TEENAGE PREGNANCY IN BROMLEY Teenage pregnancy disproportionately affects those from lower socio-economic groups who live in more deprived areas. Children born to teenage parents are at increased risk of: Dying during the first years of life Being premature Being low weight at birth Being shorter in stature Being less likely to achieve A-levels Being a teenage parent Teenage parents are more likely to: Have a mother who has no formal qualifications Suffer from post natal depression Have a partner who is unemployed Smoke BACKGROUND It has been widely recognised that teenage pregnancy and early motherhood can be associated with poor educational achievement, poor physical and mental health, social isolation, poverty and related factors. The National Teenage Pregnancy Strategy was launched in 1999. The Strategy has essentially two major goals: Halve the rate of conceptions in under 18’s in England and to establish a downward trend in conception rates in under 16’s by the year 2010 Getting more teenage parents into education, training or employment to reduce the risk of long-term social exclusion It has become increasingly clear that socio-economic disadvantage can be both a cause and a consequence of teenage parenthood . Who is most vulnerable to becoming a teenage parent? Young people living in deprived areas Young people who do not attend school Young people who are looked after by or who are leaving local authority care services Young people who are homeless Young people who are the children of teenage parents Young offenders ISSUES IN BROMLEY Bromley is a Borough of great contrast - with a relatively low teenage pregnancy conception rate masking a large amount of variation. Some parts of the Borough, such as Penge and Anerley, Mottingham and the Crays, are known areas of deprivation and have rates as high as Lambeth, Southwark and Lewisham. Other less deprived areas, such as Chelsfield and Pratts Bottom, have very low rates. The link to teenage pregnancy and those living in deprived areas is highlighted by an analysis of data from the 2000 ward data statistics. This illustrates the strong link to educational achievement, with under 18 conceptions more prevalent in areas where there are low figures for those achieving 5 GCSE’s A-C. Ward Number of Female Rate Deprivation % girls % Girls Pregnancies pop per rank (1 = with 5+ with No 15-17 1000* least GCSE’s GCSE’s deprived) A-C Cray Valley East 13 219 59.3 2256 38.9 5.6 Crystal Palace 11 160 68.7 1201 40.0 6.7 Mottingham & 5 168 29.7 2203 52.3 6.2 Chislehurst North Penge & Cator 18 283 63.6 1915 46.1 7.9 Chelsfield &Pratts 0 255 0 7334 81.7 0 Bottom *Note: The measure for teenage pregnancy is per thousand of the population in the appropriate age range. Targets The baseline figure for Bromley in 1998 was 32.1 per thousand. The target is to reduce this by 45% by 2010. We achieved a reduction to 30.9 per thousand in 2004. This was a big reduction since the figures had been increasing previously. The latest data for 2005 shows another increase to 36 per thousand. This data will be analysed and the Teenage pregnancy action plan developed accordingly. The target figure for Bromley is 17.7 per thousand by 2010 Why does teenage pregnancy matter? There are considerable health issues associated with being a teenage parent or child of a teenage parent. There is evidence that teenage mothers who experience social isolation can also experience mental health issues such as depression, anxiety and low self esteem. Many young mothers go on to have a second child fairly quickly, thus applying more pressures on them around finance and their own well being. Teenagers who do not use contraception have a 90 per cent chance of conceiving in one year and those who do not use condoms are also exposed to a range of sexually transmitted infections (STIs). In a single act of unprotected sex with an infected partner, teenage women have, a 30 per cent risk of genital herpes and a 50 per cent chance of contracting gonorrhoea. The death rate for the babies of teenage mothers is 60 per cent higher than for babies of older mothers and they are more likely to have low birth weights (teenage mothers are 25 per cent more likely than average to have a baby weighing less than 2,500 grams. Mortality rates for both infants and children in the 1–3 age group are highest for mothers in the under 20 age group), have childhood accidents and be admitted to hospital. In the longer term, their daughters have a higher chance of becoming teenage mothers themselves. Teenage mothers tend not to have well managed pregnancies. Teenagers usually go to their doctors much later in pregnancy (as three-quarters were not planning to become pregnant in the first place) , For the same reason, they often miss out on important early