APHR Teenage Pregnancy in Bromley

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					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.

				
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