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Research suggests that childbearing does not necessarily cause psychological distress among teenagers. Dr. Stefanie Mollborn of the University of Colorado and her team investigated stress and depression using a large group of teenage girls and adult women.

In the Journal of Health and Social Behavior, they explain that teenage mothers' high depression rates have received "considerable research attention" in small studies, but a larger study of adolescent childbearing and depression was needed.

So they used figures from two large long-term surveys, the U.S. National Longitudinal Study of Adolescent Health and the Early Childhood Longitudinal Study-Birth Cohort. The participants completed questionnaires to measure depression, although the term "depression" was avoided. Questions covered areas such as how often the participants found things that did not usually bother them to be bothersome, how easily they could shake off feeling blue, and whether they had trouble concentrating.

Analysis showed that teenage mothers had higher levels of depression than other teenagers or adult mothers, but the experience of teenage childbearing did not appear to be the cause. "Rather, teenage mothers' depression levels were already higher than their peers' before they became pregnant, and they remained higher after childbearing and into early and middle adulthood," the researchers report.

But the results did suggest that the combination of poverty and existing distress was a good predictor of teen pregnancy. "In this group, depression markedly increases the probability of becoming a teenage mother," they report. However, for the majority of teenage girls, the link between depression and subsequent teenage pregnancy is "spurious," they believe.

Dr. Mollborn commented, "Psychologically distressed girls are at risk for teen childbearing, even if the two things usually do not cause each other. This could help educators and clinicians identify at-risk adolescents."

Dr. Diane Merritt of the Washington University School of Medicine in St. Louis says that screening for symptoms of depression or distress should be part of normal health screening for all teenagers. "Talking to teenagers about their sexuality and responsible behavior (such as birth control) is key," she commented, adding that having long-term goals and good self-esteem are among the best ways to prevent teen pregnancy.

Teenage childbearing may be "a positive adaptive mechanism for humans raised in a hostile environment," suggests Dr. Julie Quinlivan of the University of Melbourne, Australia. This makes sense from an evolutionary perspective, she believes, because "life history theory suggests that in risky and uncertain environments the optimal reproductive strategy is to reproduce early in order to maximize the probability of leaving any descendents at all."

Among teenage mothers who have planned their parenthood, some positive behavioral changes are often observed, Dr. Quinlivan adds. For example, many teenagers reduce risk-taking behavior regarding cigarettes, alcohol, and marijuana. "Once pregnant, rates of consumption are usually lower compared with their non-pregnant peers or even their own personal pre-pregnancy rates of consumption," she writes.

Given that teenage motherhood is not simply going to vanish, her opinion is that we should "focus research and services on validated interventions that may assist teenage mothers fulfil their ambitions of parenthood and simultaneously provide the best outcomes for their offspring," such as teenage pregnancy clinics and regular home visits by nurses.

Further work based on the National Longitudinal Survey of Youth looked at depression in later life. Dr. Ariel Kalil from the University of Chicago found that unmarried teenage mothers "displayed higher levels of depressive symptoms in young adulthood," but the psychological health of married teenage mothers in later life was as good as that of married adult mothers.

It appears that unmarried adult mothers and unmarried teenage mothers had similarly poor outcomes. The authors write, "The findings of this study suggest that marital status, rather than age at first birth, may be more relevant for later-life psychological health."

As for teenage fathers, they may have unrecognized psychological problems, according to a study carried out by Dr. Quinlivan and her team in Melbourne. They write, "It is recognized that pregnant teenagers have higher levels of psychological symptomatology compared to older pregnant women. However, there are limited data on fathers in the setting of teenage pregnancy."

Interviews carried out with teenage fathers before the birth showed that rates of anxiety and depression were significantly higher than for older fathers. A high anxiety and depression score among these teenage boys was linked to exposure to domestic violence as a child, whereas having their own father alive was significantly protective against anxiety and depression.

Another study by the same team found that teenage fathers tended to have experienced parental separation or divorce in early childhood, and have a higher rate of illicit drug use. The experts say these fathers may lack a positive role model for parenting and fatherhood. The researchers call for more mental health services aimed at teenage fathers.
References
Mollborn, S. and Morningstar, E. Investigating the relationship between teenage childbearing and psychological distress using longitudinal evidence. The Journal of Health and Social Behavior, Vol. 50, September 2009, pp. 310-26.

Quinlivan, J. A. Teenagers who plan parenthood. Sexual Health, Vol. 1, 2004, pp. 201-8.

Quinlivan, J. A. and Condon, J. Anxiety and depression in fathers in teenage pregnancy. The Australian and New Zealand Journal of Psychiatry, Vol. 39, October 2005, pp. 915-20.

Tan, L. H. and Quinlivan, J. A. Domestic violence, single parenthood, and fathers in the setting of teenage pregnancy. Journal of Adolescent Health, Vol. 38, March 2006, pp. 201-7.

Kalil, A. and Kunz, J. Teenage childbearing, marital status, and depressive symptoms in later life. Child Development, Vol. 73, November-December 2002, pp. 1748-60.

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national longitudinal study of adolescent health

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Depression and Teenage Pregnancy | Psych Central

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Research suggests that childbearing does not necessarily cause psychological distress among teenagers. Dr. Stefanie Mollborn of the University of Colorado and her team investigated stress and depression using a large group of teenage girls and adult women.

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The problems of teenage pregnancy in the UK and some solutions

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Even for the most prepared parents, raising a healthy and happy child is one of life's major challenges.

Having the ability to check off commonly accepted parenting prerequisites - a quality education, a good job, mental and emotional stability, a safe home - can make the challenge easier to tackle and overcome.

Unfortunately, adolescents who become parents often have a shortage of key life skills and other resources that are vital to the parenting process. This sad reality is supported by research showing that, on average, children who are born to teen parents are less likely to ever reach their full potential. And the effects of teenage pregnancy on parent, baby, and community can be devastating.

According to The Urban Child Institute, adolescent parenting is one of the major risk factors associated with early childhood development. In addition to its other effects, teen parenting is likely to hinder a child's social and emotional wellbeing.

When a baby is born to a teenage mother, he is likely to have more difficulty acquiring cognitive and language skills as well as social and emotional skills like self-control and self-confidence. These abilities are already developing in infancy, and they are essential for school readiness.

Studies on early childhood development find that adolescent mothers (19 years of age and younger) are less likely than older mothers to engage in emotionally supportive and responsive parenting. They tend to have less knowledge about child development and effective parenting, and often misjudge their infant or toddler's ability to adapt and learn.

We don't need research to prove that, generally speaking, age brings maturity, self-assuredness, knowledge and experience. By the age of 21, one has typically graduated from high school and is pursuing post-secondary education or participating in the workforce (or both).

Throughout our childhood and teenage years we are acquiring life skills and problem-solving abilities that prepare us to confront and navigate challenges - both unforeseen and anticipated - in adulthood. As a result, those who are beyond their teen years are more likely to make informed choices, use effective coping strategies, and think through important decisions. It's not hard to see how these qualities lead to more effective parenting.

When a baby is born to an adolescent mother, there are several interrelated risk factors at play, meaning that the likelihood that one or more unfortunate outcomes will occur is stronger.

A dream deferred - Adolescent parents commonly view quitting school as a solution to finding the time it takes to raise a baby. Feelings of embarrassment and shame associated with early pregnancy, or difficulty keeping up academically can also drive them to drop out. The popular MTV reality series "16 and Pregnant" offers numerous examples of these unfortunate outcomes, and serves as a glaring reminder of the need to direct more attention and resources to sex education for teens as well as programs encouraging teen mothers to stay in school.

Harsh parenting - Research has found that teen parents are more likely to engage in harsh parenting practices like yelling and spanking. Having fewer life experiences and coping skills, compared to older parents, can make it harder to handle the irritability and frustration that sometimes arise when caring for a new baby. Depressive symptoms or persistent stress from other sources can increase these feelings of anger and resentment.

Single parents - In a majority of cases, adolescent parents are not married and the discovery of pregnancy is unexpected. Too often, teen fathers abandon their parenting responsibilities due to fear and inability to adequately provide for their child, leaving the mother with even less social support and financial assistance.

Unfortunately, teen pregnancy doesn't only affect the individuals involved - its impact is far-reaching. High rates of teen births can weaken a community's economic conditions.

According to The Urban Child Institute, the prevalence of births to adolescent mothers negatively affects high school graduation and increases unemployment. Without a high school diploma or equivalent, teens and adults have greater difficulty securing quality employment and have lower earning potential. A less educated population and unskilled workforce negatively affects the economy, and makes it difficult for communities to break aggressive cycles of poverty and crime as resources are consistently depleted.

In Shelby County, teen pregnancy is not a new or isolated issue - it is a full-blown epidemic. The latest figures indicate that although the teen birth rate is declining, it is still above the national rate and among the highest in the country.

In 2011, national news coverage of Shelby County's teen birth rate sparked a local movement to reduce teen pregnancy. Efforts like the countywide 'No Baby' campaign helped to increase education for pregnancy prevention methods among teens, and public awareness throughout the community.

On a more positive note, it is important to understand that not all babies born to adolescent parents are doomed to fail. Increased risk is not a guarantee of future problems.

Clearly, many children of teen parents go on to become successful adults, but it often involves parents making greater sacrifices than older parents have to make. For example, some adolescent parents may abandon their own aspirations in an effort to ensure that academic and career success is attainable for their child.

However, research shows that children born to adolescent mothers are more inclined to repeat their parents' behavior. The Urban Child Institute reports that they are more likely to drop out of school, have more health problems, face unemployment and become teen parents themselves.

So what can be done to stop this cycle from continuing? Sex education programs that teach the benefits of abstinence and pregnancy prevention are essential. Parents and educators can share in this responsibility by ensuring that teens gain this knowledge at home and at school. Avoiding discussion on the issue of sex and safe practices only heightens potential for teen pregnancy to occur.

Promoting positive parenting among young mothers can also improve their children's chances for success. Increasing parents' knowledge about child development and effective parenting strategies will help them buffer their children from many of the risks that accompany early parenthood.

Starting at birth, children begin to develop social and emotional skills. It is important for parents, no matter their age, to ensure their children are adequately prepared to face challenges later in life by maintaining a loving home environment that nurtures their ability to learn about themselves and the world around them. A strong foundation of social and emotional skills will help them make better choices in adulthood, and decrease the probability that they will search for love in the wrong places.

