Teenage motherhood is often said to be the result of deficient contraceptive and abortion services. Using data from the Public Health Common Data Set (PH CDS) we demonstrate two important effects in a Regional Health Authority: higher rates of conception are related to a live birth rather than an abortion pregnancy outcome; District Health Authorities (DHAs) with high underprivileged area scores (UPA) are more likely to have high rates of conception in the teenage years than those districts with low scores.
PIP: In Regional Health Authority Areas in the UK, rates of teenage births, abortion, and pregnancy show wide variation. In this study, the impact of poverty on rates of teenage pregnancy is examined in the District Health Authority Areas (DHAs) of North East thames Regional Health Authority (NETRHA). Poverty was measured by the Jarman underprivileged area score (UPA) calculated on the basis of 1981 Census data. The conception rate was taken as the abortion rate (AR) (legal abortions/1000 women) for women 11-15 years old and 6-19 years old combined with the live birth rate (LBR). An index of the LBR minus the AR was also calculated. Spearman's rank correlation coefficient was used to compare the conception rate with index. The results showed that the abortion rate for 1990 among women 16-19 years of age was 34.1/1000 women for NETRHA and 25.9/1000 for England and Wales. The LBR was 34.8 and the conception rate was 68.9 for NETRHA; for England and Wales, the LBR was 39.6 and the conception rate was 65.5. Rates varied widely within NETRHA. The index of LBR-AR showed that Tower Hamlet DHA had 4 times as many pregnant teenagers continuing the pregnancy as Hampstead. The conception rate was correlated reasonably well with the LBR-AR index. Pregnant teenagers who had a live birth tended to live in districts with a high UPA score. The reasons for both conceiving and choosing to continue their pregnancies are many, and appear to be linked to social inequalities. Resources should be targeted to local working class areas where educational prospects are poor. In general, Health Authorities should be providing specialized services for young people in a less patchy, precarious, and marginalized way. In Sweden and HOlland, sex education in the schools has been effective in reducing school age pregnancies and school dropouts; in the US school-based clinics have been successful.