Teenage Pregnancy:

Everybody’s business!

Teenage pregnancy: A complex issue associated with a large range of risk factors… (DoH Teenage Pregnancy Unit)

Teenage Pregnancy: everybody’s business!

Teenage pregnancy: A complex issue associated with a large range of risk factors…

Looked after children/young

people leaving careBehavioural

Problems

Poor educational

attainment

Sexual abuse in

childhood

Lack of confidence in

resisting pressure to

have sexEmotional

well-being

Disengagement

from school/poor

attendance

Social

deprivation

Low aspirations

Mental health

problems

Low self-esteem

Peer influence

Cultural influence

Ethnicity

Teenage

Mother

Fear of

parents/carers

finding out

Parents and professionals lack

confidence to discuss sex and

relationship issues with young

people

Parental

influence

Alcohol/substance

misuse

Lack of confidence

in mainstream

health services

Young people lack skills and

confidence to make and

carry through positive

choices

Poor and inconsistent

contraceptive use among young

people

Lack of easy

access to

contraception

Low knowledge levels among

boys and young men

Poor knowledge and skills

among young people in

relation to sex,

relationships and sexual

health risks

Less likely to use

contraception

More likely

to have sex

earlyTeenage

Pregnancy

Source: SNS <20 births 2006-2008 by IG, Identifier: IDHS-fbirth19

Tayside: First time mums under 20 by Intermediate Geography

Intermediate Geography

First time mothers

aged 19 and under

Percentage first time

mothers aged 19 and under CHP

S02000226 Whitfield 52 34.4 Dundee City

S02000211 Hilltown 31 30.7 Dundee City

S02000218 Douglas East 27 30.7 Dundee City

S02000222 Douglas West 31 26.5 Dundee City

S02000221 Linlathen and Midcraigie 38 26.2 Dundee City

S02000214 Lochee 31 25.2 Dundee City

S02000228 Kirkton 27 24.5 Dundee City

S02000965 Letham 24 24.5 Perth & Kinross

S02000114 Arbroath Cliffburn 22 24.2 Angus

S02000115 Arbroath Warddykes 29 24 Angus

S02000126 Brechin East 15 23.8 Angus

S02000969 Hillyland, Tulloch and Inveralmond 28 23.1 Perth & Kinross

S02000978 Blairgowrie East (Rattray) 14 23 Perth & Kinross

S02000229 Fintry 31 22.3 Dundee City

S02000227 Downfield 14 21.5 Dundee City

S02000223 Caird Park 19 21.3 Dundee City

S02000216 Charleston 27 21.1 Dundee City

S02000225 Ardler and St Marys 28 20.6 Dundee City

S02000127 Brechin West 11 20.4 Angus

S02000118 Forfar West 16 20.3 Angus

S02000205 Menzieshill 24 20.3 Dundee City

S02000201 City Centre 19 19.6 Dundee City

S02000113 Arbroath Kirkton 17 19.3 Angus

S02000124 Montrose South 15 18.8 Angus

S02000209 Law 13 18.3 Dundee City

S02000967 Muirton 11 18.3 Perth & Kinross

S02000959 Moncrieffe and Friarton 9 18 Perth & Kinross

S02000953 Auchterarder 9 17.6 Perth & Kinross

S02000112 Arbroath Harbour 16 16.5 Angus

S02000123 Kirriemuir 15 15.8 Angus

S02000208 Stobswell 23 15.6 Dundee City

S02000971 North Muirton and Old Scone 7 14.6 Perth & Kinross

S02000111 Arbroath Keptie 6 14.3 Angus

S02000119 Forfar Central 13 14.3 Angus

S02000951 Milnathort and Crook of Devon 7 14.3 Perth & Kinross

S02000217 The Glens 12 14.1 Dundee City

S02000219 Fairmuir 10 13.7 Dundee City

S02000975 Stanley and Murthly 7 13.7 Perth & Kinross

S02000964 Central, North Inch and South Inch 18 13.1 Perth & Kinross

S02000107 Carnoustie West 14 12.8 Angus