This article also appears in the Tri-State Defender.

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How Adolescent Parenting Affects Children, Families, and Communities

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Even for the most prepared parents, raising a healthy and happy child is one of life's major challenges. Having the ability to check off commonly accepted parenting prerequisites - a quality education, a good job, mental and emotional stability, a safe home - can make the challenge easier to tackle and overcome.

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There are so many stories around sex, it's hard to know what to believe. Find out the facts - it's the best way to make sure you have safer sex.
1: Can you get pregnant the first time you have sex?

Yes, pregnancy is possible even if it is the first time a girl has had sex. The truth is, if a boy and a girl have sex and don't use contraception, she can get pregnant, whether it's her first time or she has had sex lots of times.

A boy can get a girl pregnant the first time he has sex with her. If you're female and have sex, you can get pregnant as soon as you start ovulating (releasing eggs). This happens before you have your first period. Read more about periods and the menstrual cycle.

Using contraception protects against pregnancy. Using condoms as well also protects against sexually transmitted infections (STIs). Before you have sex, talk to your partner about contraception, and make sure you've got some. Find out about getting contraception and tips on using condoms.

2: Can you get pregnant if a boy withdraws (pulls out) before he comes?

Yes, you can. There's a myth that a girl can't get pregnant if a boy withdraws his penis before he ejaculates (comes). The truth is, pulling out the penis won't stop a girl from getting pregnant.

Before a boy ejaculates, there's sperm in the pre-ejaculatory fluid (pre-come), which leaks out when he gets excited. It only takes one sperm to get a girl pregnant. Pre-come can contain STIs, so withdrawing the penis won't prevent you from getting an infection.

If a boy says he'll take care to withdraw before he ejaculates, don't believe him. Nobody can stop themselves from leaking sperm before they come. Always use a condom to protect yourself against STIs, and also use other contraception to prevent unwanted pregnancy.

3: Can you get pregnant if you have sex during your period?

Yes, a girl can get pregnant during her period. The truth is, she can get pregnant at any time of the month if she has sex without contraception.

Sperm can survive for several days after sex, so even if you do it during your period, sperm can stay in the body long enough to get you pregnant.

4: Can you get pregnant if you have sex standing up?

Yes, a girl can become pregnant in any position that she has sex. It is a myth that a girl can't get pregnant if she has sex standing up, sitting down, or if she jumps up and down afterwards. The truth is, there's no such thing as a "safe" position if you're having sex without a condom or another form of contraception.

There are also no "safe" places to have sex, including the bath or shower. Pregnancy can happen whatever position you do it in, and wherever you do it. All that's needed is for a sperm to meet an egg.

5: Can you get pregnant from oral sex?

No, you can't get pregnant following oral sex. The truth is, a girl can't get pregnant this way, even if she swallows sperm. But you can catch STIs through oral sex, including gonorrhoea, chlamydia and herpes. It's safer to use a condom on a penis if you have oral sex.

6: Does alcohol make you better in bed?

No, alcohol does not make you better in bed. The truth is, when you're drunk it's hard to make smart decisions. Alcohol can make you take risks, such as having sex before you're ready, or having sex with someone you don't like. Drinking won't make the experience better. You're more likely to regret having sex if you do it when you're drunk. Find out more about sex and alcohol.

7: Can you use clingfilm as a condom?

No, you cannot use clingfilm, or a plastic bag or a crisp packet instead of a condom. Only a condom can protect against STIs.

You can get condoms free from:

community contraceptive clinics

sexual health and genitourinary medicine (GUM) clinics

some young persons services

You can also buy them from pharmacies and shops. Make sure they have the CE mark or BSI kite mark on them, as this means they've been tested to high safety standards. Find sexual health services near you, including contraception clinics.

8: Will a boy's balls explode if he doesn't have sex?

No, this is not true. Not having sex doesn't harm boys or girls, and a boy's balls will not explode.

Boys and men produce sperm all the time. If they don't ejaculate, the sperm is absorbed into their body. Ejaculation can happen if they masturbate or have a wet dream. They don't have to have sex. Find out about boys' bodies.

9: Can you wash condoms and use them again?

No, condoms should only be used once. Don't believe anyone who says that you can wash condoms and use them again. If you've used a condom, throw it away and use a new one if you have sex again.

This is true for male condoms and female condoms. Condoms need to be changed after 30 minutes of sex because friction can weaken the condom, making it more likely to break or fail. Get tips on using condoms.

10: Can you get pregnant if you have sex only once?

Yes, it is possible to get pregnant even if you only have sex once. You may have heard the myth that you have to have sex lots of times to get pregnant. The truth is, all it takes is for one sperm to meet an egg. To avoid pregnancy, always use contraception, and use a condom to protect against STIs.

11: Do you always get symptoms if you have an STI?

No, you might not know if you have an STI due to signs such as it hurting when you pee, or noticing a discharge, unusual smell or soreness.

Many people don't notice signs of infection, so you won't always know if you're infected. You can't tell by looking at someone whether they've got an STI. If you're worried that you've caught an STI, visit your GP or local sexual health clinic. Check-ups and tests for STIs are free and confidential, including for under-16s. Find sexual health services near you.

12: Can women who have sex with women get STIs?

Yes, women who sleep with women can get or pass on STIs. If a woman has an STI, the infection can be passed on through vaginal fluid (including fluid on shared sex toys), blood or close bodily contact.

Always use a new condom on shared sex toys. If a woman is also having sex with a man, using contraception and condoms will help to prevent STIs and unintended pregnancy.

13: Do all gay men have anal sex?

No, this isn't true. Anal sex, like any sexual activity, is a matter of preference. Some people choose to do it as part of their sex life and some don't, whether they're gay, straight, lesbian or bisexual.

According to the Third National Survey of Sexual Attitudes and Lifestyles (published in 2013), 18.5% of men and 17% of women in the 16-24 age group had had anal sex in the previous year. Whatever kind of sex you have, use a condom to protect yourself and your partner against STIs. However, having sex isn't the only way to show your feelings for someone.

14: Does starting her periods mean a girl is ready to have sex?

No, this isn't true. Starting your periods means that you're growing up, and that you could get pregnant if you were to have sex. It doesn't mean that you're ready to have sex, or that you should be sexually active.

People feel ready to have sex at different times. It's a personal decision. Most young people in England wait until they're 16 or older before they start having sex. Find out more about periods and the menstrual cycle.

15: Can I get help and information on sex if I need it?

If you want to talk to someone in confidence, you can call the national sexual health helpline on 0300 123 7123.

Find sexual health services near you.

To find your nearest people's service, visit the Ask Brook website.

Find out where to get help when sex goes wrong.

Condom, no condom? is an interactive video on YouTube where you decide what happens. Just choose which button to click at the end of each section to continue the story, and see the consequences of your choices.

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There are so many stories around sex, it's hard to know what to believe. Find out the facts - it's the best way to make sure you have safer sex. Yes, pregnancy is possible even if it is the first time a girl has had sex.

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Sex and Relationship Education in Schools (England) - Commons Library briefing - UK Parliament

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This House of Commons Library briefing provides an overview of the legislation and guidance currently in place regarding sex and relationship education (SRE) in schools, and also outlines related reviews and proposals in Parliament.

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Conceptions in England and Wales - Office for National Statistics

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Pregnancies leading to a birth or legal termination by age group, including women aged under 18 years.

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It doesn't happen.

Sex and relationship education (SRE) that is taught in primary schools (ages 4-11) is point blank not about teaching young children how to have sex. It is about giving age-appropriate information that is evidence-based on the issues that SRE encompasses.

It also doesn't happen because the last two governments have failed to respond to overwhelming evidence that SRE is crucial and a basic right for children. It is necessary to provide children with the knowledge to apply in their lives to make the best of their time. Without providing this information how can we expect children and young people to make healthy decisions? It is no wonder that Britain has such a high rate of teenage pregnancy, sexually transmitted disease and increased prevalence of body image disorders. In the same way that we take reading and writing skills for granted as basic abilities that are crucial for a successful life, so should we regard SRE. We are letting society down by not helping educate children to be respectful of others. Every day sexism and harassment is a real issue. It may not affect you personally but it certainly affects many women.

SRE is not the only way to tackle such wide issues in society, but there is no doubt that it is helpful and a beneficial addition that is warranted. Bringing SRE into statutory law would not be fool proof just as no law is, but the lack of support in the House of Lords in Tuesday 28th January's vot e highlighted many issues that are not being addressed. Rational arguments were made to teach issues such as consent in efforts to reduce sexual violence but they fell on deaf and stubborn ears.

SRE also certainly takes into account religious beliefs and cultural morals. High quality SRE deals in providing facts and information about the world around everyone, from which no community of people in the modern world is separate. Some people do believe in no sex before marriage or anticipates SRE contradicts them. However, learning what consent is, how to put a condom on a plastic penis, learning about sexuality of yourself, and others, is not in violation in respect to those people. There are plenty of religious doctors who deal in intimate knowledge and handling of patients. Learning information is just not sacrilege in any way and research does highlight that SRE leads to young people having safer sex and also having sex at an older age.

Of course SRE needs to be taught to a decent standard and that needs to be regulated and enforced. Schools across the UK have differing standards in every area of curriculum and that will most certainly apply to statutory SRE too. Teachers would need training to be comfortable in the material, but examples from other European countries like Denmark, show that this is achievable. The fact that Ofsted found that as many as 40% required improvement or was inadequate in delivering PSHE, displays a need to improve their SRE provision. The story is not better in other countries in Britain either.

Age appropriate SRE means teaching young children about what puberty involves at the right time in their lives. Many in primary school will be experiencing the first signs of bodily changes and need help in how to deal with this mentally and socially. Contrarily, SRE will not teach STI information until secondary school when the complexities of understanding infection and symptoms will be more able to be understood. More than ever, children and young people need help to make sense of the fast changes that technology provides in 'sexting' and cyberbullying.

Of course there is a need for parents to be involved, that is important, but not all parents know the correct information on STIs, abortions and promoting positive body image. Even if they do know, not all parents are willing to talk to their child about it, nor might the child be willing to talk back about these vital issues with their parents. What is needed is a standard core of information given at school level that will prepare children and young people to seek out further information, if they wish, from reliable sources rather than resorting to pornography, friends who may also be clueless or social media.

