1. Prevention of Teenage Pregnancy
Dr Nicky Mullin
Clinical Lecturer in Community Gynaecology

2. ‘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

3. 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

4. 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

5. 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

6. 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

7. Decrease in rates of teenage conceptions per 1000 females

8. 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

9. Prevention of teenage pregnancy
delay first sexual intercourse
increase use of contraception

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. ‘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

17. Thank you for listening.
Any questions?