England has one of the highest rates of teenage pregnancy in Europe. To counter this, the government launched its national teenage pregnancy strategy in 1999 with the aim of halving the conception rate among under-18s by 2010. Strong correlations between social disadvantage, exclusion, poverty and pregnancy have been well documented and this link is even stronger in the case of young people in, or leaving, local authority care.

The social and health problems experienced by young parents can be reduced by financial and emotional support from their families, but young women leaving public care have limited sources of help. But if this could be rectified, the tribulations associated with teenage pregnancy could be alleviated, an unpublished study by the Thomas Coram Research Unit for the Department of Health found.

The Children Act 1989 gave local authorities obligations and guidelines for young people leaving care, including "advice and befriending", while the Quality Protects initiative and the Children (Leaving Care) Act 2000 place new duties of care and support on local authorities. But, in cases of young parents leaving care, few local authorities have specific policies in place and the provision of services from health to housing varies.

Although it is known that looked-after young people are less likely than others to take up and use health services generally, little is known about their access to sexual health services. The young people interviewed reported limited access to information on sexual health and relationship matters for several reasons: among them were concern over raising issues with foster and residential carers because of their views on sex and negative attitudes on the part of care workers and GPs.

Poor communication skills also hindered access, particularly in cases when the young person had a learning difficulty. Young people interviewed described learning about sex through "trial and error", with 90 per cent reporting either sporadic or no use of contraception. Many missed school regularly or described poor quality sex education programmes.

The reaction to pregnancy was often one of shock but, despite the problems associated with becoming a teenage parent, the researchers found that the outcomes were not routinely negative. For the majority of the young men and women it was a positive event, often described as "calming" and providing a focus in their lives as well as love and affection. This was important, as young people described feelings of rejection, isolation and loneliness as a result of experiences before and during care. They also had difficulties trusting people and services and often developed a strong sense of self-reliance and a desire to do things for themselves.

A 17-year-old mother with one child said: "I needed someone to sit down and talk to me about life, but I had to work it all out by myself. I've been able to look after myself since the age of about nine."

Importantly, many of them had been in situations where they were vulnerable to exploitation, violence and homelessness. Some of their experiences in care had exposed them to early sexual activity and experimentation with drugs and alcohol. Often, their circumstances represented an accumulation of vulnerability and disadvantage. A nurse specialist for looked-after children said: "I had one girl who was at a residential unit. She came for a medical and she said she was under pressure to start thinking about prostitution."

The young people in the study had mixed experiences of social services. Young mothers were reluctant to access support because of concerns about "interference" and the possibility that their children might be taken into care. Although some relationships with social workers were positive, others were more complex. Young people felt "checked up on" by the child protection assessment process, which was viewed as punitive and alienated them from the sources of support they needed. Facing parenthood at the same time as dealing with independence required access to a range of services. Some leaving care services were described as holistic and consistent and were appreciated by the young people who had benefited from them, but quality and provision varied greatly.

Many professionals described past and current family influences as key factors in how well a young person coped as a parent. The support of a partner - where the relationship was working well - was described as another vital factor in helping young mothers cope. Of the young women interviewed, 51 per cent reported being with a partner (usually, but not always, the father of one of their children).

Of the young men, 56 per cent were with the mother of at least one of their children. The rest had varying degrees of contact with their children by an ex-partner. Young fathers described various economic, social and structural barriers to playing their part in children's lives and said their needs often went unacknowledged. One care leaver said: "When we found out that my partner was pregnant, I was offered help, but not her or the baby. I was offered a one-bedroom flat and told she could sleep at the flat but not live there as she was not a care leaver."

What emerged from the discussions with these young people was a need for a trusted person to provide reliable emotional and practical support to help them navigate the system and gain access to the services they needed.

The report highlighted the role played by key workers who could act as confidants and help ease the transition from care, providing neutral support and advice. The role of personal advisers in leaving care teams or Connexions services should be extended and developed to provide holistic support for young parents. This would help them to access health, sexual health and parenting services, tackling concerns over lack of confidentiality and stigmatisation.

An independent advocate could also steer young people through the pre- and post-birth child protection assessments, increasing their participation in the process and refocusing on affirmative action and supportive practice. To underpin the planning of joined-up services, data need to be collected on young parents in and leaving care and what happens to them, not just in the sense of assessing risk but to help improve services so that they provide better care and life chances for them and their children.

How the study was conducted  

The study reviewed what is already known about rates of pregnancy among looked-after young people and those leaving care and gathered information from four locations in England. In-depth discussions were held with 47 mothers and 16 fathers aged 15-23, all of whom had been or were about to become first-time parents as teenagers. Seventy-eight professionals and carers were also interviewed.    

Elaine Chase, Abigail Knight and Ian Warwick are researchers, Peter Aggleton is director and Cathy Brownjohn is communications officer at Thomas Coram Research Unit, Institute of Education, University of London. 

Further reading

The research will soon be published in peer review journals. For more information contact Elaine Chase at E.Chase@ioe.ac.uk or Cathy Brownjohn at C.Shaw@ioe.ac.uk or phone 0207 612 6944