Teachers are professionals who are equipped with the ability to deliver high quality education and having a basis of lesson formats that have been produced by expert groups ( Brook, PSHE Association and the members of Sex Education Forum) will prove of great value. This basis then allows teachers to add and emphasise certain lessons that are suitable to the catchment area that they serve, while still covering all aspects that are deemed crucial to forming a healthy individual. All efforts to improve education, and therefore society, should be taken. In this endeavour, SRE that provides life-long lessons is central. Education should not just build up young people towards a job, but make the most of their lives by facilitating relationships that is a life-long fundamental element of humans as social animals.

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It doesn't happen. Sex and relationship education (SRE) that is taught in primary schools (ages 4-11) is point blank not about teaching young children how to have sex. It is about giving age-appropriate information that is evidence-based on the issues that SRE encompasses.

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Find out about help and support for young mums and pregnant teenagers, including carrying on with your education.

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Introduction

Teenage pregnancy (defined as under-18 conceptions including those leading to live births and terminations) and early parenthood are widely recognised to be associated with poor health and social exclusion. Having children at an early age can affect young women's health and wellbeing and can limit their education, career and economic prospects. Although young people can be competent parents, longitudinal studies show that the children born to teenagers are more likely to experience a range of negative outcomes in later life, and are more likely to become a teenage parent themselves. In addition, serious case reviews have identified teenage parents as being vulnerable families who may need additional support to help them achieve positive futures for themselves and their children.

Evidence suggests that the mother's age, disadvantaged socioeconomic background and limited uptake of antenatal care come together to contribute to poor outcomes overall ( see footnote 1). The maternal and child outcomes associated with teenage parenthood include; late booking for maternity services, smoking in pregnancy, poor maternal health, postnatal depression, isolation and relationship breakdown, repeat unplanned pregnancies, no qualifications, not in education, training or employment, parenting difficulties, mothers at risk of poverty and poor housing in later life, premature birth and low birth weight, infant mortality, hospitalisation of the infant, low breastfeeding rates, poor diet, accidental injuries in childhood and finally children at risk of lower academic achievement, poverty and unemployment in later life. Therefore reducing the number of teenagers who become parents is central to the wider agenda of reducing health inequalities and child poverty.

See related JSNA chapters on sexual health, infant mortality, maternity, looked after children, safeguarding adults, safeguarding children, alcohol and substance misuse in children and young people, children and young people's mental health, domestic violence, unemployment, housing and deprivation.

There is also a strong economic argument for reducing teenage pregnancy, which places a significant burden on public services, estimated at £63 million a year. It is estimated that every £1 spent on pregnancy prevention/contraception saves £11 in health plus welfare costs ( see footnote2).

Reducing teenage pregnancy continues as a priority for the coalition Government however the economic environment provides the government and local areas with an enormous challenge when it comes to planning teenage pregnancy prevention and support. The under-18 conception rate is an indicator within the Public Health Outcomes Framework, a measurement indicator in the Child Poverty Strategy and is a measure of success for the Positive for Youth Policy. The Framework for Sexual Health Improvement in England ( see footnote 3) highlights reducing rates of under 18 conceptions and sexually transmitted infections(STIs) as two of the five priority areas for improvement (DH, 2013). A main objective of the Framework is to build an open and honest culture around relationships and sexual health, something that is common in comparable countries with low teenage pregnancy rates.

In Haringey, reducing the under-18 conception rate is a priority in the Health and Wellbeing Strategy, the Children and Young People's Plan, the Child Poverty Strategy and the Strategy for Youth. The Health and Wellbeing Board has set a challenging local target to reduce Haringey's rate to the rate for London for 2015.

The latest ONS under 18 conception rates released on 25 February 2014 show a continuing downward trend for Haringey, with a rate of 33.1 per 1000 in 2012 compared to the rate for London (25.9 per 1000) and for England and Wales (27.9 per 1000).

Both under 18 and under 16 rates for 2012 show a decrease from 2011 rates and are Haringey's lowest ever recorded rates with the under 16 rate (4.8 per 1000) now similar to the rate for London (4.4 per 1000) and below the rate for England and Wales (5.6 per 1000).

The percentage change in rate from 1998 - 2012 shows that Haringey has had an encouraging decrease of 46.9%, This decrease is similar to London's decrease of 49.3% and better than the decrease of 40.8% for England and Wales.

In Haringey the teenage pregnancy rate fell to its second lowest rate in 2011 (36.2 per 1000 females aged 15-17) with an encouraging decrease of 41.9% since the 1998 base rate. Haringey's under-16 conception rate also decreased to its lowest rate, 9.3 per 1000 but remains higher than the rate for London and England and Wales. ( See footnote 3). The percentage change from 1998 to 2011 for maternity in this age range shows a decrease of 53.1%, and for abortions in this age range shows a decrease of 28.8%.

In 2011, there were 152 conceptions with 56.6% leading to a termination, a decrease on the percentage shown in the two previous years. In 2010, there were 203 conceptions compared to 171 in 2009. This number is lower than the 248 conceptions in 2007 when the rates was 70.2 per 1000 and also lower than its highpoint in 2002 when the rate was 80.4 per 1000 and there were 313 conceptions.

It is important to bear in mind that, given the small numbers involved, there can be large year on year fluctuations in the rate and comparing the three year aggregate conception rate 2010- 2012 against 1998-2000 gives a more robust picture of overall performance.
Figure 1: Under-18 conception trends shown in three year aggregate data Source: ONS and DfE
As more teenage conceptions in Haringey lead to abortion, this suggests that the pregnancies were unplanned and indicate early onset of sexual activity, poor or no contraceptive use and increased risk of sexually transmitted infections therefore should be considered as an indicator of poor sexual health in the community. Interventions and services to reduce teenage pregnancy and support teenage parents need to be clearly integrated into local sexual health services.

Details on infant mortality, maternity, children in care, safeguarding - children, safeguarding - adults, alcohol, children and young people's mental health, domestic violence, immunisations and vaccinations are dealt with in separate sections.

Key Issues and gaps

Issues

Between 1998 and 2008 Haringey's teenage pregnancy rate increased by 12%. In response Haringey introduced a comprehensive Teenage Pregnancy Strategy and Action Plan in late 2007 (based on evidence from the Teenage Pregnancy Unit) and this contributed to the significant decreases in the teenage pregnancy rate between 2008 and 2009 (18% decrease).
Gaps
1 Further abortion data analysis is needed to understand the barriers for young women experiencing poor or no contraceptive use following a termination.

2. Further analysis of repeat use of Emergency Hormonal Contraception is needed in order to reveal more opportunities to identify young women at risk of poor contraceptive use and sexual health

3. Further analysis is needed on the use of both Long Acting Reversible Contraception and condoms in young people under 18 and under 25.

Who is at risk and why

The recent study, Teenage Pregnancy in England, by the Centre for Analysis of Youth Transition, ( see footnote 4) highlighted that the girls most at risk of pregnancy before 18 were those:

Eligible for free school meals

Persistently absent form school

Making slower progress than expected academic progress between key stages 2 and 3(ages 11-14) (Crawford et al, 2013).

Other risk factors are:

Being in care or a care leaver

Experiencing sexual abuse and exploitation

Alcohol use and misuse

Having had a previous pregnancy

The Department of Health Teenage Pregnancy: Accelerating The Strategy to 2010 ( see footnote 5) pointed out that:

'young people experiencing risk factors for teenage pregnancy are highly concentrated within particular areas and among vulnerable groups and that the risk factors for teenage pregnancy are well recognised and provide a compelling case for targeted action on young people who are exposed to these risks. To target effectively those most at risk requires both a geographical focus on high rate neighbourhoods and the identification of vulnerable groups at high risk of teenage pregnancy'

1. Targeting high rate neighbourhoods

Variations in teenage pregnancy rates are highly correlated with levels of deprivation across England

Half of all under-18 conceptions in England occur in the 20% most deprived wards

Teenage pregnancy rates among the most deprived 10% of wards are four times higher than in the 10% least deprived wards

Teenage pregnancy 'hotspots', where more than 6% of girls aged 15-17 become pregnant, are found in virtually every local authority in England.

2. Identifying those most at risk of teenage pregnancy

Teenage pregnancy is a complex issue, affected by a wide range of personal, social, economic and environmental factors. However, research evidence has identified the key risk factors which are known to increase the likelihood of teenage pregnancy. These can be broadly grouped into: risky behaviours; education-related factors; and family and social circumstances.

a) Risky behaviours include early onset of sexual activity, poor contraceptive use, mental health/conduct disorder/involvement in crime, repeat abortions, teenage motherhood, alcohol and substance misuse

Girls having sex under 16 years of age are three times more likely to become pregnant than those who first have sex over 16 years of age.

Around 60% of boys and 47% of girls leaving school at 16 with no qualifications had sex before 16, compared with around 20% for both males and leaving school at 17 or over with qualifications.

Early onset of sexual activity is also associated with some ethnic groups. Among 16-18 year olds surveyed in London, non-use of contraception at first intercourse was most frequently reported among Black African males (32%), Asian females (25%), Black African females (24%) and Black Caribbean males (23%)

Around a quarter of boys and a third of girls who left school at 16 with no qualifications did not use contraception at first sex, compared to only 6% of boys and 8% girls who left school at 17 or over, with qualifications

A number of studies have suggested a link between mental health problems and teenage pregnancy. A study of young women with conduct disorders showed that a third became pregnant before the age of 17

Teenage boys and girls who had been in trouble with the police were twice as likely to become a teenage parent, compared to those who had no contact with the police

Research among south London teenagers found regular smoking,drinking and experimenting with drugs increased the risk of starting sex under 16 for both young men and women

A study in Rochdale showed that 20% of white young women reported going further sexually than intended because they were drunk

Other studies have found teenagers who report having sex under the influence of alcohol are less likely to use contraception and more likely to regret the experience

A significant proportion of teenage mothers have more than one child when still a teenager. Around 20% of births conceived under 18 are second or subsequent births

Around 7.5% of abortions under 18 follow either a previous abortion or pregnancy. Within London this proportion increases to around 12% of under 18 abortions.

b) Education-related factors including leaving school at 16 with no qualifications, disengagement from school, low educational attainment

The likelihood of teenage pregnancy is far higher among those with poor educational attainment, even after adjusting for the effects of deprivation.

