Teenage pregnancy

We look at the under-18 conception rate in England and how it has changed over time.

Indicator

Last updated: 31/03/2022

Effective clinical care
Public health Children and young people

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. Whilst abortion was made legal in England, Scotland and Wales in 1967, Northern Ireland legalised abortion in October 2019.

Reducing the rate of under-18 conceptions is an ambition in the Department of Health's A Framework for Sexual Health Improvement in England and is measured as an indicator in the Public Health Outcomes Framework.


How has the under-18 conception rate changed over time? 31/03/2022

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Between 1993 and 2019, the under-18 conception rate in England and Wales decreased by 63%, from 42 per 1,000 women to 16 per 1,000 women. The rate of decline appeared to accelerate in 2007. In 1999, the Teenage Pregnancy Strategy for England was launched, with the aim of halving the under-18 conception rate by 2010, from a baseline of 46.6 per 1,000 women. The evidence-based whole-system approach, alongside investment in contraceptive services, helped to achieve success in many local areas. Although this national target was not met, the under-18 conception rate has continued to fall since the end of this strategy.

The under-18 conception rate has decreased for 12 years running. In 2019, there were 14,857 under-18 conceptions in England and Wales, equating to 16 conceptions per 1,000 women in the age-group. This was a 5% decrease compared with 2018, and a 61% decrease compared with 2007. Public Health England (now the UK Health Security Agency and Office for Health Improvement and Disparities) accredits this reduction in teenage pregnancies to a long term evidence based teenage pregnancy strategy delivered by local governments and their health partners. Nevertheless, continued focus is needed as teenage birth rates in England are higher than their Western European counterparts.

Long Acting Reversible Contraception (LARCs), such as IUDs and the hormonal implant, has 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 in their response to the Health and Social Care Committee report on Sexual Health that there should be access to LARC at all sexual and reproductive health services.

The under-18 conception rate has decreased for 11 years running. In 2018, there were 15,644 conceptions to women aged under 18 in England and Wales, equating to 17 conceptions per 1,000 women. This was a 6% decrease compared with 2017, and a 60% decrease compared with 2007. There are many factors that could explain recent reductions in under-18 conceptions, including programmes to improve access to contraceptives, a shift in aspirations of young women towards education, and the perception of stigma associated with being a teenage mother.

In 2018, 53% of under-18 conceptions resulted in an abortion, which is the highest percentage in over 25 years. This suggests that more needs to be done to prevent unwanted pregnancy through better sexual education for young people, promoting effective contraception, and improving access to sexual and reproductive health services.


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 to 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 to 17 age group is effectively treated as the 'population at risk'. For more information, see the Conception statistics Quality and Methodology Information report.

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