Teenage Conceptions

Introduction

Teenage pregnancy refers to under-18 conceptions leading to live or still births and terminations. 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 and often results in poor outcomes for both the teenage parent and the child, in terms of the baby’s health, the mother’s emotional health and well-being and the likelihood of both the parent and child living in long-term poverty.

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 problems¹.

Much of the reduction in teenage conception has been attributed to the Teenage Pregnancy Strategy (1999-2010) with the most substantial reductions in the most deprived areas, where rates were originally highest. Participation in work, education, or training by young women who became mothers before age 18 years doubled over the period of the Teenage Pregnancy Strategy. The programme had many components, and while it's still not known which were more effective than others, the combination of sex and relationships education, increased access to contraception, and social inclusion strategies are necessary elements².

While early evaluations concluded that England’s focused, well-funded, and evidence-based interventions “probably contributed substantially” to the observed fall in teenage conceptions, a 2021 comparative analysis found similar teenage pregnancy trends elsewhere, suggesting that some of the decline mirrored a broader, international trend and might not be entirely attributable to England’s Teenage Pregnancy Strategy³. 

More background information and advice on tackling teenage pregnancy is provided in Public Health England's Teenage Pregnancy Prevention Framework (May 2018). 

Facts and Figure

Blackpool has seen significant improvement in teenage pregnancy rates over the years and figures for 2022 show:

• 60 women under the age of 18 in Blackpool became pregnant in the year, 13 of them were aged under 16
• The under 18 conception rate in 2022 was 26.4 per 1,000 women aged 15-17, significantly higher than the England and North West average of 13.9 and 16.8 respectively
• The under 16 conception rate in Blackpool was 5.7 per 1,000 women, significantly higher than the England and North West averages of 2.2 and 2.9 respectively (Figure 2)
• Since 2004 the Blackpool under 18 conception rate has fallen by 67% from 72.0 per 1,000 to 26.4 per 1,000 in 2022. This compares to a 63% reduction across England (Figure 1)
• Blackpool currently ranks as the 4th highest UTLA in England for under 18 conceptions and the 3rd highest for under 16 conceptions.

Figure 3 shows Blackpool's under 18 conception rate compared with the North West and England. It demonstrates that while significant improvements have been made, teenage pregnancy remains an issue for Blackpool.

Figure 3: Trend in under 18 conceptions rate, Blackpool, North West and England: 2004 to 2022

Figure 4 compares the under 18 conception rate across all upper tier local authorities in England. Blackpool has the 4th highest rate with Redcar and Cleveland, Kingston upon Hill and Middlesbrough having higher rates.

Figure 4: Under 18 conception rate, 2022 - Comparison of upper tier local authorities in England

In 2022, the estimated number of under 18 conceptions in Blackpool rose by 30% from 46 in 2021 to 60. The number of conceptions do fluctuate year on year and despite occasional increases the general trend continues to fall from the high rate of 81 per 1,000 in 2003. Figure 5 shows the trend in the rate of all age conceptions and under 18 conceptions in Blackpool and England since 2001.

Figure 5: Trend in all age and under 18 conceptions in England and Blackpool, 2001 to 2022

The size of the female population of child bearing age (women aged 15-44) will also influence the number of conceptions as these are peak age groups for maternities (25-29 and 30-34) and abortions (20-24) and the relative sizes of these groups will impact upon the number and rate of conceptions. Projected population estimates for females in Blackpool show the under 25 population increasing slightly until the mid 2030's before declining into 2040's. The 25-44 age group remains relatively stable through the 2030s and into the 2040s.

Variation within Blackpool

There is wide variation in teenage conceptions within Blackpool. ONS conception data for 2018-2020 shows that there are areas within Blackpool that have significantly higher proprtions of teenage conceptions than either the Blackpool or national averages (figure 6):

Figure 6: Under 18 conceptions in Blackpool by ward, compared Blackpool median, 2018-2020

Across Blackpool, under 18 abortion rates and maternity rates are generally continuing to fall (figure 7). Over the last ten years the abortion rate has gone down by over a third (35%), from 18.3 per 1,000 in 2012 to 11.9 per 1,000 in 2022. The maternity rate has fallen by 42% from 24.8 per 1,000 to 14.5 per 1,000 over the same period. The proportion of conceptions resulting in an abortion had also been falling but 2022 saw an increase to 48.3% from 34.8% in 2021 (figure 8).  Nationally the proportion of conceptions resulting in an abortion has risen from 53.4% in 2021 to 58.2% in 2022.

