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Prevention of Teenage Pregnancy
Dr Nicky Mullin Clinical Lecturer in Community Gynaecology
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‘I knew about contraception but I “I didn’t bother with it
‘I knew about contraception but I “I didn’t bother with it. You know it’s a possibility that you could get pregnant, but it’s like winning the Lottery, you just don’t think it will happen.” Shelley, 23, pregnant at 14
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Teenage sexual behaviour
UK Average age for first sexual intercourse = 17 years One in three has had sex before age National Survey of Sexual Attitudes and Lifestyles, 2001 Young people are less likely to use contraceptiom because: they do not expect to have sex do not know about contraception lack access to it lack the ability or power to make decisions
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The consequences of early sex:
poor use of contraception Between one-third and half do not use contraception at first SI 1/4 teenage mothers have their second child within 2 years National Sexual Health Strategy, 2001 sexually transmitted infections chlamydia infections doubled in the 1990s incidence is % in under 25s Chlamydia screening I ntarget groups 2002 Nat Sexual Health Strat target: 3.12 reduce by 25% diagnosis of newly acquired HIV and GC by end 2007
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The consequences: unplanned pregnancies lack of antenatal care
90,000 teenagers become pregnant every year British teenage birth rate 3x France, 6x Netherlands The Social Exclusion Unit Report, June National Sexual Health Strategy, 2001 lack of antenatal care low birth weight babies infant mortality highest among mothers <20yr Manchester Health Authority, Public Health Report 2001 3 in to 19 yr olds give birth every year infant mortality rate = deaths in first year of life
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The consequences: abortions social deprivation regret
,000 abortions in England & Wales social deprivation Nat Sexual Health Strategy - strong links between social deprivation, STIs, TOPs and teenage conceptions regret while 93% teenage women report their first SI was voluntary, 1/4 report that it was unwanted TOP rate highest in s Manchester 25% all conceptions end in legal abortions Only 2% above national average
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Decrease in rates of teenage conceptions per 1000 females
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Social Exclusion Report on Teenage Pregnancy
Four themes: Better Prevention - sex and relationships education Better Prevention - effective contraception, advice and information services Better support for Teenage Parents National and local campaigns
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Prevention of teenage pregnancy
delay first sexual intercourse increase use of contraception
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What works………… broad based SRE - pure abstinence programmes not as effective using strategies that have worked for other health interventions with teenagers variety teaching methods, role play, negotiation skills peer education improving self-esteem of young women educating and supporting teachers American studies Promote value of completing education and going on to higher education help teachers to be aware of gender issues to help girlsin the classroom
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What works…………. parenting- involvement, avoiding mixed messages, ‘latch-key kids’ accessible, friendly, confidential clinics/ health professionals easy access to condom machines school health centres / school nurse
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Best practice advice on the provision of effective contraception and advice services for young people involving young people age specific service confidentiality staff attitudes atmosphere location opening hours full range of services publicity November 2000 Services: Full range contraception STI screening and treatment non-judgemental pregnancy testing suport services for teenage parents youth counselling referral for TOP referral for ANC
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Manchester’s 10 year Vision and Goals
Vision - In 10 years time, all young people in Manchester can expect to receive: high quality sexual and reproductive health services which are responsive to their needs; the best possible education and youth service support that ensures their sexual health and reproductive health & well being sufficient suport for themselves and their children, that allows them to take full advantage of education and career opportunities
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Goals 1. Contribute towards the National Targets
Halve rate conceptions among under-18’s by 2010 plus downward trend in conception rates for under-16’s by 2010 achieve reduction in risk of long term social exclusion for teenage parents and their children achieve reduction in conceptions among under-18’s of 15% by 2004
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Goals 2. Achieve the local targets
55% reduction in rate under-18’s conceptions by 2010 (in per 1000 to 27.4 per 1000), reporting 2012 15% reduction in rate under-18’s conception by 2004 (in per 1000 to 51.7 per 1000), reporting 2012
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‘If I could turn back the clock, I would wait until I had enjoyed my adolesence and my career was established. You miss out on so many experiences.’ Shelley
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Thank you for listening.
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