Teenage pregnancy shows sharp decline in England

In a significant revelation, a recent study has found that rates of teenage pregnancy in England have halved since the implementation of the Government’s Teenage Pregnancy Strategy (TPS) in 1999.

The study published in the Lancet is the first to show the long term effect of a nation-wide strategy launched by the Labour government in 1999 which was aimed at reducing under-18 conception rates by 50% by 2010 and limiting social exclusion among young parents.

According to the study, “England’s under-18 conception rate has fallen to its lowest level since the 1970s”, says lead author Professor Kaye Wellings at the London School of Hygiene & Tropical Medicine, London, UK.

“What’s more, progress has been made towards halting the cycle of inequality that has long been associated with teenage pregnancy.”

The strategy had several components including providing high-quality sex and relationships education, youth friendly contraceptive services, support for young parents to take part in education, employment, and training and co-ordinated action, at government and local level. Local implementation grants were allocated according to teenage pregnancy rates in each area. The findings show that, from its peak in 1998, the under-18 conception rate showed a moderate decline until 2006, when it fell more sharply.

However, between 1998 and 2013 the conception rate dropped from approximately 47 to fewer than 25 conceptions per 1000 young women aged 15–17 years.

The most deprived areas and those where more strategy-related resources were targeted had higher under-18 conception rates before the TPS was implemented and experienced greater declines. Importantly, between 1998 and 2013, the conception rate dropped by 34 conceptions per 1000 young women aged 15–17 (approx. 65 to 31 per 1000) in areas receiving the highest TPS funding, compared with just 16 per 1000 in areas with the lowest level of funding (approx. 36 to 20 per 1000).

According to the study, the proportion of young women, who conceived before the age of 18 and were engaged in work, education or training, nearly doubled between 1999 and 2013 (from 20% to 36%) despite the less “favourable” economic climate. This trend was not seen in other young women of the same age. However,although teenage mothers are more likely to take part in education and training than previously, they are still far less likely than their (never-pregnant) peers to participate in education, work or training.

The authors highlight the comparatively small subsample of young women in this 18–24 year old age group and point out that estimates should be used with caution.

Experts say that despite the achievements in reducing under-18 conception rates, further reductions are still needed to bring them in line with other high-income countries.

England’s teenage pregnancy rates are still high by comparison with countries in Scandinavia or the Netherlands. According to Professor Wellings, continued preventive efforts are needed across a broad policy front.

“Our findings suggest that shifts in the educational aspirations of young women and the increasing use of highly effective contraception are both driving the trend towards fewer early conceptions. One provides the motivation not to get pregnant, the other the means.”