1. The Teenage Pregnancy Strategy for
England:
Supporting young people to prevent subsequent
pregnancies
Alison Hadley, Director, Teenage Pregnancy Knowledge
Exchange, University of Bedfordshire

2. The problem:
20% births conceived to under-18s are to teenage
mothers
11% of abortions to under-19s are repeat abortions

3. 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

4. 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

5. 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

6. Posters for maternity services

7. Contraceptive nurse – an integral
part 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

8. Post-pregnancy contraception
outreach nurse
Early 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

9. 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.

10. Progress so far: 1998-2011
&
Ingredients of success

11. Repeat births reduced by 35%

12. 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

13. For more information:
Teenage Pregnancy Knowledge Exchange
www.beds.ac.uk/knowledgeexchange
alison.hadley@beds.ac.uk