The Labour Government’s Teenage Pregnancy Strategy was a clearly defined 10 year programme. However it was never intended as a one-off strategy but as a catalyst for change with the principles and actions integrated into mainstream provision to support successive generations of young people. Twenty five years on from the implementation of the strategy Alison Hadley, Professor Roger Ingham, Professor Joanna Nichols and Dr Venkatraman Chandra-Mouli have authored a 2nd edition of Teenage Pregnancy and Young Parenthood. In this blog Alison, a member of the AYPH Advisory Council, highlights some key findings and makes some ‘asks’ for action.
A reminder of the teenage pregnancy strategy
Launched in 1999, it was the first cross government strategy to address England’s historically high teenage pregnancy rates with a goal of halving the under-18 conception rate by 2010. Teenage pregnancy was positioned as a cause and consequence of inter-generational inequality and social exclusion requiring collective multi-agency action. Based on international evidence, the strategy aimed to equip young people to make well informed choices about pregnancy, parenthood and supporting themselves and their children. With national support and regional co-ordinators all 150 local government areas agreed a 10 year reduction target, appointing coordinators, setting up a cross-agency partnership board, and adapting national guidance locally.
The results?
Fast forward 25 years, and huge efforts, we have seen a 72% decline in the under-18 conception rate (with the original target reached in 2014), from 41,000 pregnant under-18s in 1998 to 12,000 in 2021*, and a steeper decline in areas of highest deprivation.
Where are we now?
Despite the 72% reduction, the latest data are a stark caution against complacency with the first increase in 14 years and significant inequalities highlighted in the data. There is a 7-fold difference across the socioeconomic spectrum and disadvantage increases some young people’s early pregnancy risk notably family poverty, persistent school absence, four or more Adverse Childhood Experiences and experience of the care system.
Despite fewer young parents, this cohort of young mothers and fathers enter parenthood with increased vulnerability and complex needs with resultant outcomes for them and their children disproportionately poor. The higher rates of infant mortality, maternal depression, delayed verbal ability and repeat care proceedings are a stark reminder of the impact on inter-generational inequality.
What’s the local experience of maintaining teenage pregnancy work?
To further understand the data, we reviewed the national policy context, alongside key stakeholders, interviewing 16 Local Authorities about factors supporting or hindering progress, issues highlighted include:
The impact of austerity and cost of living crisis
- On Local Authority and public health budgets, with funding cuts fracturing well established partnerships and upstream prevention shifting to downstream crisis management
- On young people experiencing an increase in the risk factors for early pregnancy – family poverty and disengagement from education, an impact clearly evidenced in the increased vulnerability of teenage parents
The impact of the Covid-19 pandemic which exacerbated many of the pre-existing problems for services and young people with:
- stress, long term sick leave and retirement further depleting staff numbers and weakening the fragile multi-agency partnerships
- a large rise in numbers of pupils absent from education in years 9-11 – a key risk for early pregnancy
Digital services and social media
- Increased online services benefit some with increased access to contraception and sexual health service but jeopardises access for some marginalised young people and this also applies to moves to all age services
- Social media has potential to disseminate accurate information but some content normalises unhealthy relationships, including violence. Influencers opinions such as negative views of hormonal contraception, can carry more weight than professionals
Losing the priority
Despite the persistent inequalities, respondents often encountered a sense of complacency that the ‘rates are down, so the job is done’ with a lack of national leadership or monitoring making it hard for local prioritisation.
What next?
Faced with these challenges, what was so notable from the local areas was extraordinary commitment and an optimism that with some national support, the partnerships can be rekindled and the work continued. These three ‘asks’ to the Government are informed by both the review of the national policy context and the findings from the local areas. All will save money, improving intergenerational outcomes and halt the widening inequalities.
- Provide national leadership – restating why teenage pregnancy still matters and how progress benefits the NHS, local councils and Integrated Care Boards, saving money, through:
- Updating the Teenage Pregnancy Prevention and Young Parents Support Frameworks to re-establish an effective system wide response
- Improving the data to inform local monitoring and commissioning
- Refocus efforts on upstream prevention through:
- Effective implementation of statutory Relationships Health and Sex Education (RHSE) extended to 18 using evidence-based guidance and teacher training
- Improving access for all groups to youth-friendly sexual and reproductive health services locally
- Prioritising early intervention support for young parents through coordinated local support services, alongside national oversight to eliminate the current postcode lottery
- Develop a cross-departmental youth strategy to join up and synergise youth programmes to rebuild the prevention eco-system. Providing leadership and oversight of local programmes, through:
- Applying the learning of the previous coordinated approach to youth strategy, described so well in Trends in Adolescent Disadvantage 1997-2019, and local area knowledge and expertise
- Involving young people in its design to ensure the strategy addresses lived experiences
Author: Alison Hadley, Director, Teenage Pregnancy Knowledge Exchange, University of Bedfordshire.
May 2025