S02000957 Crieff South 7 12.5 Perth & Kinross

S02000961 Gannochy and Walnut Grove 4 12.1 Perth & Kinross

S02000125 Montrose North 8 11.6 Angus

S02000980 Pitlochry 3 11.1 Perth & Kinross

S02000117 Kirriemuir Landward 4 10.3 Angus

S02000968 Scone 4 10.3 Perth & Kinross

S02000981 Rannoch and Aberfeldy 6 10.3 Perth & Kinross

S02000207 Craigie and Craigiebank 7 9.6 Dundee City

S02000206 Broughty Ferry Wes 7 9.3 Dundee City

S02000976 Coupar Angus and Meigle 7 9.3 Perth & Kinross

S02000204 Balgay 4 8.7 Dundee City

S02000963 Viewlands, Craigie and Wellshill 7 8.6 Perth & Kinross

S02000950 Kinross 4 8.5 Perth & Kinross

S02000974 Luncarty and Dunkeld 5 8.5 Perth & Kinross

S02000199 Perth Road 6 8.3 Dundee City

S02000202 Logie and Blackness 9 8.3 Dundee City

S02000972 Guildtown, Balbeggie and St Madoes 4 8.2 Perth & Kinross

S02000122 Friockheim 8 7.9 Angus

S02000979 Alyth 3 7.9 Perth & Kinross

S02000958 Crieff North 2 7.4 Perth & Kinross

S02000116 Letham and Glamis 4 7 Angus

S02000224 West Pitkerro 9 6.9 Dundee City

S02000977 Blairgowrie West 5 6.8 Perth & Kinross

S02000105 Monifieth West 3 6.7 Angus

S02000955 Bridge of Earn and Abernethy 4 6.5 Perth & Kinross

S02000203 Docks and Wellgate 6 6.3 Dundee City

S02000200 Westend 4 6.1 Dundee City

S02000128 Hillside 2 5.6 Angus

S02000106 Monifieth East 3 5.5 Angus

S02000982 Blair Atholl, Strathardle and Glenshee 2 5.3 Perth & Kinross

S02000966 Western Edge 3 5.1 Perth & Kinross

0

10

20

30

40

50

60

70

80

90

100

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

SIMD Vigintile (2009)

Ave

rag

e fir

st-

tim

e <

20

mu

ms p

er

10

00

16

-19

fe

ma

les*

Tayside: First time mums aged 19 and under

Average (2006-2008) annual number of first time mothers aged 19 and under: rate per 1,000

female 16-19 population by SIMD Decile (*Population: mid-2008 estimate, SIMD 2009)

Why it matters

Although teenage pregnancy can be a positive experience, it is strongly associated with a wide range of subsequent adverse health and social outcomes.

Why it matters Teenage pregnancy severely limits young women’s

education and career prospects

Teenage mothers are:

less likely to finish their education

more likely to bring their child up alone and in poverty

3 times more likely to smoke during pregnancy

50% less likely to breastfeed

have 3 times the rate of post natal depression of older mothers

have a higher risk of poor mental health for 3 years after the birth

Why it matters

Rates of teenage pregnancy are highest among deprived communities: the most deprived groups have 10 times the rate of delivery as the least deprived.

The poorer outcomes also mean that the effects of deprivation are passed on from one generation to the next, so it is an important issue to address as part of the wider aim to tackle inequalities and give children and young people the best start in life.

“Reducing Teenage Pregnancy in Tayside” Driver Diagram

AIM Statement Primary Drivers Secondary Drivers

Reduce pregnancy in

in the under 20s in the

most deprived

communities by 15%

by 2013

Reduce pregnancy in

under 16s by 20% by

2013

Reduce pregnancy in

the under 20s in

deprived communities

by 25% by 2017

Reduce by 50%

pregnancies among

under 18s looked

after/young people

leaving care by 2020

Early Childhood Experience &

Development.

