Teenage pregnancy and reproductive health: consensus views

Baker, Phil, Guthrie, Kate, Hutchinson, Cindy , Kane, Ros and Wellings, Kaye (2007) Teenage pregnancy and reproductive health: consensus views. In: Teenage pregnancy and reproductive health. RCOG Press, pp. 305-308. ISBN 9781904752387

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Descriptive research
1.There is an urgent need for comparative, up-to-date, age-specific data on conceptions, births and abortions from European and other developed countries, disaggregated by ethnicity, socio-economic status and marital/cohabitation status.

Research aimed at improving young women and men's sexual health
1.Insights into young people's attitudes to contraceptive and sexual health services - including barriers to use and how they might be removed – should be obtained to inform public education campaigns and commissioning of services.
2. Greater understanding is needed of the perceived risks associated with various contraceptive methods, and their influence on decision making. Interventions to improve effective contraceptive decisions need to be developed.
3.The impact on practitioners and young people of public health strategies seeking to encourage delay in onset of sexual activity needs to be assessed. Rigorous evaluation is needed of the impact on teenage pregnancy of school- based programmes aimed at raising career and life aspirations.
4.Research is needed into the norms and aspirations of young men and the social influences on these, with a view to guiding interventions aimed at helping them develop the competence and confidence to form mutually respectful relationships.
5. Local needs assessments should be carried out to develop culture- and faith-sensitive sexual health services and programmes, and their feasibility, transferability and effectiveness should be evaluated.

Research aimed at supporting teenage parents
1.The government should identify and resolve any contradictory policies that obstruct young parents being able to engage in learning.
2.Research is required to identify and evaluate the best methods for supporting young parents to maximise their social wellbeing and health and that of their children.

Research aimed at determining the specific effects of maternal age on health outcomes for mother and child
1.Research is needed to explore the independent impact of young maternal age on adverse health outcomes (e.g. low birthweight, prematurity, infant mortality and maternal health), using designs capable of dealing with confounding factors.
2.The effects of becoming pregnant at a very young age (e.g. before 16 years) for both mother and baby need to be explored using large multicentre studies.


Policies aimed at preventing unplanned teenage pregnancy
1.The government should continue to prioritise teenage pregnancy to ensure that the progress of the Teenage Pregnancy Strategy is accelerated to 2010. The public service agreement (PSA) should remain jointly held by the Department for Education and Skills (DfES) and the Department of Health (DH) and be retained in the next comprehensive spending review.
2.Research findings should inform forthcoming revisions of the strategy to support teenage parents, referenced in Teenage Pregnancy: Accelerating the Strategy to 2010 .
3.Factors contributing to the success of some areas in reducing teenage pregnancy rates should be incorporated, where feasible, in others areas. Further evaluation, and monitoring of these areas should be undertaken through performance management arrangements of the DfES and the DH, _ with a close focus on areas at risk of failing to meet their 2010 target.
4.Local data on teenage conceptions should be used in commissioning by Children's Trusts to ensure effective and targeted delivery of teenage pregnancy strategies. Primary care trusts should be actively involved.
5.National and local implementation of the Teenage Pregnancy Strategy must link to policies and programmes addressing the underlying causes of early pregnancy: socio-economic inequalities, poor educational attainment, and low self-esteem and aspirations.
6.Policies and interventions, including Sex and Relationship Education (SRE), aimed at reducing teenage pregnancy and supporting teenage parents should be developed and implemented in a context of respect for young people, an acceptance of teenage sexuality, and the promotion of responsible and mutually consensual relationships.
7.Strategies to reduce teenage pregnancy must continue to be universally targeted, but efforts should be strengthened among groups and in areas in which risk is higher. The focus should be on risky situations, rather than risky individuals.
8.All individuals working with children and young people should be trained and equipped with the knowledge and skills to address issues of health and emotional wellbeing.
9.The health of children and young people should be prioritised in the NHS and the revised Quality and Outcomes Framework to ensure the provision of accessible young-people-centred services that include contraception and sexual health.
10. Health promotion and ill-health prevention should be incentivised to ensure delivery in a healthcare system driven by payment by results (PbR).
11.Personal, Social and Health Education (PSHE), which includes SRE, should be made a statutory foundation subject in schools at all stages of education, starting at 4 years until 18 years, and based on the features of good SRE identified by pupils and research.
12.Ofsted inspections should include provision of PSHE as part of a school's requirement to meet the Every Child Matters five outcomes, and should ensure that PSHE provision meets the Qualification and Curriculum Authority (QCA) end of Key Stage assessments and the needs of pupils.

Policies aimed at supporting teenage parents
1.Revisions of the Teenage Pregnancy Strategy to support teenage parents should focus on improving outcomes for teenage parents and their children, and the most crucial of these should be measured in order to assess improvement. The current target of 60 % of 16- to 19-year-old mothers in education, training or employment should be modified such that reference is to those mothers with a child over the age of 1 year.


Prevention of teenage pregnancy
1.Both single and mixed gender SRE work should be offered in both schools and community settings.
2. Following evaluation of the Young People Development Pilots (March 2007), areas should commission personal development programmes for young people most at risk of teenage pregnancy.
3.The tension between the principle of confidentiality vital to delivery of effective services to young people and the duty of professionals to safeguard their physical and emotional wellbeing needs to be carefully managed. Information sharing between key agencies such as social services and the police is unavoidable. Multi-agency training is needed to increase the confidence of professionals to work across agencies.
4. Youth-friendly contraceptive services which meet the DH ‘You're Welcome' quality criteria should be universally available to all young people, with targeted work to ensure teenagers at greatest risk have services they trust and can access easily.
5.•Local areas should explore, with young people, innovative ways of providing services that are less medicalised and more in keeping with their lifestyles, for example, condom schemes in leisure settings and drop-in services in high street stores.
6. Healthy Schools, Extended Schools and colleges of further education (FE) should include on-site access to contraceptive and sexual health advice, as part of generic health advice services.

Support of young parents and their children
1.Early access to a ‘teen-focused’ maternity healthcare package should be provided to ensure earlier access to medical and midwifery care.
2. Maternity services aimed at the young should be staffed by midwives and healthcare professionals specially trained to avoid judgemental and stigmatising attitudes.
3.To prevent unplanned repeat pregnancies, help should be given to all teenagers who have been pregnant to choose and use an effective method of contraception.
4.Every pregnant teenager, teenage mother and teenage father should have access to a dedicated personal adviser provided through Children’s Trusts. Individual needs should be assessed and a package of support coordinated, linked to specialist education, health and housing services, and continued until the young person is able to conduct his or her affairs independently. To ensure continuity of care, maternity services should provide advisers with details of teenage parents (with their consent).
5.Increased attention should be given to the development and evaluation of programmes that enable young parents to continue education and career development. The Care to Learn childcare programme should continue to be evaluated to ensure it addresses any barriers to learning.
6.Agencies working with teenage parents and their babies should identify housing difficulties and ensure contact with appropriate local social, housing or teenage parent support services that may offer assistance.
7.Flexible childcare provision should be available for school-age parents and those in their late teens and early 20s to ensure full participation in education and to mitigate social isolation and depression.

Keywords:National teenage pregnancy strategy, Teenage conception, Teenage pregnancy, Teenage relationships, bmjopen
Subjects:A Medicine and Dentistry > A900 Others in Medicine and Dentistry
A Medicine and Dentistry > A990 Medicine and Dentistry not elsewhere classified
Divisions:College of Social Science > School of Health & Social Care
Relation typeTarget identifier
ID Code:11985
Deposited On:07 Oct 2013 08:53

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