On average, deprived wards with poor levels of educational attainment had an under-18 conception rate double that found in similarly deprived wards with better levels of educational attainment (80 per 1000 girls aged 15-17 compared with 40 per 1000).

A survey of teenage mothers showed that disengagement from education often occurred prior to pregnancy, with less than half attending school regularly at the point of conception. Dislike of school was also shown to have a strong independent effect on the risk of teenage pregnancy.

Poor attendance at school is also associated with higher teenage pregnancy rates. Among the most deprived 20% of local authorities, areas with more than 8% of half days missed had, on average, an under-18 conception rate 30% higher than areas where less than 8% of half days were missed.

Overall, nearly 40% of teenage mothers leave school with no qualifications.

Among girls leaving school at 16 with no qualifications, 29% will have a birth under 18, and 12% an abortion under 18, compared with 1% and 4% respectively for girls leaving at 17 or over.

Leaving school at 16 is also associated with having sex under 16 and with poor contraceptive use at first sex.

c) Family/background factors including parental aspirations, ethnicity, daughter of a teenage mother, in care or a care leaver

Research has shown that by the age of 20 a quarter of children who had been in care were young parents, and 40% were mothers.

The prevalence of teenage motherhood among looked after girls under 18 are around three times higher than the prevalence among all girls under 18 in England.

Research findings from the 1970 British Birth Cohort dataset showed being the daughter of a teenage mother was the strongest predictor of teenage motherhood.

Data on mothers giving birth under age 19, identified from the 2001 Census, show rates of teenage motherhood are significantly higher among mothers of 'Mixed White and Black Caribbean', 'Other Black' and 'Black Caribbean' ethnicity. 'White British' mothers are also overrepresented among teenage mothers, while all Asian ethnic groups are under-represented.

A survey of adolescents in east London showed the proportion having first sex under 16 was far higher among Black Caribbean men (56%), compared with 30% for Black African, 28% for White and 11% for Indian and Pakistani men. For women, 30% of both White and Black Caribbean groups had sex under 16, compared with 12% for Black African, and less than 3% for Indian and Pakistani women.

Poor contraceptive use has also been reported for some ethnic groups.

Research shows that a mother with low educational aspirations for her daughter at age ten is an important predictor of teenage motherhood.

Those identified at risk in Haringey include those mentioned above. In addition:

Haringey is typical of many inner city areas, having a younger population than England and additionally, areas of high social disadvantage and income deprivation typically associated with higher rates of teenage pregnancy.

Haringey's teenage pregnancy rates are higher in the eastern wards, similar to the wards with higher deprivation.

The four maps below show the downward trend in rates and decreases in levels achieved across the wards in the east of the borough but also highlight the on-going health inequality for girls and young women resident in these wards.

Figure 2: Teenage pregnancy rate across Haringey wards for conceptions in 2006-2008 Figure 3: Teenage conception rate by ward 2007-2009 (per 1,000 females ages 15-17) Figure 4: Teenage conception rate by ward 2008-2010 (per 1,000 females ages 15-17) Figure 5: Teenage conception rate by ward 2009-2011 (per 1,000 females ages 15-17)
With the unavoidable delay in reporting teenage conceptions, it is therefore necessary to collect more timely local data, including numbers of live births and terminations that suggest needs and can inform further analysis of the impact of interventions and services.

In 2010, local data suggests that there were approximately 173 under-18 conceptions with 62 leading to a live birth and 111 leading to termination. The data suggests that the number of births is highest amongst White British, Other White, Black Caribbean, Black African and Other Ethnic Groups. A low proportion is to women living in the west of the borough.Thedata suggests that the number of terminations is highest amongst White British, Black Groups and Other Ethnic Groups. A high proportion of local termination data does not have an ethnicity stated. Terminations are considerably higher in the east of the borough.

In 2009, local data collected on terminations suggested that a significant proportion (20%) of the young women attended the single sex school in the borough. A significant proportion (31%) was schooled outside of the borough.

Other at risk groups in Haringeyinclude:

Children in care and care leavers. Nationally, children in care are more at risk of teenage pregnancy and poor sexual health and more likely not to choose a termination. In Haringey, teenage pregnancy amongst children in care has been low but increases with age, with care leavers being more at risk. Asylum seekers and young people with no recourse to public funds are also at risk. Since October 2010, 36.4% of Haringey's Family Nurse Partnership clients (first time teenage mothers referred before 26 weeks of pregnancy) are currently, or have been historically children in care or care leavers

Referrals to Social Care. Since October 2010 49.9% of clients referred to the Family Nurse Partnership were known to social care at referral

Repeat terminations. Local data collected from the follow up support and tracking offered to vulnerable young women under 19 having a termination since April 2011 showed that 10 % of the young women seen had had a previous termination and of these, 0.04% had a subsequent termination since receiving the follow up support

Other BME groups. Haringey council's Gypsy, Roma and Travellers Support Team based within the Children and Young People's Service (the team ceased to exist from April 2011) identified teenage pregnancy and poor sexual health as a risk factor for their clients and families they came into contact with

Not in Employment, Education and Training (NEET). National and local data suggests thatyoung women aged 16 to 19 who are NEET and teenage mothers who are NEET are at risk of teenage pregnancy and poor sexual health.

The level of need in the population

In 2012, there were 142 conceptions with 60.6% leading to a termination. This is reduction on the rate and numbers of conceptions in 2011.

In 2011, there were 152 conceptions with 56.6% leading to a termination, a decrease on the percentage shown for the previous year. In 2010, there were 203 under 18 conceptions, compared to 171 in 2009. This number is lower than the 248 conceptions in 2007 when the rates was 70.2 per 1000 and significantly lower than its highpoint in 2002 when the rate was 80.4 per 1000 and there were 313 conceptions.

The percentage change in maternity rate per 1000 women in this age group for the period 1998 - 2012 shows Haringey has had a decrease of 61.2% and suggests that more young women under 18 in Haringey are not choosing to become teenage parent. As Haringey's under-18 conception rates have decreased the Department of Health's estimate of teenage mothers in Haringey aged under 20 also decreased as shown in the table below ( see footnote 6).
Figure 6: Estimates of numbers of teenage mothers in Haringey and the circumstances in 2011 of those known to the Youth, Community and Participation Service
Current services in relation to need

The following section does not include the range of services implemented in 2008 and 2009 that were affected by efficiency savings in 2010/2011 and the loss of Area Based Grant funding in 2011/2012.
1. Teenage pregnancy prevention

The NHS Whittington Health Trust's Contraception and Sexual Health Service provides the following; a sexual health telephone helpline available Monday to Friday, 9.30am to 4.30pm. Advice and information available in various clinics and health centres across the borough. Clinic details and appointments can be found on the Shhout - Lets talk about sex website (external link)

Shh..! Is an A6 booklet (hard copy and electronic)developed with young people providing a range of sexual health information

The Come Correct C-Card Scheme is a free condom distribution scheme for young people under 25 in Haringey and across London

A number of community pharmacies provide free Emergency Hormonal Contraception (EHC) to women under 25 in Haringey and can be accessed alongside chlamydia testing and Come Correct

Haringey's Clinical Commissioning Group commissions AQB Providers ( including the British Pregnancy Advisory Service, Marie Stopes and Pregnancy Advisory Service) to provide local termination of pregnancy services. The service can be accessed through self-referral or via GPs and other health services

Speakeasyis an accredited training course which enables parents and professionals to speak comfortably about sex and relationship issues

The Teens and Toddlers is a targeted youth development programme for pupils at risk in a number of targeted secondary schools

Sex and Relationships Education is provided in schools and is supported by the local Healthy Schools programme

2. Support available for teenage mothers and fathers

The Family Nurse Partnership is a programme providing intensive support for first time teenage mothers in Haringey. Clients must be referred before 28 weeks of pregnancy and support is provided until the child is 2 years of age

The Young Parents Team is a specialist midwives service at NHS Whittington Health Trust

Family support for teenage mothers and fathers is provided via the Common Assessment Framework

The Youth, Community and Participation Service in Haringey council provide targeted support for teenage mothers and fathers

Children's Centres offer support for teenage parents

Service users and carers opinion

The Haringey Sexual Health Needs Assessment 2009 (revised in 2010) ( see footnote 7)included interviews and focus groups from at risk groups. The following is synopsis of the findings and the participants' views and feedback of services:
1. Young mothers
They were very well informed about sexual health and were comfortable and familiar with accessing services in Haringey. They were the most satisfied with the services received from St. Ann's Clinic although the geographical location caused some difficulties.

Relationships with their own parents affect the choices that young women make about their own sexual and reproductive health. Some of the young mothers described how their inability to talk about sexual health with their parents negatively affected the choices they made. Young mothers suggested that Sex and Relationships Education (SRE) and especially education, information and advice on contraception should begin at an earlier age for school children.

Several young mothers saw prevention, especially through contraceptive provision testing for sexually transmitted infections (STIs), as the most important goal for sexual health services.

Some young mothers preferred to access pregnancy and antenatal services in GP settings rather than hospitals or clinics.

Young mothers stressed the importance of targeted advice and counselling for both women and men.
2. Young people in care and unaccompanied minors
Young people in care have a diverse range of sexual health needs and concerns. They listed STIs as their primary sexual health concern. Half of the young people in care had accessed services at St. Ann's Sexual Health Clinic, and many had also received sexual health services through GPs and the 4YP service. Most listed parents and siblings as important sources of advice and information for sexual health, despite the fact that they were living in care. Only one in five said that they would not talk to any family members about sexual health.

Incorrect information about some aspects of sexual health presented a barrier to accessing the appropriate services. This was especially the case around contraception, with several young people concerned that long term use of oral contraceptives or repeated use of EHC would likely cause infertility. There was also misinformation about HIV, with many young people believing that HIV was a "death sentence" and not knowing that advances in HIV treatment have dramatically extended the lives of people living with HIV.

Though half of the young people in care had accessed St. Ann's Sexual Health Centre, most felt the location was not convenient and this created a barrier to access for many young people. In addition to more clinics throughout the borough, young people in care were interested in seeing more sexual health services offered through GP practices in order to improve accessibility and convenience. Young people in care often lack the confidence to access sexual health services on their own. This barrier can be mediated by caseworkers who accompany young people to a clinic or GP appointments. However, when young people leave care the confidence issues may persist.

