Background
Research has shown 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 mental health problems than older mothers. Infant mortality rates are 60% higher for babies born to teenage mothers. As children, they have an increased risk of living in poverty and are more likely to have accidents and behavioural problems.
Access to safe and free abortion and contraception are key issues when it comes to teenage pregnancy. While abortion was made legal in England, Scotland and Wales in 1967, Northern Ireland legalised abortion only in October 2019. Here, we explore the number of abortions and rate of conception in women below the age of 18 in England and Wales over time.
Teenage abortions and conception rate
The under-18 conception rate has decreased considerably since 2007. Between 2007 and 2021, the under-18 conception rate in England and Wales decreased by 68%, from 42 per 1,000 women to 13 per 1,000 women, resulting in 13,131 under-18 conceptions in England and Wales in 2021. The number of abortions also saw a rapid reduction, going from 21,494 in 2007 to 6,999 in 2021 (a 67% decrease). The most recent year, however, saw a small increase in both the rate of under-18 conceptions and number of abortions.
Reducing the rate of under-18 conceptions was an ambition set in 2013 in the Department of Health's A Framework for Sexual Health Improvement in England. While this ambition has succeeded, there remain stark inequalities in the conception rate with a seven-fold difference in rates across different local authorities. The teenage pregnancy prevention strategy published a framework for local authorities to address this disparity and invest further resources in educational and contraceptive support for women at higher risk of early pregnancy. Another challenge is the change in use of Long Acting Reversible Contraception (LARCs), such as IUDs and the hormonal implant, which have been credited with reducing teenage pregnancy rates. However, due to changes in funding arrangements, there has been a 13% drop in their use as many women are no longer able to access LARC. The government recommends further access to LARC at all sexual and reproductive health services, especially because £1 spent on contraception is estimated to save the NHS £11 plus welfare costs.
About this data
Under-18 conception rate per 1,000 population:
• Numerator: total conceptions in all women aged under 18.
• Denominator: total female population aged 15–17.
Office for National Statistics (ONS) conception statistics are compiled by combining information from birth registrations and abortion notifications. Conception statistics include pregnancies that result in:
• one or more live or still births
• a legal abortion under the Abortion Act 1967.
Miscarriages and illegal abortions are not included. The date of conception is estimated using recorded gestation for abortions and stillbirths, and assuming 38 weeks’ gestation for live births. A woman’s age at conception is calculated as the number of complete years between her date of birth and the date she conceived. Data prior to 1993 is not fully comparable, due to changes to the definition of a stillbirth in 1992. A stillbirth is defined as a child born after 24 weeks of gestation that did not show any signs of life. Prior to 1993, the definition was set at 28 weeks of gestation.
The postcode of the woman’s address at time of birth or abortion is used to determine the local authority/ward of residence at the time of conception.
Estimated number of abortions for under-18s:
- The number of conceptions for women aged under 18 multiplied by the percentage of conceptions leading to abortion for women aged under 18
Only about 5% of under-18 conceptions are to girls aged 14 or under, and to include younger age groups in the base population would produce misleading results. The 15–17 age group is effectively treated as the 'population at risk'. For more information, see the Conception statistics Quality and Methodology Information report.