Levels of teenage pregnancy in the UK are high in relation to other European countries. By 2010 the government is aiming to reduce by half the level of teenage pregnancies among under-18s and create a downward trend among under-16s. Looked-after young people are at greater risk of teenage pregnancy and are 2.5 times more likely to become pregnant than other teenagers. Scie’s research briefing – preventing teenage pregnancy in looked-after children – looks at the risk factors and, using the available evidence from research, considers how pregnancy rates in looked-after children can be reduced.
It is now recognised that the health and educational needs of looked-after children are different from and greater than many other groups of children and young people.
Teenagers who become parents are known to experience more educational, health, social and economic difficulties than young people who are not parents. Consequently, their children may be exposed to greater social deprivation and disadvantage. These outcomes have been demonstrated to be more adverse still in the case of looked-after children who become parents. This is because this group is more likely than others to be unemployed, have more mental health problems, be expected to be independent and have little support.
Sexually active earlier
Research has demonstrated that looked-after children are likely to satisfy many of these criteria and living in care is, in itself, a risk factor. Looked-after children are more likely to become sexually active earlier than other groups of children. A quarter of young women leaving care are either pregnant or already mothers, and almost half of female care-leavers become mothers between the ages of 18 and 24. Pregnant looked-after children are less likely than other groups to choose abortions or adoption because of personal experiences.
The principal source of advice on sexual health and contraception for young people is school-based. Research has pointed to the inadequacy of school-based sex and relationship education (SRE) and advice schemes as failing to stem teenage pregnancy, especially among looked-after children. Care-based programmes have also been found lacking.
Recent reviews have concluded that there is good evidence that school-based SRE, particularly when linked to contraceptive services, can have an impact on young people’s knowledge and attitudes and can delay sexual activity and reduce pregnancy rates. However, these findings are the result of descriptive, non-randomised studies. Also, looked-after children are known to have low levels of school attendance and therefore school-based SRE alone is not enough.
No strong evidence
There is no evidence that SRE programmes lead to earlier sexual activity. There is no strong evidence for the effectiveness of abstinence education programmes or those encouraging vocational development. Some studies have advocated peer-led SRE schemes, but again there is no evidence that such programmes are effective in reducing levels of teenage pregnancy.
Research has shown that young people agree that some school-and-care-based education and advice programmes on sex and relationships are inadequate. They also report experiencing problems accessing confidential contraceptive services.
A study to canvass the views of young people on more effective SRE to prevent teenage pregnancy found that they wanted consistent information from “youth-centred” services within youth settings or from media sources used by young people, such as magazines or the internet. These sources of information satisfied the need for easy and confidential access. It has also been found that authorities that consult young people and develop specialist sexual health services for them are successful in reducing teenage pregnancy.
● Socio-economic deprivation.
Preventing teenage pregnancy in looked-after children
This article appeared in the 24 January issue under the headline “Preventing teenage pregnancy in looked-after children”