Confidentiality and anonymity were important to most young people in care. For some of them concerns about being recognised while accessing sexual health services presented barriers and made them uncomfortable going to sexual health clinics.
3. Young people
When asked what their main sexual health concerns were, young people ranked HIV testing as most important, with access to contraception and STI testing the other main concerns. Sex and relationship education is a major source of information and learning about sexual health. Friends were also listed as a major source of sexual health information, followed by family and public health information such as posters, leaflets and television advertisements.

Young people are familiar with Haringey's sexual health services and most in the interview sample had accessed clinics in the borough. Several of the young people described feeling intimidated or unwelcome at times when confronted with staff that they perceived as too busy or uncaring.

Though most of the young people interviewed displayed relatively high levels of awareness about sexual health issues and the services available in Haringey, several described low levels of awareness amongst their peers and young people in general.

Provision of contraception in educational settings was seen as an effective method of outreach and a convenient alternative to accessing clinics.

In 2009 Haringey commissioned the Schools Health Education Unit to undertake a Health Related Behaviour Survey ( see footnote 8). This included responses from over 1200 secondary age pupils in Year 8 and Year 10 from eight Haringey schools, including the Pupil Referral Unit.

72% of boys and 61% of girls had heard of the 4YP service. 25% of Year 10 boys had used it and found it useful.

62% of pupils said that their lessons on sex and relationships had been useful.

62% of pupils said they thought that condoms were reliable to stop pregnancy. 34% (53% Year 10 girls) said that the 'morning after pill' was reliable to stop pregnancy.

34% thought condoms would be reliable to stop infections like HIV.

16% of pupils said that they thought chlamydia can be treated and cured. 43% said either they have never heard of it or know nothing about it.

A Sex and Relationships Education Pupils Survey ( see footnote 9) was completed by 100 young people in 2008. All the pupils were elected members of their School Council and were spread across the 11 to 18 age range. Eight secondary schools participated in the survey.

We asked participants about the subjects they had learnt about. The most common five topics were human reproduction, puberty, sexually transmitted infections, peer pressure and contraception. When asked what they would like to learn about, the most important five topics were being a parent, self-awareness and emotional resilience, strategies for making choices, managing risk and assertiveness skills and same sex relationships. The emphasis on aspects of relationships issues and emotions reinforces the findings of the UK Youth Parliament Report 'Are You Getting It? (based on a survey of over 21,000 young people nationally)

We also asked students how they would like to learn. Interactive and participatory approaches came out top underlining the importance of making lessons active and varied in the style of delivery. The top preferred learning approaches were DVD/film, visiting speakers/experts, debate, discussion, theatre groups and TV programmes. Least popular were textbooks and worksheets.

67% of participants had heard about the 4YP Service and 55% had someone in school to ask for SRE help.

Expert opinion and evidence base

1. The Department of Health requested the National Institute for Health and Clinical Excellence (NICE) to produce public health guidance on the NHS provision of contraceptive services for socially disadvantaged young people up to the age of 25 ( see footnote 10). Draft guidance was issued in October 2010 for public consultation but a decision was subsequently made to end the consultation process. Although the guidance was never published a summary of the findings for effectiveness and cost effectiveness was released and is provided below.
Figure 7: Effectiveness and cost effectiveness of contraceptive services amongst socially disadvantaged young people. Source: NICE Strong evidence was found for:
i) Advanced supply of emergency hormonal contraception
Four randomised controlled trials support the advanced provision of EHC to adolescents to increase EHC use. In most cases increased use was not at the expense of other contraceptive use, and did not promote risky sexual behaviour; the exception was one study with adolescent mothers.

ii) Interventions to promote adolescent condom use
Five studies support interventions that combine discussion and demonstration of condom use to increase adolescent condom use and engagement with clinical services.

iii) School based health centres
Four papers support the direct provision of contraceptives dispensed on site from school based health centres as a way to increase contraceptive provision.

iv) Community outreach
Three studies suggest curriculum interventions that include community outreach components can be effective in preventing teenage pregnancy and risky sexual behaviour.

Moderate evidence was found for:

i) Outreach to existing mainstream services
Five studies suggest that outreach programmes may be effective in increasing service use, but the effect on reducing teenage pregnancy rates is unclear.

ii) Virtual world intervention
One study suggests that a virtual world intervention was effective when associated with a curriculum based intervention about sexual risk behaviour.

iii) Media based interventions:
Evidence for computer based interventions from one randomised control trail (RCT).

Weak evidence was found for:
i) Social marketing campaigns from two before and after studies.

Unclear evidence was found for:
i and ii) Interventions to prevent repeat pregnancy

There is inconsistent evidence from three RCTs for home visitor interventions. There is moderate evidence from one RCT for generic programmes for teenage mothers.

iii) Generic youth interventions
There is conflicting evidence from two studies suggesting that a generic youth programme run after school could be effective in preventing pregnancy, reducing sexual activity and improving contraceptive use.
Cost-effectiveness
The economic analysis indicates that, from a public sector perspective, the provision of contraceptives within schools is effective. Compared with no dispensing of contraceptives within schools it results in net cost savings. The analysis also suggests that dispensing hormonal contraceptives within schools is likely to be more effective for preventing pregnancies and may lead to greater cost savings than dispensing condoms within schools, although this comparison is subject to considerable uncertainty.

The economic analysis also suggests that, from a public sector perspective, intensive case management results in a cost per repeat teenage pregnancy averted of £4000 compared with no follow up after a teenage birth. Excluding government-funded benefits from the analysis leads to an estimated cost per repeat teenage pregnancy averted of £15,000.

Advanced provision of EHC is estimated to be more effective and less costly than no advanced provision of emergency EHC from a public sector perspective. The analysis suggests that the advanced provision of EHC is likely to remain cost saving from a public sector perspective when provided alongside the dispensing of contraceptives within schools.

2. The ten areas for action identified by the Teenage Pregnancy Unit's Self-Assessment Toolkit ( see footnote 11) supported local areas in monitoring and performance management of the their teenage pregnancy strategies to ensure actions were in line with the key guidance issued by central government to local authorities and primary care trusts (PCTs). The ten areas were:

a) Strategic leadership of the teenage pregnancy strategy

b) Detailed, accurate and up-to-date data and information

c) An effective media and communications strategy

d) Strong delivery of Sex and Relationship Education /Personal Social Health Education

e) Provision of young people focused contraception and sexual health services

f) Workforce training on teenage pregnancy and sex and relationship issues

g) Targeted work with at risk groups of young people

h) Work on raising aspirations

i) Work with parents/carers on preventing teenage pregnancy

j) Supporting teenage mothers and young fathers

Haringey adopted the ten areas in the redevelopment of its Teenage Pregnancy Prevention and Support Strategy and Action Plan in 2008

3. Teenage Pregnancy Strategy: Beyond 2010 ( see footnote 12)

Sets out the progress that has been made in reducing England's teenage pregnancy rate between 1998 and 2008 and presents a review of the evidence-base on what works in reducing teenage pregnancy rates, including examples of effective practice in local areas.

4. Teenage Pregnancy Independent Advisory Group final report ( see footnote 13)

Teenage Pregnancy: Past successes - future challenges is the final report from the Teenage Pregnancy Independent Advisory Group which for 10 years advised ministers on reducing teenage pregnancy and improving support for teenage parents. The report says that over the past decade there has been significant progress in reducing teenage pregnancy, but there have also been missed opportunities while England's under-18 pregnancy rate is currently at its lowest level for 20 years, it is still unacceptably high.

5. Getting maternity services right for pregnant teenagers and young fathers ( see footnote 14)

This guide was first produced in 2008 by the Department of Health. It was revised in 2009 with the help of the Fatherhood Institute, following feedback from midwives and other maternity workers who wanted more guidance on engaging young fathers.

6. Teenage parents: Who cares? A guide to commissioning and delivering maternity services for young parents ( see footnote 15)

The revised edition of this guide, published jointly by the Department of Health and the Royal College of Midwives contains practical pointers as to how commissioning and delivery of maternity services for young parents can be achieved, with case studies of successful services. It places renewed emphasis on multi-agency working in the commissioning and delivery of services.

7. Targeted youth support and teenage pregnancy - working together to reduce teenage pregnancy rates and support young parents ( see footnote 16)

The publication reports that local authorities that have reduced teenage conception rates have successfully developed strong, effective partnerships with health, education, social care and youth services.

8. Lead members for children's services briefing on teenage pregnancy ( see footnote 17)

This is a summary of key points in relation to progress in reducing teenage pregnancy rates; what works; and what action lead members in local authorities can take to challenge and support local teenage pregnancy strategies.

9. You're welcome quality criteria - making health services young people friendly ( see footnote 18)

This is Department of Health guidance to make health services young people-friendly.

10. Improving access to sexual health services for young people in further education settings ( see footnote 19)

Sets out the rationale for, and examples of good practice, in relation to the provision of contraceptive and sexual health in further education colleges.

11. Multi-agency working to support pregnant teenagers Department of Health ( see footnote 20)

This midwifery guide, jointly published by the Department of Health and the Royal College of Midwives, highlights effective practice on issues of confidentiality and sharing information about individual teenage mothers.

12. Teenage Parents Next Steps: Guidance for Local Authorities and Primary Care Trust on Improving Outcomes for Teenage Parents and their Children ( see footnote 21)

It describes the poor outcomes to which teenage parents are at risk and sets out measures that can be taken locally and what is being done nationally to improve these poor outcomes.

13. Teenage pregnancy next steps: Guidance for local authorities and primary care trusts on effective delivery of local strategies ( see footnote 22)

This guidance for councils and PCTs gives advice on what works in areas with declining rates and confirms the evidence base for reducing teenage pregnancies. It highlights seven key factors to help reduce rates including active engagement of mainstream delivery partners, a strong senior champion, accessible young people-centered contraceptive and sexual health advice services, and priority being given to developing comprehensive sex and relationship education programmes.

14. Teenage pregnancy: Accelerating the strategy to 2010 ( see footnote 23)
Accompanying guidance to Teenage pregnancy next steps, showing how local areas need to develop strategies taking account of what has worked in areas with rapidly declining rates.

