JOINT STRATEGIC NEEDS ASSESSMENT (JSNA) TEENAGE PREGNANCY May 2016 Business Performance Team
Teenage conceptions, maternities, terminations Teenage pregnancy and early motherhood can be associated with poor educational achievement, poor physical and mental health, social isolation, poverty and related factors. There is also a growing recognition that socioeconomic disadvantage can be both a cause and a consequence of teenage motherhood. This led the previous Government to set a target to halve the teenage conception rate in England by 2010, when compared with 1998 (the national target was underpinned by local strategies to reduce the local rates by between 40% and 60%). Teenage conceptions has remained an area of policy interest; the current Government has included the [age under 18 years] teenage conception rate as one of its three sexual health indicators in its Public Health Outcomes Framework (PHOF) and it is one of the national measures of progress in tackling child poverty. Figure 1 shows the number of conceptions per annum in Hillingdon in females aged <18 years. Figure 1
Figure 1 shows that the number of conceptions for 2014 in Hillingdon (n = 105) is less than half of the recent peak in 2007 (n = 221). Table 1 shows how the conception rates for females aged <18 years have changed from 2002-04 to 2012-14, and 2009-11 to 2012-14. Table 1 2012-14 compared with 2002-04 2012-14 compared with 2009-11 Difference in rates Reduction Difference in rates Reduction Hillingdon 48.5 24.1 = 24.4 50% 30.8 24.1 = 6.7 22% London 50.0 23.2 = 26.8 54% 32.7 23.2 = 9.4 29% England 42.2 25.1 = 17.1 40% 34.0 25.1 = 8.9 26% Source: National Statistics Table 1 shows that conception rates in females aged <18 years were reduced by 40% across England, and were halved in London and Hillingdon between 2002-04 and 2012-14. Table 2 shows recent conception data for the 12 month periods ending at the end of the months shown. Table 2 Conception rate per 1,000 15-17 year old females 12 months ending Dec 2011 Dec 2012 Dec 2013 Dec 2014 Mar 2015 Hillingdon 27.9 27.7 23.0 20.5 19.7 London 28.7 25.9 21.8 21.5 20.6 England 30.7 27.7 24.3 22.8 22.3 Source: National Statistics
There were 101 conceptions in females aged <18 years for the 12 months ending March 2015. Table 2 shows that the corresponding rate of conceptions = 19.7 per 1,000 females aged 15-17 years (which is not statistically significantly different from London or England). The rolling conception rate (smoothed over three quarters) for Hillingdon, London and England is shown in Figure 2. Figure 2 The reduction in the number of conceptions in females aged <18 years since 2007 in Hillingdon has already been noted (Figure 1). Figure 2 shows the smoothed quarterly conception rate in Hillingdon compared with London and England and demonstrates that since the first quarter of 2011 the conception rate in Hillingdon has followed the national and regional conception rate. The rate (per 1,000 females aged 15-17 years) in Hillingdon has reduced from a 2013 average of 23.0 to a 2014 average of 20.5.
The conception rate is split by: maternity rate (i.e. intention to keep the pregnancy until delivery), and termination (i.e. abortion) The overlapping error bars representing 95% confidence intervals (see Figure 3) indicate that there is no significant difference between the 2014 conception rates in Hillingdon, London and England. Figure 3 Figure 3 shows that the rate of conceptions in 2014 in females aged <18 years = 20.5 per 1,000 females aged 15-17 17 years (not statistically significantly different from London or England). In 2014 the proportion of conceptions [in females aged <18 years] leading to termination in Hillingdon = 71% (London = 64%, England = 51%). For the previous three years, 2012-2014, the proportion of conceptions [in females aged <18 years] leading to termination in Hillingdon = 62% (London = 63%, England = 50%).
The 2014 data shows that the maternity rate for females aged <18 years in Hillingdon (rate = 6.0 maternities per 1,000 females aged 15-17 years) is lower than the averages for all London boroughs (rate = 7.7) and for England (rate = 11.1 maternities per 1,000 females aged 15-17 years). The conception rate and proportion leading to termination for females aged <18 years and <16 years for the three-year period 2012-14 is shown in Table 3. Table 3 <18 years of age <16 years of age Conception rate Proportion Conception rate Proportion per 1,000 15-17 leading to per 1,000 13-15 leading to year old females termination year old females termination Hillingdon 24.1 62% 4.4 80% London 23.2 63% 4.2 70% England 25.1 50% 4.9 62% Source: National Statistics Table 3 shows that in Hillingdon the conception rate for females aged <18 years is less than England, but greater than London; for females aged <16 years the conception rate in Hillingdon is also less than England and greater than London. For the period 2012-14 there were 360 conceptions in females aged <18 years (138 leading to maternity); 66 of the 360 conceptions were to females aged 15 years and younger (13 leading to maternity). Figure 4 shows the rate of repeat terminations in those aged <19 years for the years 2013 (light coloured bars) and 2014 (darker coloured bars). The numbers shown for the year 2014 have been rounded to the nearest 10 persons.
Figure 4 The rate of repeat terminations in those aged <19 years in England and London in 2014 is approximately the same as the year before. The rate of repeat terminations in Hillingdon is consistent with the England and London rates; the actual number of repeat terminations is relatively small. Map 1 overleaf shows a map of Hillingdon with the rate of conceptions for females aged <18 years in Hillingdon wards pooled over 3 years compared with the England average.
Map 1 Conception rate, age <18 years (2011-13) compared with the 2013 average rate for England
There are 12 wards with a higher conception rate in the <18 year old age group than the England average (24.3 per 1,000 females aged 15-17 years); these wards are: Botwell, Brunel, Cavendish, Harefield, Heathrow Villages, Hillingdon East, Northwood Hills, Pinkwell, South Ruislip, Townfield, West Drayton, Yiewsley.