the teenage pregnancy strategy for england supporting young people to prevent subsequent pregnancies
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The Teenage Pregnancy Strategy for England: Supporting young people to prevent subsequent pregnancies
Alison Hadley, Director, Teenage Pregnancy Knowledge Exchange, University of Bedfordshire
The problem:
20% births conceived to under-18s are to teenage mothers
11% of abortions to under-19s are repeat abortions
Pregnant teenagers…
were unaware of their fertility and how quickly they can get pregnant again
had poor knowledge about the full range of contraception and relying on myths and misinformation from peers
were misled by anti-choice information that abortion causes infertility
were being offered contraception too late in the care pathway
Some causes of the problem from the teen perspective
Not all managers & providers were aware of the problem and not all were addressing it
Local repeat abortion data published annually by Department of Health but no local data set on repeat births
Local variation in focus and progress in reducing repeat conceptions
Supporting young people to prevent subsequent pregnancies
Proactive advice and postnatal contraceptive provision included in Department of Health guidance for maternity services
Advice and offer of contraception included in Department of Health national specification for National Health Service abortion services contracts
Posters for maternity services
Contraceptive nurse – an integralpart of the maternity team
First meeting at antenatal booking visit – to begin discussion about a contraceptive plan
Subsequent meetings at antenatal visits at 28, 34 and 38 weeks to agree a contraceptive plan – vast majority of young women choose a method before birth
Method of choice provided on postnatal ward or in young people friendly contraceptive clinic
Nurse liaises with postnatal support team to assist the young women with attending appointments and to provide on-going contraceptive support during the first two years
If young woman chooses combined oral contraception, the nurse calls/texts a reminder to start the pills on 21st day
Post-pregnancy contraceptionoutreach nurseEarly contact established through referral pathways with
contraception, abortion and maternity services
Nurse meets young woman (and partner) at location of choice to build trusted relationship
Focus on providing up to date, accurate information about all methods and dispelling myths – particularly important for LARC methods
Contraception plan agreed before abortion or birth
Method of choice provided in a trusted local service meeting the You’re Welcome criteria
Follow up contact through text and mobile phone for advice and reassurance
Dedicated teenage parent support service
• Partnership care led by dedicated Teenage Pregnancy Support Service liaising with midwifery, other mainstream support services and contraception/sexual health services
• TPSS provides pregnancy testing & pregnancy options advice so identifies young mothers early
• TPSS does needs assessment and personal development plan - one for young mother, one for young father – including postnatal contraception choice
• TPSS provides individual follow up
• Method of choice provided in maternity unit or at TPSS centre.
Progress so far: 1998-2011&
Ingredients of success
Repeat births reduced by 35%
Key ingredients of success(from the adolescent perspective)
Improved understanding of fertility and risks
Improved knowledge about & confidence in contraceptive methods
Trust in nurse practitioner and contraceptive service provider
Support in contraceptive planning ahead of need
Consistent messages about benefits of delaying subsequent pregnancies – in relation to the individual young woman
For more information:
Teenage Pregnancy Knowledge Exchange
www.beds.ac.uk/knowledgeexchange