Preventing teenage pregnancy
- Department of Child Health and Department of Public Health Medicine, North and East Devon Health, University of Exeter Postgraduate Medical School, Exeter
- Dr J H Tripp, University of Exeter, Postgraduate Medical School, Church Lane, Exeter EX2 5SQ.
Preventing unwanted pregnancy in teenagers has become a high priority for health care purchasers and providers. The publication of the White Paper ‘Health of the Nation’ raised the profile of teenage pregnancy by selecting pregnancy in under-16s as a target area.1 Although the rate of pregnancy in teenagers had been falling recently in the United Kingdom, it has recently risen; we still have a higher teenage fertility rate than most other European Community countries.2 The UK government has recently announced the possibility of an initiative to target high risk girls (school under achievers) for specialist attention (by mentoring) in relation to sex education. There is no evidence that such programmes have been effective. While the overall aim of programmes is to prevent all unwanted pregnancies, even for wanted pregnancies babies born of teenagers are more likely to be premature, small for gestational age, or have a low birth weight.3 The proportion of adolescents who have first intercourse under the age of 16 has increased at least over the last half of this century.4 Non-users of contraception are unlikely to be in a steady relationship and tend to have more sexual partners.5 Once established, this pattern of behaviour appears to last into adulthood.4 Teenage pregnancy is more common in deprived areas, and in cities as opposed to rural areas. The outcome of pregnancy for teenagers in cities is more likely to be a maternity than an abortion.6 The outcome of the pregnancy is also associated with socioeconomic deprivation (in terms of educational attainment, social class, housing tenure, and access to cars), with girls from the less socioeconomically disadvantaged groups being more likely to opt for an abortion,7 8 possibly because of social or parental pressures. The stability of the relationship with …