Teenage conceptions, abortions and births in England, 1994–2003, and the national teenage pregnancy strategy

Wilkinson, Paul and French, Rebecca and Kane, Ros and Lachowycz, Kate and Stephenson, Judith and Grundy, Chris and Jacklin, Paul and Kingori, Patricia and Stevens, Maryjane and Wellings, Kaye (2006) Teenage conceptions, abortions and births in England, 1994–2003, and the national teenage pregnancy strategy. The Lancet, 368 (9550). pp. 1879-1886. ISSN 0140-6736

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Teenage conceptions, abortions, and births in England, 1994–2003, and the national teenage pregnancy strategy
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Official URL: http://dx.doi.org/10.1016/S0140-6736(06)69777-8

Abstract

Summary
Background The aim of this study was to quantify the change in the number of conceptions and abortions among
women younger than 18 years in England in relation to the government’s national teenage pregnancy strategy.
Methods We undertook geographic analysis of data for 148 top-tier local authority areas. The main outcomes were
changes in under-18 conceptions, abortions, and births between the 5-year period before implementation of the
strategy (1994–98) and the period immediately after implementation (1999–2003).
Findings The number of teenage conceptions peaked in 1998, then declined after the implementation in 1999 of the
teenage pregnancy strategy. Under-18 conception rates fell by an average of 2·0% (95% CI 1·8 to 2·2) per year
between 1998 and 2003, below the rate needed to achieve the target of 50% reduction by 2010. The net change
between 1994–98 and 1999–2003 was a fall in conceptions of 3·2% (2·6 to 3·9) or 1·4 per 1000 women aged
15–17 years, a rise in abortions of 7·5% (6·5 to 8·6) or 1·4 per 1000, and a fall in births of 10·6% (9·9 to 11·3) or
2·8 per 1000. The change in the number of conceptions was greater in deprived and more rural areas, and in those
with lower educational attainment. The change was greater in areas where services and access to them were poorer,
but greater where more strategy-related resources had been targeted.
Interpretation The decline in under-18 conception and birth rates since 1998 and evidence that the declines have
been greatest in areas receiving higher amounts of strategy-related funding provides limited evidence of the eff ect of
England’s national teenage pregnancy strategy. The full eff ect of local prevention will be clear only with longer
observation, and substantial further progress is needed to remedy England’s historically poor international position
in teenage conceptions.

Item Type:Article
Additional Information:Summary Background The aim of this study was to quantify the change in the number of conceptions and abortions among women younger than 18 years in England in relation to the government’s national teenage pregnancy strategy. Methods We undertook geographic analysis of data for 148 top-tier local authority areas. The main outcomes were changes in under-18 conceptions, abortions, and births between the 5-year period before implementation of the strategy (1994–98) and the period immediately after implementation (1999–2003). Findings The number of teenage conceptions peaked in 1998, then declined after the implementation in 1999 of the teenage pregnancy strategy. Under-18 conception rates fell by an average of 2·0% (95% CI 1·8 to 2·2) per year between 1998 and 2003, below the rate needed to achieve the target of 50% reduction by 2010. The net change between 1994–98 and 1999–2003 was a fall in conceptions of 3·2% (2·6 to 3·9) or 1·4 per 1000 women aged 15–17 years, a rise in abortions of 7·5% (6·5 to 8·6) or 1·4 per 1000, and a fall in births of 10·6% (9·9 to 11·3) or 2·8 per 1000. The change in the number of conceptions was greater in deprived and more rural areas, and in those with lower educational attainment. The change was greater in areas where services and access to them were poorer, but greater where more strategy-related resources had been targeted. Interpretation The decline in under-18 conception and birth rates since 1998 and evidence that the declines have been greatest in areas receiving higher amounts of strategy-related funding provides limited evidence of the eff ect of England’s national teenage pregnancy strategy. The full eff ect of local prevention will be clear only with longer observation, and substantial further progress is needed to remedy England’s historically poor international position in teenage conceptions.
Keywords:Teenage pregnancy, strategy, evaluation, Teenage conception, Abortion, National teenage pregnancy strategy
Subjects:A Medicine and Dentistry > A990 Medicine and Dentistry not elsewhere classified
Divisions:College of Social Science > School of Health & Social Care
ID Code:1894
Deposited By: Ros Kane
Deposited On:09 Jul 2009 15:47
Last Modified:13 Mar 2013 08:32

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