Figure 7: Outcome of conceptions in under 18's in Blackpool, 2006 to 2022 - Proportion resulting in birth and abortion

Figure 8: Proportion of under 18 conceptions resulting in an abortion - England, North West and Blackpool, 2006 to 2022

High Risk Groups

The individual risk factors associated with young women experiencing pregnancy before 18 are:⁴

• • Free school meals eligibility: a poverty indicator
  • Persistent school absence by Year 9
  • Slower than expected academic progress
  • First sex before 16
  • Looked after children and care leavers
  • Experience of sexual abuse and exploitation
  • Lesbian or bisexual experience
  • Alcohol
  • Experience of a previous pregnancy

The individual risk factors associated with young men experiencing fatherhood are:

• • To have been subjected to violent forms of punishment at home and are twice as likely to have been sexually abused
  • To have pre-existing serious anxiety, depression and conduct disorders
  • To have poor health and nutrition
  • To drink, smoke and misuse other substances

As with Adverse Child Experience analysis, young people who have experienced a number of these factors will be at significantly greater risk.

Current Services

• • Blackpool Council commissions a young people's sexual health and substance misuse harm reduction service. Blackpool Young People’s Service Family Practitioners provide Brief Interventions and 1:1 Therapeutic support for young people at risk of poor sexual outcomes and young people misusing substances to improve their outcomes.
  • Staff in Primary Care have been trained to fit and remove contraceptive implants and intrauterine systems/devices and local enhanced service agreements are in place with a number of GP practices in Blackpool for both their registered and non-registered patients. These LARC methods of contraception are more reliable than user-dependent methods like oral contraceptives and are less likely to lead to unintended conceptions.
  • Provision of Relationships, Sex and Health Education (RSHE) became statutory from September 2020. However, due to the COVID-19 pandemic, schools were given until September 2021 to fully implement these requirements. Whilst sex education is statutory in secondary schools, primary schools may choose if they teach sex education in their setting. Following a pilot programme, a PSHE Support Officer works with schools to develop the PSHE provision across the authority and give PSHE leads a network of best practice, access to high quality training and a suite of quality assured schemes of work, lesson plans and resources.  Also see Sexual Health and Relationships section.
  • Blackpool's main clinical sexual health service is delivered from Whitegate Health Centre. This includes the provision of an open access Level 1, 2 and 3 service which is open to anyone of any age, irrespective of where they live. Elements of a Level 1 service include the provision of emergency oral contraception, sexual history taking and Chlamydia testing.  The service also offers a domiciliary service which provides joint visits with mental health, vulnerable children, drug and alcohol and learning disabilities services. 
  • Connect Young People's Service provides a Level 2 open access clinical service for anyone aged under 25, which includes sexually transmitted infection (STI) screening, contraception service and management of uncomplicated infections.
  • Two GP Practices, Adelaide Street and Stoneyhill, have also been commissioned to provide Level 2 sexual health services for Blackpool residents.
  • Lancashire & South Cumbria Integrated Care Board (ICB) commissions two termination of pregnancy providers - Marie Stopes and National Unplanned Pregnancy Advisory Service (NUPAS).

National and local strategies

• • PHE, Teenage pregnancy prevention framework, January 2018 - Guidance for local teenage pregnancy prevention programmes to help young people avoid unplanned pregnancies and develop healthy relationships.
  • NICE guideline [PH51] Contraceptive services for under-25s (Reviewed Oct 2017) aims to ensure all under-25s are given advice and information on all types of contraception
  • PHE, Teenage mothers and young fathers: support framework, April 2019 - This framework helps local healthcare commissioners and service providers review support arrangements for young parents in their area.
  • Dept for Education, Relationships Education, Relationships and Sex Education (RSE) and Health Education, July 2025 contains information on what schools should do and sets out the legal duties with which schools must comply when teaching Relationships Education, Relationships and Sex Education and Health Education
  • Blackpool Health and Wellbeing Board Sexual Health Strategy 2023-2026 and the accompanying action plan sets out Blackpool's measures to deliver their objectives of improving sexual health and reducing sexual health inequalities

[1] DHSC, Sexual and Reproductive Health Profile, Teenage Pregnancy

[2] Skinner SR, Marino JL (2016) England's Teenage Pregnancy Strategy: a hard-won success, The Lancet, Vol 388, No. 10044, p538-540, August 2016

[3] Baxter AJ, Dundas R, Popham F, Craig P. How effective was England's teenage pregnancy strategy? A comparative analysis of high-income countries. Soc Sci Med. Feb 2021 

[4] PHE, Teenage Pregnancy Prevention Framework, Supporting young people to prevent unplanned pregnancy and develop healthy relationships, May 2018