The UK has the unenviable distinction of having the highest teenage pregnancy rate in Western Europe. Each year in the UK around 56,000 babies are born to teenage mothers - of these nearly 8,000 are to girls under 16 and 2,200 to under 14-year-olds - with women in deprived areas six times more likely to be pregnant before the age of 20 than those from the most affluent areas.

Our rates are twice those of Germany and six times those of the Netherlands, and while the trend in Europe is for declining numbers of teenage pregnancies, the UK rate has remained stubbornly static since the late 1970s.

The social exclusion unit’s report on teenage pregnancy prompted the government to pledge to halve the number of pregnancies among under-18s by 2010; and encourage more teenage parents into education, training or employment to reduce their risk of long-term social exclusion.

The report also included a 30-point action plan, including the creation of Sure Start Plus (SSP), a new programme that forms part of the teenage pregnancy strategy.

Sure Start Plus is a five-year pilot based in 20 areas around the UK. Launched in April 2001, it aims to address the personal and social consequences of teenage pregnancy and tackle social exclusion among pregnant teenagers and their families. The pilots are based in areas where there are high rates of teenage pregnancy, where there is an existing Sure Start programme and a health action zone.

SSP projects offer teenagers counselling on options for those who are newly pregnant. It also encourages teenage mothers to return to education or employment after the birth and can arrange a package of support to help them overcome the barriers to getting back to school, college or a job. It provides information and practical help on health for mother, father, and baby during and after pregnancy, and advice on contraception.

Mandy Jarvis is personal adviser with the Leicester Sure Start Plus project which is run by Connexions. She is one of a team that also includes a consultant midwife and midwifery educator who together educate midwives and work with pregnant teenagers to improve their experience of pre- and postnatal services. Also on the staff is a reintegration worker who works with teenage mothers to help them get back into education or training, and a young parent representative.

Mandy’s role is to offer support and guidance to young parents and pregnant women under 18 and those who work with them, and she spends a lot of time working with other professionals who advise young people to bring them up to speed on what young mothers and young pregnant woman want, and the work SSP is doing.

Young people can get one to one emotional support, or use the weekly drop-in centre for young parents and pregnant teenagers and they can also get advice on pregnancy and contraception. Pregnant women are supported whether they decide to continue with their pregnancy or not.

"My priority is to ensure we have young people at the heart of what we are doing and to find out what they want from SSP," she says. "Some professionals tend to look down their noses at young mothers and make assumptions about their lives; for example that their own childhood hasn’t been great. They may also wrongly assume that they are not going to make very good parents."

Her view is supported by Demelza Hall, Leicester SSP’s young parent representative and herself a young mother with an 18-month-old daughter. "In my experience and that of my friends and the people I work with, the first thing young parents have to deal with is finding somewhere to live, and making sure they have enough money and the things they need for their baby.

"Many of them, however, encounter prejudice. The whole reason I got into this was because when I had my daughter I encountered prejudice - a smartly dressed man tutted at me when I was walking down the road with my daughter. Sometimes teenagers are not given information about the pregnancy and they are not given options about pain relief during the birth. It’s a prejudice that is invisible and acceptable, unlike racism or sexism," she says.

"It’s important to expose the whole myth about young women getting pregnant to get benefits and access to a council house - nobody would want to live on £80 a week in a council house," she says.

Jarvis and Hall are currently working on a peer research project and have recruited 10 peer researchers, all of them young parents who have had bad experiences when using health, housing and the benefits system. They will be interviewing 100 young parents about what they want and need and the results will be used to tell the different agencies how they need to shape their services.

Jarvis is working with a caseload of 20 young people and the emphasis is very much on helping them get back into education, training or work. She feels that the timescales are sometimes unrealistic and put too much pressure on young parents. "The majority of the young people I work with are keen to get back to school or training, but not after three months, which is the aim of the government," she says. "Most are probably ready to make this transition at the end of their baby’s first year."

She says that parenthood is a positive experience for the majority of teenagers and that they do want to get on with their lives and provide for their children: "The stereotype of the feckless irresponsible teenager just isn’t true," she says.

Ultimately, she feels, if we are to successfully tackle our high teenage pregnancy rates we must increase the often very limited choices of these young women and raise their self-esteem.

It seems appropriate to give the last word to her: "Someone once said to me that aspiration is the best form of

contraception."

‘Enjoying motherhood’

Stefanie Derry has just turned 18 and gave birth to her daughter Siobhan eight weeks ago. "I hated the thought of being pregnant and having a child," she says. "I was confused and, although I kind of knew what to do, I didn’t know the best way to go about it, and I needed somebody to help me sort out the Benefits Agency because they kept making lots of mistakes with my claim."

Derry was put in touch with Leicester Sure Start Plus through Connexions and, she says, the service has made a big difference to her. "The council was spending a lot of time messing around and not helping me - I was hidden homeless living on my mates’ sofas. I now have a two-bedroom flat which I wouldn’t have had without help from my personal adviser, who has also sorted out my benefits," she says.

She says young mothers especially need support after their baby is born, and although her experience of the professionals involved in her care has been mainly good, she has found that some of the midwives have been very critical of her. "It’s very difficult because nobody tells you what colic is like, or what oral thrush looks like, so you sit there wondering ‘what do I do now?’"

Eight weeks after the birth of her daughter, she is enjoying motherhood and is planning to return to college next year with a view to doing a degree the year after that. "Sure Start Plus has been very helpful - it really is a very good idea and whoever thought it up should get their hand shaken and a big certificate!"