15. Enabling young people to access contraceptive and sexual health information and advice ( see footnote 24)

This is guidance for Youth Support workers. Youth support workers can play a key role in helping young people develop the confidence and self-esteem to resist peer pressure to be sexually active until they feel ready to make safe and responsible choices.

16. Enabling young people to access contraceptive and sexual health information and advice ( see footnote 25)

This report provides the legal and policy framework for social workers, residential social workers, foster carers and other social care practitioners.

17. NICE One to one interventions to reduce the transmission of sexually transmitted infections (STIs) including HIV, and to reduce the rate of under-18 conceptions, especially among vulnerable and at risk groups ( see footnote 26)

Public health intervention guidance

18. Teenage Pregnancy and Parenthood: a review of reviews. Evidence Briefing, Health Development Agency ( see footnote 27)

A review of reviews about the prevention of teenage pregnancy and the effectiveness of interventions to improve outcomes.

18. Sure Start Plus national evaluation - final report ( see footnote 28)

An independent evaluation of the Sure Start Plus pilot programme aimed at supporting teenage parents.

19. Reaching out to pregnant teenagers and teenage parents ( see footnote 29)

This report provides briefings on innovative practice from the Sure Start Plus pilot programme including:

Briefing 1 - Long-term consequences of teenage births for parents and their children

Briefing 2 - Living on the Edge: Sexual behaviour and young parenthood in rural and seaside areas

Briefing 3 - The education of pregnant young women and young mothers in England

Briefing 4 - Protective and risk factors for early sexual activity and contraception use among black and minority ethnic adolescents in East London

Briefing 5 - Exploring the attitudes and behaviours of Bangladeshi, Indian and Jamaican young people in relation to reproductive and sexual health

Briefing 6 - An exploration of the teenage parenting experiences of black and minority ethnic young people in England

Briefing 7 - Teenage parenthood and social exclusion: A multi-method study

Briefing 8 - Consequences of teenage parenthood: Pathways which minimise the long-term negative impacts of teenage childbearing

20. Family Nurse Partnership: Developing an instrument for identification, assessment and recruitment of clients ( see footnote 30)

This publication reports on work that was commissioned in support of a proposal to pilot the Nurse-Family Partnership a model of intensive home visiting targeted at selected women and their partners having their first baby. The programme looked to reduce adverse outcomes and social exclusion for the children of these families. The research aimed to design an 'Instrument' that could be used to identify women eligible for the health-led parenting programme.

21. Early Intervention Findings from the C4EO research evidence ( see footnote 31)

The Teens and Toddlers projects in Birmingham and Manchester and the Westminster families Teens and Toddlers were identified as an effective early intervention programme including working families with multiple problems and looked after children and young people.

22. Positive for Youth ( see footnote 32)

The Government's Positive for Youth strategy includes the following objectives so that all young people:

receive the information, advice and support they need - from parents, teachers and other professionals - to deal with pressure to have sex; enjoy positive and caring relationships; and experience good sexual health; and

can access and know how to use contraception effectively when they do reach the stage that they become sexually active, so they can avoid unplanned pregnancies and sexually transmitted infections.

Projected service use in 3-5 years and 5-10 years

Haringey's population estimates and fertility rates identified in the JSNA Demographic section suggests that contraception and sexual health service use in 3-5 years and 5-10 years will increase.

Unmet needs and service gaps

The following were identified in the NICE draft guidance on NHS provision of contraceptive services for socially disadvantaged young people up to the age of 25 and are gaps in local service provision:

Advanced supply of Emergency Hormonal Contraception- identify opportunities for administration of advanced supply to high risk groups

Promotion of condoms - significantly increase take up of the free condom distribution scheme across young people aged 25 and under

School-based provision - reintroduce provision of school based contraception services (all these services ended by March 2011) and extend to other targeted secondary schools, including single sex secondary school

Community outreach - increase opportunities for contraception and sexual health services in community settings

Recommendations for consideration by commissioners

Evidence suggests that teenage pregnancy can be reduced by effective sex and relationship education (SRE) combined with easy access to contraceptive and sexual health services with additional support needed for young people most at risk.

Speakeasy Training. Sex and Relationships Education is the earliest possible intervention provided to children and young people that can impact on a conception not taking place, it is essential that training is available to parents/carers and professionals.

Free Emergency Hormonal Contraception for young women under 25. Emergency Hormonal Contraception is the last service that can impact on a conception not taking place, it is essential that it continues to be available and in pharmacies that young women can access easily, including increasing availability on Sundays as analysis of local use to date suggests that Mondays are the busiest days.

A comprehensive borough-wide free condom scheme for young people under 25.

A young people friendly, nurse led targeted community outreach service to include provision of Long Acting Reversible Contraception and other contraception and sexual health services, including post termination support, supply of Emergency Hormonal Contraception to be available in a range of school based and non-healthcare settings for young people under 25.

Teens and Toddlers targeted youth development programme for secondary pupils at risk of teenage pregnancy and becoming Not in Employment, Education and Training.

Recommendations for further needs assessments

1. Strengthening links with abortion providers and their commissioners (Clinical Commissioning Group) in order to reduce repeat terminations to young women under 25, including under18s following a termination.

2. Identify trends in repeat use of Emergency Hormonal Contraception in order to reveal more opportunities to support young women under 18 at risk of poor contraceptive use and sexual health and identify opportunities for advanced supply of Emergency Hormonal Contraception.

3. Identify trends in the uptake of Long Acting Reversible Contraception and condom use by young women under 25, including under 18s.

4. Strengthening links with GPs in order to increase access to contraception and sexual health services with GPs by under 18s.

Key Contact

Vivien Hanney - Teenage Pregnancy Coordinator.

Footnotes

1. Berrington, A., Diamond, I., Ingham, R., et al. (2005) Consequences of teenage parenthood: Pathways which minimise the long term negative impacts of teenage childbearing (external link - PDF, 348KB). Final report - Nov 2005

2. McGuire A and Hughes D. (1995). The Economics of Family Planning Services (London: FPA)

3. The Framework for Sexual Health Improvement in England , Department of Health (2013)

4. Teenage Pregnancy in England, by the Centre for Analysis of Youth Transition,Institute of Education, the Institute for Fiscal Studies, and the National Centre for Social Research, Crawford et al (2013)

5. Office for National Statistics (2012) Statistical Bulletin. Conceptions in England and Wales 2010 Under-18 conception

6. Department of Health, Abortions by PCT of residence

7. Department of Health, (2006) Teenage pregnancy: Accelerating the strategy to 2010

8. North London Client Caseload Information System (NCCIS) , (2012)

9. NHS Haringey (2009, revised 2010). Sexual Health Needs Assessment (external link)

10. London Borough of Haringey. (2009) Schools Health Education Unit , Every Child Matters, Health Related Behaviour Survey Summary Report (PDF: 193KB)

11. London Borough of Haringey. (2008) Sex and Relationships Education, Pupils Survey (PDF: 362KB)

12. National Institute of Health and Clinical Excellence (NICE). (2010) Draft guidance, NHS provision of contraceptive services for socially disadvantaged young people up to the age of 25 (external link - PDF, 368KB), NICE website

13. Teenage Pregnancy Unit (2009). Teenage pregnancy prevention and support: A self-assessment toolkit for local performance management (PDF 258KB)

14. Department for children, schools and families and the Department of Health. (2010) Teenage Pregnancy Strategy: Beyond 2010 (external link)

15. Teenage Pregnancy Independent Advisory Group. (2010). Teenage pregnancy: past successes - future challenges

16. Department for children, schools and families and the Department of Health. (2009). Getting Maternity Services right for pregnant teenagers and young fathers. 2nd edition

17. Department of Health and the Royal College of Midwives. (2009) Teenage parents: Who cares? A guide to commissioning and delivering maternity services for young parents (2nd edition)

18. Department of Education. (2008) Targeted youth support and teenage pregnancy - working together to reduce teenage pregnancy rates and support young parents (external link)

19. Department of Education. (2008) Lead members for children's services briefing on teenage pregnancy

20. Department of Health. (2007) You're welcome quality criteria - making health services young people friendly

21. Department of Health. (2007) Improving access to sexual health services for young people in further education settings

22. Department of Health. (Revised 2009) Getting maternity services right for pregnant teenagers and young fathers

23. Department for children, schools and families and the Department of Health. (2007). Teenage Parents Next Steps: Guidance for Local Authorities and Primary Care Trust on Improving Outcomes for Teenage Parents and their Children

24. Department for children, schools and families and the Department of Health. (2006) Teenage pregnancy next steps: Guidance for local authorities and primary care trusts on effective delivery of local strategies

25. Department of Education. (2006). Teenage pregnancy: Accelerating the strategy to 2010

26. Department of Education. (2005). Enabling young people to access contraceptive and sexual health information and advice

27. Department for Education and Skills and the Teenage Pregnancy Unit. (2004). Enabling young people to access contraceptive and sexual health information and advice

28. National Institute for Health and Clinical Excellence. (2007) One to one interventions to reduce the transmission of sexually transmitted infections (STIs) including HIV, and to reduce the rate of under-18 conceptions, especially among vulnerable and at risk groups

29. Health Development Agency. (2007) Evidence Briefing. Teenage Pregnancy and Parenthood: a review of reviews.

30. Social Science Research Unit, Institute of Education, University of London. (2005). Sure Start Plus national evaluation - final report

31. Department of Education. (2005) Reaching out to pregnant teenagers and teenage parents

32. Hall, David and Hall, Susan, Department for Children, Schools and Families (DCSF). (2007) Family Nurse Partnership: Developing an instrument for identification, assessment and recruitment of clients (external link)

33. Centre for Excellence in Outcomes. (2010) Early Intervention Findings from the C4EO research evidence (PDF 274KB external link).

34. Department of Education. (2011) Positive for Youth (external link)

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Teenage pregnancy (defined as under-18 conceptions including those leading to live births and terminations) and early parenthood are widely recognised to be associated with poor health and social exclusion. Having children at an early age can affect young women's health and wellbeing and can limit their education, career and economic prospects.

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You may be eligible for help with your learning costs if you're a full-time student with children. This is called Parents' Learning Allowance.

How much you get depends on your household income.

