Teenage pregnancy

Teenage pregnancy is recognised as an important indicator of health outcomes and health inequalities and as such is included as a key indicator for the Public Health Outcomes Framework (PHOF).

What do we know?

Teenage pregnancy and sexually transmitted infections are indicators of health inequalities. Specifically children born of teenage mothers are:

  • more likely to be born prematurely or at a low birth-weight
  • more likely to die in the first year of life than babies of mothers aged over 20 (see infant mortality page)
  • twice as likely to be admitted to hospital as a result of an accident or gastro-enteritis

Teenage mothers also have specific problems. They are:

  • three times more likely to get post-natal depression than older mothers
  • at a higher risk of poor mental health for three years after the birth
  • three times more likely to smoke during pregnancy than mothers over 35
  • one third less likely to breastfeed
  • likely to struggle to complete their education
  • find it difficult to gain employment.

Teenage pregnancy is associated with poor sexual health outcomes described in the sexual health section of the Joint Strategic Needs Assessment (JSNA).

Key risk factors for early parenthood were identified by Harden et al (2009) were: dislike of school; poor material circumstances and unhappy childhood; and low expectations for the future. Further risk factors are; poor family relationships, low self esteem, unhappiness at school, missing from school, poor emotional health and wellbeing, alcohol and substance misuse, low educational attainment, early onset of sexual activity, low aspirations, risk of being looked after.

Teenage pregnancy is both a cause and consequence of child poverty. Evidence shows that:

  • children of teenage mothers have a 63% increased risk of being born into poverty
  • half of all under 18 conceptions occur in the 20% most deprived wards
  • over one third of teenage mothers have no qualifications and 70% are not in education, training or employment
  • teenage mothers, young fathers and their children are more likely to be in poor health and to live in poor housing.

Facts, figures and trends

Pregnancies and births

The rate of pregnancies in under 18s has been falling both nationally and locally in Slough for many years (Figure 1). The latest data for 2013 shows that there were 19 pregnancies in every 1,000 young women aged 15-17 in Slough which is lower than the England rate of 24 per 1,000.

This represents total pregnancies - including those that end in miscarriage, stillbirth or termination. In terms of under 18 pregnancies that result in a live birth the rate in Slough is 5 per 1,000, again lower than the England rate of 8 per 1,000. We can also view teenagers who deliver as a proportion of total number of mothers who deliver (Figure 2). In Slough this percentage is 0.5%, which is lower than the national average of 0.9%.

Figure 1 Under 18s conception rate per 1,000 in Slough

Figure 1. Under 18 teenage conceptions (2008-10) versus Index of Deprivation (IMD) 2010, England. Source: Office for National Statistics

Figure 2. Under 18s deliveries as a proportion of total deliveries in Slough

Figure 3: Percentage of conceptions to under 18 years olds which result in abortion 1998 to 2011.

Of the total number of teenage pregnancies in Slough, around 15% are in those aged under 16 (Figure 3). As with the rate of total teenage pregnancies, the rate of under 16s pregnancies is also falling both nationally and locally in Slough.

Figure 3. Under 16s conception rate per 1,000 in Slough

Figure 3: Percentage of conceptions to under 18 years olds which result in abortion 1998 to 2011.

Abortions

As well as total pregnancies, it is important to consider rates of abortion. As a medical procedure, terminations of pregnancy pose certain risks to health and therefore preventing avoidable abortions is important.

Abortion rate in under 18s increased slightly from 2013 to 2014 in Slough from 8 per 1,000 aged 15-17 to 9 per 1,000 which is significantly lower than the national rate of 11 per 1,000. In terms of the proportion of teenage pregnancies that lead to abortion, this figure has remained fairly constant for over a decade at around 50%.

Unplanned pregnancies and abortions in Slough are a greater issue for the slightly older age group of young people with abortion rates significantly higher than the national average. Around a quarter of young people under 25 who have had one abortion will go on to have repeated abortions.

National and local strategies (current best practices)

A number of key documents have been published since the transition of responsibility for commissioning public health services to local authorities in April 2013. These include guidance for local authorities on sexual health commissioning, and a national framework for sexual health in England which cites the following priorities for young people.

  • Priority 1 - all young people are able to make informed and responsible decisions, understand issues around consent and the benefits of stable relationships, and are aware of the risks of unprotected sex.
  • Priority 2 - prevention is prioritised.
  • Priority 3 - all young people have rapid and easy access to appropriate sexual and reproductive health services.
  • Priority 4 - all young people’s sexual-health needs – whatever their sexuality – are comprehensively met.

Local strategies which impact on teenage pregnancies are supported by the ‘Raising Participation’ strategy and the key themes are described in the Not in Education, Employment or Training (NEET) section of the Joint Strategic Needs Assessment (JSNA).

What is this telling us?

This section shows that the trend in teenage pregnancy rate in Slough continues to fall in line with national trends. Teenage delivery rate is also lower than the national average though showing less of a reduction than total pregnancies.

What are the key inequalities?

As highlighted above teenage pregnancy is correlated with deprivation, and is an indicator of health inequalities. Teen mothers and their children are more likely than other mothers and babies to face health and social care problems.

Recommendations for consideration by other key organisations:

  • To promote the new Berkshire Sexual Health website and relevant contraceptive or family planning services
  • To continue to support teenage mothers and fathers in education, employment and training