Exploring the evidence on strategies to reduce teenage pregnancy rates
Posted on October 22, 2009
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Despite more than £200m being spent on the Teenage Pregnancy Strategy, there has been little discernible impact on conception rates, at least at a national level. Although disappointing, these results should not be surprising.
The evidence that direct interventions such as improved school sex education and confidential access to family planning services help to lower teenage pregnancy rates is, at best, weak.
In the case of access to emergency contraception, a large number of studies using a range of data and methodological approaches have failed to find evidence of any reduction in pregnancy rates. Limitations in the quantity and/or quality of research means there should be caution in drawing general policy conclusions.
Some of the more encouraging evidence is on measures aimed at increasing parents’ involvement in younger teenagers’ abortion decisions. However, while this evidence is consistent with qualitative research emphasising the importance of family influences (Stammers, 2007), points of contention still remain.
These findings have implications for nurses working to implement the Teenage Pregnancy Strategy in schools, in community settings and those involved in policy discussions. The fact that many of the measures currently in place appear unlikely to have an impact on teenage pregnancy rates does not necessarily mean that nurses should abandon them. Interventions may have a number of objectives beyond simply cutting teenage pregnancy rates and these objectives may be sufficient to justify them.
However, it is important that practitioners and policymakers avoid giving the impression to stakeholders, for example parents, that particular measures need to be introduced to cut teenage pregnancy when the evidence does not back this up. Rather, a particular initiative should be considered on its own merits.
Ethical considerations should of course be paramount, especially when considering the provision of information and services to children below the age of consent. Even where a particular course of action is felt to be ethical, policymakers and practitioners need to pay careful attention to the possibility that measures designed to improve sexual health among teenagers will affect behaviour in unintended ways.
Lots more detail…
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