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Teenage pregnancies hit record low, reflecting efforts of England’s strategy to reduce under-18 conceptions

Rates of teenage pregnancy in England have halved since the implementation of the Government’s Teenage Pregnancy Strategy (TPS) in 1999, and the greatest effect is seen in areas of high deprivation and areas that received the most TPS funding, according to research published in The Lancet.

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

The study shows that participation in education and work has improved for women who conceive under the age of 18, but rates of participation still remain lower than their non-pregnant peers.

“England’s under-18 conception rate has fallen to its lowest level since the 1970s”, says lead author Professor Kaye Wellings at the London School of Hygiene & Tropical Medicine, London, UK. “What’s more, progress has been made towards halting the cycle of inequality that has long been associated with teenage pregnancy.”1

The strategy had several components including providing high-quality sex and relationships education, youth friendly contraceptive services, support for young parents to take part in education, employment, and training and coordinated action, at government and local level. Local implementation grants were allocated according to teenage pregnancy rates in each area.

This observational study reports the long-term independent evaluation of the strategy by a team of researchers at the London School of Hygiene & Tropical Medicine and University College London, UK. The team used data from 148 local authority areas in England to model changes in under-18 conceptions, abortions, and birth rates in relation to TPS funding, deprivation, and region between the 5-year periods immediately before (1994-1998), and after (2009-2013), implementation of the strategy. They also used data from the National Surveys of Sexual Attitudes and Lifestyles (Natsal) to assess changes in factors associated with under-18 conception between the periods of fieldwork for Natsal-2 (1999-2001) and Natsal-3 (2010-12). The researchers also assessed changes in young mothers’ participation in education, work, and training over the period.

Their findings show that, from its peak in 1998, the under-18 conception rate showed a moderate decline until 2006, when it fell more sharply (figure 1). Between 1998 and 2013 the conception rate dropped from approximately 47 to fewer than 25 conceptions per 1000 young women aged 15-17 years. The most deprived areas and those where more strategy-related resources were targeted had higher under-18 conception rates before the TPS was implemented and experienced greater declines (figure 2). Between 1998 and 2013, the conception rate dropped by 34 conceptions per 1000 young women aged 15-17 (approx. 65 to 31 per 1000) in areas receiving the highest TPS funding, compared with just 16 per 1000 in areas with the lowest level of funding (approx. 36 to 20 per 1000).