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).
Teenage pregnancy and sexually transmitted infections are indicators of health inequalities. Specifically children born of teenage mothers are:
Teenage mothers also have specific problems. They are:
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:
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%.
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.
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.
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.
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).
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.
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.