This crude rate shows conceptions in women aged under 16, per 1,000 females aged 13-15 in Bury. The numerator is the number of pregnancies that occur in women aged under 16 and result in either one or more live or still births or legal abortion under the Abortion Act 1967. (using ONS Conception Statistics). The denominator is the number of women aged 13-15 living in the area (using ONS Population estimates for England and Wales).

In 2017, the rate in Bury was 4.3, having reduced from 8.1 in the previous 7 years, and having been lower than the England rate for 4 of those years (current England rate is 2.7), however it should be noted that there have been data quality issues attached to this rate over the previous 6 years (*).

Under 16 conceptions, rate per 1,000 population

      
 2010 2011 2012 2013 2014 2015 2016 2017
Bury 8.1 5.6 5.6* 5.1* 3.7* 2.5* 1.6* 4.3*
England 6.7 6.1 5.6 4.8 4.4 3.7 3.0 2.7
North West 7.8 7.0 6.6 5.8 5.1 4.6 3.8 3.5
  
      
Source for Table: Office for National Statistics

Other caveats- There are few conceptions to girls aged 12 or under and to include younger age groups in the base population would produce misleading results. The 13-15 age group is effectively treated as the population at risk.

Most teenage pregnancies are unplanned and around half end in an abortion. As well as it being an avoidable experience for the young woman, abortions represent an avoidable cost to the NHS. And while for some young women having a child when young can represent a positive turning point in their lives, for many more teenagers, bringing up a child is extremely difficult.

Research evidence, particularly from longitudinal studies, shows that teenage pregnancy is associated with poorer outcomes for both young parents and their children. Teenage mothers are less likely to finish their education, are more likely to bring up their child alone and in poverty, and have a higher risk of poor mental health than older mothers. Infant mortality rates for babies born to teenage mothers are around 60% higher than for babies born to older mothers. The children of teenage mothers have an increased risk of living in poverty and poor quality housing, and are more likely to have accidents and behavioural problems .

  Fingertips Definitions (2019) http://fingertips.phe.org.uk/public-health-outcomes-framework#page/6/gid/1000042/pat/6/par/E12000002/ati/102/are/E08000002/iid/90639/age/169/sex/2

Bury OCO- Council and CCG.
Schools/education
Integrated Sexual Health Services
Young Person’s SH Outreach service
Youth services
MASH and Sunrise
Youth Offending Services
Bury LCO
School Nursing Teams
LAC/ care leavers support services
YP substance Misuse services.

The local ISHS provider Virgin Care is in the process of setting up a Bury Young Persons Sexual Health multi-agency meeting which will strengthen the partnership working within the TP prevention agenda.

It has been 20 years since the then government launched its Teenage Pregnancy Strategy in response to England having one of the highest teenage pregnancy rates in Western Europe. Since then, thanks to a multi-agency approach the under-18 conception rate has reduced by 60%.

However, despite the significant progress England’s teenage birth rate remains higher than comparable western European countries  and inequalities in the under-18 and U16 conception rate persist between and within local areas.

Maintaining the downward trend is a priority in the Department of Health Framework for Sexual Health Improvement in England  and key to PHE priorities, including reducing health inequalities, ensuring every child gets the best start in life and improving sexual and reproductive health .

The Teenage Pregnancy Prevention Framework (published in January 2018) is designed to help local areas assess their local programmes to strengthen the prevention pathway for all young people. A self-assessment checklist is provided for councils to collate a summary of the current local situation, and identify gaps and actions.

International evidence identifies the provision of high quality, comprehensive sex and relationships education (SRE) linked to improved use of contraception as the areas where the strongest empirical evidence exists on impact on teenage pregnancy rates. SRE also has wider safeguarding and health benefits but, to have impact, provision needs to reflect the internationally recognised effectiveness factors .

From September 2020, new legislation requires all primary schools to provide relationships education, all secondary schools to provide relationships and sex education and both primary and secondary to provide health education .
Draft statutory guidance for schools setting out the subject content was approved by Parliament in Spring 2019. This includes specific reference to all secondary school pupils know about local services providing confidential SRH advice and care. Final guidance will be published after summer 2019 .

Contraceptive services need to be accessible and youth friendly to encourage early uptake of advice, with consultations that recognise and address any knowledge gaps about fertility and concerns about side effects, and support young people to choose and use their preferred method . An open and honest culture around sex and relationships is also associated with lower teenage pregnancy rates. Countries with more open approaches to young people’s sexual health, as assessed by better SRE, more parental communication and more accessible contraceptive services, have lower conception rates.

Measures to reduce teenage pregnancy need to be both universal and targeted. Some young people will be at greater risk of early pregnancy and require more intensive SRE and contraceptive support, combined with programmes to build resilience and aspiration – providing the means and the motivation to prevent early pregnancy. Reaching young people most in need involves looking at area and individual level associated risk factors.

Child poverty and unemployment are the two area deprivation indicators with the strongest influence on under-18 conception rates. At an individual level, the strongest associated risk factors for pregnancy before 18 are; free school meals eligibility, persistent school absence by age 14, poorer than expected academic progress between ages 11-14, and being looked after or a care leaver. Other associated risk factors include first sex before 16, experience of sexual abuse or exploitation, alcohol and experience of a previous pregnancy. Young women with lesbian or bisexual experience are also at increased risk of unplanned pregnancy. As with Adverse Childhood Experiences, young people who have experienced a number of these factors will be at significantly higher risk

  SRE – the evidence. Sex Education Forum. 2015. Available from:
www.sexeducationforum.org.uk/evidence.aspx
  Public Health England (2019) Teenage pregnancy and young parents report for Bury https://fingertips.phe.org.uk/profile/child-health-profiles/data#page/13/gid/1938133228/pat/6/par/E12000002/ati/102/are/E08000002 accessed July 2019
  Relationships education, RSE and PSHE. Policy statement. Department for Education. 2017.
Available from: https://www.gov.uk/government/publications/relationships-education-rse-and-pshe
  Teenage pregnancies that end in abortion: What can they tell us about contraceptive risk-taking?
Hoggart, L. & Phillips, J. 2011. Journal of Family Planning and Reproductive Health Care 37 (2) 97-
102
    Public Health England (2019) Teenage pregnancy and young parents report for Bury https://fingertips.phe.org.uk/profile/child-health-profiles/data#page/13/gid/1938133228/pat/6/par/E12000002/ati/102/are/E08000002 accessed July 2019