The allowance:

does not have to be paid back

is paid on top of your other student finance

will not affect your benefits or tax credit

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Parents' Learning Allowance for full-time students with children - funding, apply, eligibility.

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Why are we asking this now?

The case of Alfie Patten, said to have fathered a child at the age of 13 with a girl of 15, has reignited controversies over sex and morality education, with Conservative party leader David Cameron believing the case is evidence that his claim that Britain has become a "broken" society is right.

The case comes on top of the fact that statistics show that the UK has the highest percentage of teenage pregnancies in Western Europe - and is second only to the United States, according to figures compiled by the World Health Organisation.

What is the government's policy on sex education in schools?

A government review of how the subject is broached in schools recommends that sex education should be a compulsory part of the national curriculum in primary and secondary schools under a new curriculum to be introduced in September 2010. However, the plan has provoked controversy - particularly among faith-based groups. As a result, a new review led by a respected East London headteacher, Sir Alasdair MacDonald, will look at the question of whether there should be an opt-out clause for parents who do not want their children to take part in the lessons.

Why was this review necessary?

Because statistics - in the form of our teenage pregnancy rates - make it obvious that we have not been successful in delivering this in the past. Currently secondary schools only have to teach the mechanics of sex in biology classes and not in conjunction with relationships and sexual health. Most schools do teach personal, social and health education (PSHE) but it is not compulsory.

A recent survey of pupils showed that four in every 10 had received no sex education at school. Teaching of sex education in the UK also poses particular problems in faith schools. For instance, contraception, abortion and homosexuality are against the teachings of the Catholic faith and there has been some controversy within Catholic schools where diocese have issued edicts barring their schools from allowing pro-choice groups into schools to talk about abortion.

The Government, said Mr Knight, is planning supplementary guidance for faith schools indicating that they must teach all elements of the curriculum alongside Catholic values.

Why do we have the highest teenage pregnancy rate in western Europe?

Some would back David Cameron's "broken Britain" line - arguing that there has been a general reduction of family values with less emphasis on marriage and a growth in single parent families. Others would argue that today's youngsters have been subjected to "sexploitation" - both by the commercial world as witnessed in several reports, most notably the recent inquiry into childhood by the Children's Society which talked of advertisers aiming sexy clothing ads at an increasingly younger age group, and through the internet with a report last week claiming that "tens of thousands" of school and university websites worldwide had become affected by hardcore pornography. Dr Tanya Byron, the TV psychologist who conducted a review of internet use and video games for the Government, recommended that all schools should use an accredited service for their internet provision - which can have blocks put on it to bar hardcore porn from websites used by pupils.

How is the issue tackled in countries with lower teenage pregnancy rates?

The teenage pregnancy rate in Holland is only one-fifth as high as that of the UK - only five births per 1,000 teenagers compared to the UK's 27. Its abortion rate per teenage head of the population is also one of the lowest in Europe. The approach to sex education, though, in a country where pupils are as likely as not to walk through an authorised red-light district on their way to school is very different. Yes, children can discuss sex during their primary school years but it is discussed in an atmosphere of talking about relationships and caring and respect for others.

As Siebe Heutzepeter, headteacher of De Burght school in Amsterdam, puts it: "The English are embarrassed to talk about sex. They are too squeamish. Here adults and children are better educated. It would be unthinkable for a Dutch parent to withdraw their child from sex education. I have only had one Muslim mother who left halfway through a parents' talk on sex." He added: "There is no point in telling children just to say 'no' - this is a liberal country: you need to tell them why they are saying 'no' and when to say 'yes'.

Why is our sex education different?

The curriculum - even that proposed under the review - is more prescriptive. On the face of it, it looks as though it is presenting pupils with a number of facts rather than trying to encourage them to come to a deeper understanding of emotions. For instance, all children from the age of five will learn about body parts and animal reproduction, puberty and intercourse from the age of seven and pregnancy, contraception and safer sex from the age of 11 when they have transferred to secondary school. However, the new curriculum will attempt to stop sex education being consigned to biology lessons ("now we have naming of parts" as it is often caricatured) and ensure that children learn about relationships and the option of abstinence along with the facts of life.

Does that suggest a will to learn from countries like Holland?

In launching the review, Schools Minister Jim Knight was careful to refer to the need for "relationship education". One of the reasons why the subject has been so poorly delivered in the past has been because there are not enough teachers trained to deliver it. In a secondary school, in particular, it would not be a favoured option for most teachers to volunteer to deliver a class on sex education to youngsters approaching or in their teens. The government hopes to rectify this by providing and encouraging more teachers to become dedicated PSHE teachers by 2010.

Are the curriculum reforms likely to work?

That is hard to say. As educationists in Holland put it, it is as much about changing attitudes and culture in the UK as it is about developing lesson plans. Sanderjin van der Doef, an author of a series of books on sex education for use in Holland schools, says: "Here sex is a normal daily part of life, like shopping or football. In England it is a joke or a nudge."

An example of the polarisation of views on Britain's recognition as the teenage pregnancy capital of western Europe can be seen from comments placed on a newspaper website recently asking what age children should be taught the facts of life following the publication of the Government review of the subject.

"I think it is a terrible idea to teach sex education to children aged five. Giving sex lessons to innocent children destroys their childhood," said one contributor. This view was backed up by another who added: "Young uneducated unmarried girls are not having babies because of a lack of sex education." This was counteracted by another contributor who argued: "The Netherlands educates children about sex very early and has the lowest number of teenage pregnancies in Europe." Another added: "Children need facts, not ignorance."

Should the UK learn from other countries?

Yes

*Teenage pregnancy rates in the UK demand that we learn from those with much lower rates

*In the Netherlands, sex education is delivered in the context of learning about relationships not biology

*The UK does not have enough teachers trained in the delivery of the subject to teach it effectively

No

*It is not the business of schools to teach children about sex - it should be left to the parents.

*Lessons abroad touch on topics which would be viewed by some faith groups as inappropriate in class

*Better to educate parents about their responsibilities rather than change the curriculum

Reuse content

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The Big Question: Why are teenage pregnancy rates so high, and what

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Why are we asking this now? The case of Alfie Patten, said to have fathered a child at the age of 13 with a girl of 15, has reignited controversies over sex and morality education, with Conservative party leader David Cameron believing the case is evidence that his claim that Britain has become a "broken" society is right.

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How the UK halved its teenage pregnancy rate

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Political support at all levels, long-term commitment and changes to social norms behind success of public health strategy

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About this information

In this information, child means someone aged under 14 and young person means someone aged 14 or over but under 18. Parent means someone with parental responsibility.

Adoption

If you are under the age of 18, you can be adopted if you are not married or in a registered civil partnership. As a child, you will have little say over who adopts you, but you should be consulted by the adoption agency or social services department involved in the adoption.

If you are under 18, you have no legal right to know the identity of your birth parents. Once you reach 18, you have a right to apply to see your birth record and to use the Adoption Contact Register. The Register helps adopted people get contact details of birth relatives who have also registered.

To apply to the Adoption Contact Register, write to:-

In England and Wales

Adoptions Section
Room C201
The General Register Office
Trafalgar Road
Southport
PR8 2HH
Tel: 0151 471 4830 (9am to 5pm Monday to Friday)
Fax: 0151 471 4755
E-mail: adoptions@ons.gsi.gov.uk
Website: www.gro.gov.uk

In Northern Ireland

The General Register Office
Oxford House
49/55 Chichester Street
Belfast
BT1 4HL
Tel: 028 9025 2000
Website: www.groni.gov.uk

Changing your name

You cannot change your name until you are 16 years old. Between 16 and 18 you can complete a change of name deed with parental consent.

For more information about changing your name,see Change of name

Local authority care

You can only be taken into care if you are under 18 and the local authority has obtained a court order. You have a right to know why you are in care, under what law, and how long you are likely to remain there.

You can be accommodated by a local authority without a court order if a parent requests it or gives permission. However, the local authority must take your wishes into account. Further information may be available from the Who Cares Trust (see under heading Further help).

For more information about care and what to do if things go wrong whilst you're in care, see Children and local authority care.

Marriage

If you are under 16 and marry, it will not be legal unless your marriage took place in a country with a lower marriage age limit than 16.

If you are 16 or 17 you cannot marry without parental consent. Both parents with parental responsibility must give parental consent. In some circumstances, other people may give parental consent. In Northern Ireland a young person under 18 cannot marry without the consent of certain people.

If they refuse permission, in England and Wales you can apply to the Family Court for permission to marry. In Northern Ireland you apply to the County Court.

Anyone aged 18 or over can be married without parental permission.

In England and Wales, both opposite sex and same sex couples can get married. For more information on marriage, see Getting married.

In Northern Ireland, although two people of the same sex cannot get married, they can register a civil partnership - see under heading Civil partnerships.

Civil partnerships

A civil partnership is a legal relationship which can be registered by two people of the same sex. If you are in a gay or lesbian relationship, registering a civil partnership will give your relationship legal recognition. This will give you added legal rights, as well as responsibilities.

You are not allowed to register a civil partnership if one of you is under 16. If you are a young person of 16 or 17 who wants to register a civil partnership, you may only do this with the consent of your parents.

Anyone aged 18 or over can register a civil partnership without parental permission.

For more information about registering a civil partnership, in England and Wales see Registering a civil partnership.

Parents aged under 16

Mothers aged under 16

If you are under 16 and have a baby, you have the same legal rights and responsibilities towards the child as any mother.

Benefits and Tax Credits

If you live with your parents and they are claiming Child Tax Credit, both you and your child can be included in the claim. Your parents may also be able to claim a Social Fund Maternity Grant for you and your child. If they are claiming Housing Benefit, they can include you and your child in their claim.

For information on Housing Benefit, see Help with your rent - Housing Benefit.

As a young mother, you can claim Child Benefit once the baby is born.

Benefit claims in these circumstances can be complicated and you or a parent should seek advice from an experienced adviser, for example, at a Citizens Advice Bureau. To search for details of your nearest CAB, including those that can give advice by e-mail, click on nearest CAB.

Vouchers for free milk, fruit and vegetables

If you are at least ten weeks pregnant, your parents can get vouchers for free milk, fruit and vegetables for you. It doesn't matter what their income is.