pre-conception health measures such as taking folic acid supplements. During pregnancy, teenage mothers are the most likely of all age groups to smoke – Nearly two-thirds of under 20s smoke before pregnancy and almost a half during it. For many, any kind of conventional ante-natal planning is an impossibility, as they face huge problems of family conflict, likely change of care or fostering arrangements, relationship stress or breakdown, and problems with education, housing and money. Post-natal depression is three times as common amongst teenage parents, with four out of ten teenage mothers affected. Teenage mothers are only half as likely as older mothers to breastfeed. Children of teenage mothers are more likely to suffer accidents – especially poisoning or burns – and twice as likely to be admitted to hospital as the result of an accident or gastro-enteritis. Social and economic factors The economic consequences of teenage pregnancy are wide ranging. From the cost to the health economy through the pre and post natal delivery of services, the additional requirements of housing and the benefits needed to be paid. This is on top of the personal consequences to the teenage parents themselves, often resulting in isolation and exclusion from mainstream education. Researchers have never found any young women who said that benefits were their motivation, although some young people claimed to know of others who had. A recent study of teenage parents found that most of the teenage mothers in their survey had only a hazy idea of what benefits they were entitled to when they were pregnant. A number of other factors makes it seem improbable: The benefits available to a young parent are not generous, and most of the young people the Social Inclusion Unit talked to were finding it extremely hard to manage. Relatively few young lone parents actually live in council flats – it is estimated that only 2,000 16–17 year old lone parents have sole tenancy, mainly in social housing, though more are on the waiting list. (the above figures were taken from the Report on Teenage Pregnancy by the Social Exclusion Unit) WHAT IS BEING DONE IN BROMLEY The Teenage Pregnancy Partnership Board (TPPB) meets every quarter to look at progress in the Local action plan and discuss ways in which the issues can be addressed. The TPPB is comprised of a range of statutory and voluntary agencies across the borough, who work with young people. There are 4 sub groups working to the board looking at specific aspects of the work delivered and being developed. These are Media and Communications, Sex and Relationships Education, Contraception, advice and information and Better support for teenage parents. Each strand looks at ways in which initiatives can be developed and supported. Examples of work delivered so far are SRE Policies are in all schools in Bromley. School nurses have been resources through the TP funding to enhance SRE within the schools. The Confidentiality Toolkit and training has been received by fourteen GP Surgeries. Four of these are now participating in the Condom Distribution Scheme. The Condom Distribution Scheme has proved to be popular amongst all agencies working with young people. There are 45 outlets for this scheme and include Health Visitors and Midwives. Education for young teenage mothers and mothers has been increased from three days per week to full time five days per week. Supporting People Strategy now includes Teenage Pregnancy and a six unit supported accommodation project has now opened in Central Bromley. Three Family Planning clinics that are young people-specific are delivered, one of which is on a Saturday lunchtime Connexions has a Teenage Pregnancy Personal Advisor giving advice and guidance to teenage parents. ‘Delay’ training has been developed. This supports agencies working with young people to explore ways of delaying the first sexual experience until they are ready. Speakeasy training is being delivered to parents to encourage and support discussion with their children around the issues of sex and relationships. Information cards and websites have been developed to allow young people access to information, advice and guidance. Emergency Hormonal Contraception is free for under 16’s. WHAT ARE THE GAPS IN BROMLEY? We are now over half way through the 10 year strategy and issues arise which require reviews on the services delivered. Below are some key areas to address: There is a strong need to develop SRE training for all professionals working with young people, not just teachers and school nurses. Continued roll out of Delay and Speakeasy training Targeted work with young men and boys to explore roles, expectations and aspirations Develop a programme of age appropriate SRE to ensure key messages are delivered at an early stage.