Prevention of Teenage Pregnancy

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. 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 16 National Survey of Sexual Attitudes and Lifestyles, 2001

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 10 - 12% in under 25s

5. The consequences: unplanned pregnancies 90,000 teenagers become pregnant every year British teenage birth rate 3x France, 6x Netherlands The Social Exclusion Unit Report, June 1999. 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

6. The consequences: • abortions • 1999 - 174,000 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

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

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. involving young people age specific service confidentiality staff attitudes atmosphere location opening hours full range of services publicity November 2000 Best practice advice on the provision of effective contraception and advice services for young people

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 1998 60.8 per 1000 to 27.4 per 1000), reporting 2012 • 15% reduction in rate under-18’s conception by 2004 (in 1998 60.8 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?