Competent Workforce

Increase expectations & aspirations

and build social capital of young

people

Young people make informed

decisions about their sexual health

Young people focussed

contraceptive and sexual health

services

Strong commitment of all partner

agencies

* All pregnant women under 20 identified and offered intensive ante-natal support

and during first 2 yrs of infancy

* Parenting skills programmes

* Intensive pre-school support for vulnerable children

* Support for young men to continue parenting involvement and support for

couples

* Improve relevance and enjoyment of school

* Improve educational attainment

* Youth development programmes that aim to promote self-esteem, positive

aspirations and a sense of purpose through vocational, educational, volunteering

& life skills

* Volunteering and befriending & peer led opportunities

* Well resourced Youth Services with a clear remit to address teenage pregnancy

•Work with parents through parenting programmes to encourage better

communication about relationships, sexual health & aspirations

•Promote community resilience and co-production of community led

(collaborative) social marketing

* High quality consistent sexual health & relationships education (SRE) that

encourages young people to delay sexual activity

* Tailored SRE for most at risk groups delivered in a range of settings

* Skills based programmes

* Easy access to information and support

* Health drop-ins available in all secondary schools

* Young people involved in informing what & how information/education is

delivered

* Dedicated young people services in or within walking distance of all secondary

schools offering advice, free condoms, pregnancy testing & Chlamydia testing

* Young people are confident to use services

* Well publicised services

* Emergency Hormonal Contraception widely available & accessible TOP

* Young people involved in planning, implementation and services so that it meets

their needs

* Relevant data & health intelligence

•Collaboration of effort embedded in community planning

•Multi-agency self-assessment

•Competent & confident workforce skilled in supporting young people to delay sex

•Training for Health care professionals, teachers, health visitors, social care &

youth workers

•Delivered by competent workforce

Background to the Project

The Sexual Health & BBV

Framework 2011-2015

Change in leadership to local

authority

Asset based approaches

Primary Research & scoping

Success in Perth & Kinross

Learning new skills

Computer Classes

1:1 mobile phone help

Digital photograph

downloading

Chair Based Exercise Instructors

Walk Leaders

1St Aid Training

Food hygiene training

Benefits of this work

Reduce isolation

Promote Mental Wellbeing

Promote active ageing

Improve social capital

Promotes resilience

Healthy Community

Collaborative

Engage with

community/key

workers

Form a team

Train / build

capacity

Look at shared

solutions, try

them out……

The PDSA Cycle for ImprovementThe PDSA Cycle for Improvement

Act

• What changes

are to be made?

• Next cycle?

Plan

• Objective

• Questions/predictions

• Plan to carry out the

cycle

(who, what, where,when)

•Plan for data collection

Study• Complete the

analysis of the data

•Compare data to

predictions

• Summarize

what was

learned

Do• Carry out the plan

• Document

problems and

unexpected

observations

• Begin analysis

of the data

Story so far.....

Steering group

Professional events in 3 areas

Tayside; partnership work

Work with Pure Media UK /

potential groups

Establishing groups

Adapting the model

Young woman who won’t go to the

sexual health clinic alone because she

can’t fill in the form

The young parents & their children who

are not getting the information they

need because of literacy issues

Confidence & aspirations: The young

woman who before she found a training

place, thought her only option was

prostitution

Young People’s Stories

hi, my gf is pregnant again!! we already

have a baby and bein a dad once at 15

is enough. B4 u say anythin yes we

have heards of comdons but tht one

split!! i love my son and my gf but I

dont want a nother baby. i want to

keep my gf but if i suggest to get rid of

it she might walk out on me... i stuck

for answers HELP!!

Cool2talk 2010

How?

Engage with key agencies

Turn the research & evidence

base into an accessible form

Adapt the model

Use this to start a conversation

with young people & the

communities they live in

Work with them to try out stuff

that makes a difference

Action Period

Team building,

Scoping & developing ideas 4-6 weeks

Action Period

To October

The Collaborative

Method

May Summit bringing together

teams to share ideas

PDSA

Engagement Workshops

Teams established

Teenage pregnancy Research

Identify issues

October summit bringing together

teams to share practice

Whitfield, Dundee

Group of local women

involved in community

development.

Plan: work with this group

to build local team

including young people:

possible link with group

young women & CLD

Young people

who have

been or are

looked after

Angus College

Work with college to

bring a team together

from across Angus.

Use this team to work

in chosen area / with

chosen group

Coupar Angus

Professionals

engaged, March

meeting set. Work

with established

networks

PURE MEDIA

working group

Workshop as

an

engagement

tool & a way to

start a

conversation

&

more….using

young people

to work with

young people

Young father’s

Working with drama

group & Michael's

story to bring

together a group of

young fathers

Michael's

story

Peer led young

mum’s group

School based

group

Braeview

Next steps

Learning

Support

Challenges & Risks

Opportunities