Teenage conception and contraception in the English regions

Abstract

Nationally available data on teenage fertility, family planning care and mortality were analysed to determine the relationship between teenage conception, availability of abortion and family planning care, and an indicator of socioeconomic disadvantage--the Standardized Mortality Ratio (SMR). In the 14 regions of England the strongest correlate of teenage conception and of the proportion of teenage conceptions aborted was female all-causes SMR. High levels of provision of NHS abortion services and uptake of family planning clinic care did not significantly reduce teenage fertility. Provision of traditional family planning services obviously plays an important role in preventing teenage pregnancy, but innovation in this service coupled with a concerted effort to reduce social disadvantage might have a greater impact on teenage fertility in England.

PIP: Amid political actions threatening the survival of District Health Authority family planning clinics and National Health Service (NHS) abortion facilities in England, this study analyzed the relationship between teenage fertility, attendance at family planning clinics, and abortion by region of the country. Data were taken from the 1989 Public Health Common Data Set for women aged 11-19 years, with regional service provision. There was a negative correlation between abortion rate and proportion of NHS abortions, and a positive correlation between conception rates and percentage of teenage women using family planning clinics. There was a significant correlation between conception rate and standardized mortality rate (SMR), with regions with high SMRs having high conception rates. There was a highly significant negative correlation between the proportion of conceptions aborted and the SMR. Both conceptions and proportion of conceptions aborted were sharply divided by north and south: northern regions had more teen conceptions and fewer abortions. Thus this study does not support the notion that high levels of family planning services result in low conception and abortion rates. Availability of abortion services in the north did not increase teen abortion rate, but neither did fewer abortion services in the south deter young women from having proportionally more abortions. The writer noted that the majority of teens are sexually active and require contraception, but teens view family planning clinics in a negative light, and many fail to return for a 2nd visit. Factors resulting in social disadvantage probably have more impact on teen pregnancy than mere availability of family planning services.