health and contraceptive services to vulnerable young people.
  • Vulnerable women's services exist within Midwifery services (POPPY Team) and in Health Visiting (CORAL Team) where designated professionals have the lead for working with pregnant teenagers.
  • A Condom Distribution (C-Card) scheme is in place and provides access to free condoms through a number of outlets particularly through the youth services.
  • Reading Borough Council employs a Teenage Parent Re-Integration Officer to work with pregnant teenagers to help them back into education, training and employment.
  • Continuing work to reduce teenage conception rates remains a priority for Reading and this area of health need has been included in the Health and Well Being Strategy and action plan.
  • The Family Nurse Partnership offers extensive sustained support to teenage girls that become pregnant for the first time and continue through to birth. The young mothers and immediate family where relevant continue to receive the support until the child becomes 2 years old.

What is this telling us?

Teenage pregnancy rates are at their lowest level for over 20 years, however, the UK still has one of the highest rates of teenage pregnancy in Western Europe. In Reading, effective local delivery of the Teenage Pregnancy Strategy has reversed the previous upward trend. The latest available data for 2013 shows that the under-18 conception rate in Reading has been reduced to around 23/1000 which is a reduction of around 52% since 2009.

The continued reduction in the number of teenage pregnancies and the subsequent increase in the proportion of terminations have resulted in far fewer births to teenage mothers. This is positive in terms of reducing the number of children generally been born into hardship and having a harder start in life. For new-borns who are born to teenage mums/families then evidence based support mechanisms will still need to be in place to give them and their families the best start in life.

What are the key inequalities?

Unplanned teenage pregnancy disproportionately affects those young people experiencing social exclusion and who are living in poverty in the more deprived areas of Reading. The young mums and their immediate family usually require additional support to help the infants get the best start in life.

What are the unmet needs / service gaps?

  • Promotion of services - Young people continue to report that they do not know what services are available and how to access them.
  • The emergency contraception pharmacy scheme needs wider promotion and co- ordination to ensure that young people know which pharmacies are offering this service and which days to access it.
  • Support for the delivery of Sex and Relationship Education (SRE) in schools and a co-ordinated SRE training programme for the young people's work force.

This section links to the following sections in the JSNA:

Sexual Health

Infant Mortality

 

References

Department of Health, 2010. Teenage Pregnancy Strategy: beyond 2010. [Online]. Available at: 

Department of Health, 2011. Quality Criteria for Young People Friendly Health Services. [Online]. Available at: https://www.gov.uk/government/publications/quality-criteria-for-young-people-friendly-health-services

National Institute for Health and Care Excellence, 2007. Sexually transmitted infections and under-18 conceptions: prevention. [Online]. Available at: http://www.nice.org.uk/guidance/ph3/chapter/Foreword

Office of National Statistics, 2015. Conception statistics, England and Wales 2013. [Online]. Available at: http://www.ons.gov.uk/ons/rel/vsob1/conception-statistics--england-and-wales/2013/index.html

  

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