Once you've had the baby, your parents can continue to get vouchers for you only if they get:

Income Support

income-based Jobseeker's Allowance

income-related Employment and Support Allowance

Child Tax Credit and have an annual income below a certain amount.

For more information on benefits for maternity and children, see Benefits for families and children.

Education

Local education authorities have a duty to ensure that all children under 16 receive an education. They still have this duty to you, even if you become a mother.

For more information, see Problems at school.

Housing

As a young mother you will not normally be able to obtain privately rented or council accommodation because you are too young to be granted a tenancy. However, you can contact the local authority social services department and ask it to find you accommodation, as long as your parents agree.

For more information, see Local authority services for children in need.

If you have housing problems you should consult an experienced adviser, for example, at a Citizens Advice Bureau. To search for details of your nearest CAB, including those that can give advice by email, click on nearest CAB.

Child maintenance

The Child Maintenance Service could arrange for the father of your child to pay maintenance. This applies if you aren't living with him.

For more information, see Child maintenance - where to start, or visit the website of Child Maintenance Options, at: www.cmoptions.org.

Fathers aged under 16

As a father aged under 16, you may want to have a formal relationship with your child by applying for a parental responsibility agreement, and or a child arrangements order

If as a young father you need to seek advice about applying for a parental responsibility agreement, you should consult an experienced adviser, for example, at a Citizens Advice Bureau. To search for details of your nearest CAB, including those that can give advice by email, click on nearest CAB.

Child maintenance

If you are aged under 16 and father a child, the Child Maintenance Service can expect you to pay maintenance for the child. Once the Agency is satisfied that you are the father, you will be expected to make maintenance payments when you begin earning or receiving a benefit.

For more information, see Child maintenance - where to start, or visit the website of Child Maintenance Options, at: www.cmoptions.org.

Wills

If you are under 18, you cannot make a valid will unless you are in the armed forces or a seafarer. No one under the age of 18 can act as a trustee, executor or administrator of a will.

Further help

The Office of the Children's Commissioner for England

33 Greycoat Street
London
SW1P 2QF

Tel: 020 7783 8330
Fax: 020 7931 7544
E-mail: info.request@childrenscommissioner.gsi.gov.uk
Website: www.childrenscommissioner.gov.uk

The Office of the Children's Commissioner for England looks after the interests and acts as the independent voice of children and young people.

Children's Commissioner for Wales

Freephone

Tel: 0800 801 1000 (Mon-Fri 9.00am -5.00pm)
Textphone: 80800 and start the message with COM
E-mail: advice@childcomwales.org.uk

South Wales Office

Oystermouth House
Phoenix Way
Llansamlet
Swansea
SA7 9FS
Tel: 01792 765600
Fax:01792 765601
E-mail: post@childcomwales.org.uk
Website: www.childcom.org.uk

North Wales Office

Penrhos Manor
Oak Drive
Colwyn Bay
Conwy
LL29 7YW
Tel: 01492 523333
Fax: 01492 523336

The Children's Commissioner for Wales can give children and young people living in Wales advice about their rights and welfare. The Commissioner can also help you make a complaint about your treatment if you are using the usual complaints procedure of an institution such as a school, care home or social services department. If your complaint is unsuccessful, the Commissioner may be able to carry out a separate investigation.

The Children's Commissioner also has powers to take action over 'whistleblowing'. 'Whistleblowing', in this case, is where an employee of an organisation for children and young people raises concerns that the organisation is acting against the interests of children in its care.

Children can use the special freephone and freetext numbers to contact the Commissioner, which won't show up on any phone bill. There's also a special email address for children to use. The service is bilingual and if you want to talk to someone in a language other than English or Welsh, they will try to make this possible.

Coram Children's Legal Centre (CCLC) (England only)

The CCLC offers free legal information and advice on child, family and education law in England to children, young people, their families, carers and professionals. You can download free fact sheets from its website at www.childrenslegalcentre.com or telephone its legal advice lines:

child and family law: 0300 330 5480

education law: 0300 330 5485

Lesbian and Gay Switchboards

There are a number of regional switchboards nationwide which supply information for gay men and lesbians and which can put you in touch with organisations providing counselling and support. To find details of your local switchboard, visit www.queery.org.uk, or phone the London Lesbian and Gay Switchboard 24-hour helpline (see below).

London Lesbian and Gay Switchboard

London Lesbian and Gay Switchboard
PO Box 7324
London
N1 9QS
Tel: 020 7837 7324 (24-hour helpline)
Website: www.llgs.org.uk

The London Lesbian and Gay Switchboard provides an information, support and referral service for lesbians, gay men and bisexual people from all backgrounds throughout the UK.

Who Cares Trust

Kemp House
152-160 City Road
London
EC1V 2NP
Tel: 020 7251 3117 (admin)
Email: mailbox@thewhocarestrust.org.uk
Website: www.thewhocarestrust.org.uk

The Trust provides information and advice for young people in care or those who have recently left care.

Meic - in Wales

Phone 080880 23456
SMS txt: 84001
E-mail: help@meiccymru.org
IM/webchat: www.meiccymru.org

Meic is an information, advice and support helpline for young people in Wales. A trained adviser will give you information, or signpost you to someone who can help you more. They're open 24 hours a day, 7 days a week.

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In this information, child means someone aged under 14 and young person means someone aged 14 or over but under 18. Parent means someone with parental responsibility. If you are under the age of 18, you can be adopted if you are not married or in a registered civil partnership.

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General Bodily Changes Contraception Sexually Transmitted Infections Gender Helplines Parenting Relationships Sexual Intercourse Sexuality Sex and relationships education

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The UK continues to have the highest teenage birth rates in Western Europe, figures published by the Office for National Statistics reveal.

Data for birth rates across the 28 countries of the European Union in 2014 show the UK had lower rates than just Bulgaria, Romania, Slovakia, Hungary and Latvia.

The rate for the UK in 2014 was 6.8 per 1,000 15-17-year-olds, compared to 1.1 in Denmark and 1.3 in the Netherlands.

Sexual health charity FPA's Head of Programmes Paul Casey said the figures are a stark reminder of how much work still needs to be done.

"We have a record low level of teenage pregnancies but still lag behind most countries in Europe," he said.

"Of course not all teenage pregnancies are unplanned or unwanted but teenagers who become parents are more likely to have poorer health, education, social and economic outcomes.

"International evidence shows the many benefits of sex and relationships education (SRE), including in reducing unplanned pregnancies.

"There is overwhelming support from young people, parents and teachers in the UK for the Government to introduce statutory SRE, but so far these calls have been ignored.

"As well as high-quality education, it is vital young people can access sexual and reproductive health information and support services. At a time when local authorities have to work with shrinking public health budgets, we must ensure this remains a priority."

How the UK compares to the rest of the European Union
Live births per 1,000 women aged 15 to 17 in EU28 countries, 2014
Source: Office for National Statistics, including Eurostat data

-ENDS-

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UK has highest teenage birth rates in Western Europe

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The UK continues to have the highest teenage birth rates in Western Europe, figures published by the Office for National Statistics reveal. Data for birth rates across the 28 countries of the European Union in 2014 show the UK had lower rates than just Bulgaria, Romania, Slovakia, Hungary and Latvia.

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Teenage pregnancies

The drop in teenage pregnancies has been accompanied by evidence of decreases in other traditionally risky behaviours such as drinking and drug taking.

Children's charities and experts have repeatedly warned that the explosion of social media is exposing young people to new dangers from online bullying to "sexting" and sexual exploitation by strangers.

But the new figures suggest that the change in how teenagers conduct their social lives could also be helping make them safer.

* Whatever happened to feckless youth? Young people more cultured than ever

Overall 22,653 girls under 18 got pregnant in England and Wales in 2014 - a drop of almost seven per cent in a single year. Among under-16s it fell by 10 per cent in the same period.

The rate of conceptions among under-18s dropped from 41.6 per 1,000 girls in the age-group in 2007 to 22.9 per 1,000 in 2014.

Prof David Paton, an economist at Nottingham University Business School - who was among the first to suggest a social media effect on pregnancies - said it was striking that a similar pattern is emerging in other countries such as New Zealand.

"It does potentially fit in terms of timing," he said.

"Rather than sitting at bus stops with a bottle of vodka they are doing it remotely with their friends."

"People [appear to be] spending time at home - rather than sitting at bus stops with a bottle of vodka they are doing it remotely with their friends."

He argued that better access to contraception could not explain the fall as it coincides with cuts to sexual health services in many areas amid a period of major austerity.

One other possibility, he said, was that major improvements in schools in areas such as London around the same time might have played a part.

But he added: "Nobody really knows why we've got this sudden change around about 2007 to 2008."

Meanwhile the number of pregnancies among older women rose, continuing a long-term trend towards later motherhood.

Notably, the figures also show that 7.8 per cent of pregnancies involving married women ended in an abortion - the highest level for 12 years.

Yet among unmarried women the abortion rate fell slightly from 31.2 per cent of conceptions to 31 per cent.

Clare Murphy, director of external affairs at the abortion provider British Pregnancy Advisory Service (Bpas) said access to contraception and sex education had "undoubtedly" played a part in the declining teenage pregnancy rate but she agreed with Prof Paton's suggestion of a social media effect.

"The plummeting level of teenage drinking, for example, may be reducing the likelihood of unprotected sex, and teenagers are also increasingly socialising online, limiting the opportunities for sexual activity," she said.

She added: "As we have seen decreases in conception rates among the under-25s, the largest rise was for women aged 35-39 (a percentage increase of 2.3 per cent).

"Women are increasingly being chivvied about starting their families in their 20s, but the reality is many will wait until their 30s to do so.

"The reasons for this are diverse and will include the time it takes to obtain financial and career security, and not least finding the right person to embark on parenthood with.

"Rather than chastising women, we should support their choices.

"There may be some increased risks with later motherhood, but these need to be kept well in perspective, and women respected as the best judges of when it is best for them to have children."

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How teenage pregnancy collapsed after birth of social media

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Teenage pregnancies The drop in teenage pregnancies has been accompanied by evidence of decreases in other traditionally risky behaviours such as drinking and drug taking. Children's charities and experts have repeatedly warned that the explosion of social media is exposing young people to new dangers from online bullying to "sexting" and sexual exploitation by strangers.

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The problems of teenage pregnancy in the UK and some solutions

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The problems of teenage pregnancy in the UK and some solutions