Scotland has a higher rate of teenage pregnancies than most other Western European countries, In 2011 in the under 16 age group there were 5.7 pregnancies per 1,000 population, under 18 age group are 30.6 per 1,000 and the under 20 age group are 45.2 per 1,000.
Young women in the most deprived areas of Scotland are up to ten times more likely to become pregnant than their counterparts in the most affluent parts of the country. A significant proportion of first sex among young people takes place without the use of condoms or other contraception.
Reducing unintended teenage pregnancy but supporting teenage parents where they chose to continue with pregnancy are key issues for the early years workforce and can contribute significantly to improving the long term health outcomes of young people in Scotland.
Teenage pregnancy and inequalities in pregnancy
Though it is a positive experience for some mothers, evidence links teenage motherhood to negative outcomes.
The picture is one of multiple associations between teenage pregnancy and inequalities, rather than teenage pregnancy being a cause of inequalities in itself.
Quick Links:
- what are health inequalities?
- policy context
- how do inequalities relate to teenage pregnancy?
- what risks are associated with teenage pregnancy?
- identifying those at risk
- protective factors
What are health inequalities?
The WHO defines health inequalities as 'differences in health status or in the distribution of health determinants between different population groups'.
Policy content
Action to reduce inequalities associated with teenage pregnancy is consistent with:
- The Early Years Framework
- Equally Well
- Achieving our Potential
- Getting it Right for Every Child
- The Sexual Health and Blood Borne Virus Framework
- Children and Young People (Scotland) Bill
The needs of pregnant teenage mothers are highlighted in A Refreshed Framework for Maternity Care in Scotland (external link).
The Scottish Government acknowledges the key influence of maternal health and wellbeing on the national indicator 'Increase healthy life expectancy at birth in the most deprived areas'(external link).
How do inequalities relate to teenage pregnancy?
- Among under 20s, the most deprived areas have approximately ten times the rate of delivery as the least deprived (56.1 per 1,000 and 5.5 per 1,000). (ISD (external link))
- In 2004-5, 9 per cent of babies born to mothers in the most deprived fifth of the
population had a low birth weight, compared to 5 per cent of those in the most affluent areas. (Equally Well)
Women from vulnerable groups are less likely to access antenatal services and other sources of support - a high risk factor for maternal and infant mortality (Growing Up in Scotland 2011 (external link)).
Where they do access services, they're likely to do so later in pregnancy, and are less likely to maintain good contact with those services.
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What risks are associated with teenage pregnancy?
- Negative short, medium and long-term health and mental health outcomes for young mothers
- Young mothers being less likely to complete their education, pursue positive post-school destinations (in employment or education), or to have qualifications in adulthood
- Teenage mothers being more likely to be in receipt of income-based benefits or in low paid work; so poverty is strongly associated with teenage parenthood
- Teenage mothers being more likely to be lone parents, and are more likely to experience family conflict
Teenage mothers living in deprivation tend to remain in poverty. Both mothers and fathers in this group are less likely to continue in education beyond age 16, to have any qualifications or to be in employment aged 33.
Birth weight is lower and infant mortality 60% higher among babies born to teenage mothers than those born to older mothers (Teenage Pregnancy and Parenthood: a review of reviews, 2003, (external link))
However, a Scottish study closely linked higher rates of infant mortality and low birth weight to higher rates of smoking during pregnancy among teenage mothers. (Teenage pregnancy: an overview of research evidence (external link))
Teenage mothers experience poorer mental health in the first three years after giving birth than do older mothers, are less likely to breastfeed, and the children themselves are more likely to become teenage parents.
The negative outcomes which babies and children born to teenage mothers, could face include—
- Babies tend to have lower than average birth weight
- Infant mortality rates are higher than for babies of older women
- Lower rates of breastfeeding, which means babies are less likely to benefit from the associated positive health outcomes
- Greater risk of living in a lone parent household, with greater risk of poverty, poorer quality housing and poorer nutrition
Identifying those at risk
It's important to link with other professionals who may know more about the family and their circumstances, e.g. carers, GPs, social workers, the police and voluntary sector agencies.
The following factors place teenage women at increased likelihood of becoming pregnant:
- being the child of a teenage mother
- young people in or leaving care
- homeless young people
- school excludees, truants and young people underperforming at school
- young people living in deprived neighbourhoods
- Young people suffering abuse.
Disliking school and violence in school and the home are also identified as factors linked to teenage pregnancy (Teenage Parenthood and Social Exclusion: A multi-method study (external link)).
Another major predictor is being in or recently having left care (SCIE research briefing 9: Preventing teenage pregnancy in looked after children (external link))
A Pathway of Care for Vulnerable Families (0-3) (external link) sets out key contact points and interactions for those working with vulnerable families.
For a fuller discussion of common risk factors for inequalities in pregnancy, see Inequalities in antenatal care.
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Protective factors
Teenage mothers who do better are aided by:
- support from family
- having a positive partner relationship
- developing a career or having employment they liked
(Teenage Parenthood and Social Exclusion: A multi-method study (external link))
