1. Identify those most at risk

The wide variety in teenage pregnancy rates between different areas in Britain and between different social groups means that in both England and Wales it should be straightforward to identify those most at risk and to target resources appropriately.
These would include

• Children in care and coming out of care
• Girls who have already have a teenage pregnancy
• Children with mental health problems
• Children who under-achieve at school, have a poor attendance record or leave at 16 with no qualifications
• The children of teenage mothers
• Wards with significantly higher rates

Government in England and Wales should identify wards with the highest rates of teenage pregnancy and all local authorities should establish close partnerships between the relevant authorities to target support to the most at risk.

2. Give children better, earlier information about sex and relationships

The Welsh Assembly’s National Framework for sexual Health (1999) was right when it pointed to one of the reasons for high rates of teenage pregnancy in Wales: ‘A lack of consistency exists in the messages young people receive about sex. Teenagers are bombarded with sexually explicit messages and an implicit message that sexual activity is the norm. But often parents and public institutions are embarrassed or silent, hoping that if sex is not talked about, it will not happen.’

Not talking about sex and refusing to ensure that every child gets all the information and the personal skills he or she needs to be able to make rational and informed decisions about their own sexual health will not make the problem go away. Silence and ignorance are no protection against pregnancy. All children should be provided with better, earlier information about sex and relationships.

3. Help parents talk to their children

The Government already acknowledges that ‘young people who can talk openly about sex with their parents tend to delay having sex and are more likely to use contraception when they do’ and provides online advice for parents on how to talk to their children. Yet even this is minimal and many parents and children alike find it difficult to talk about sex, especially in the poorest communities. In Sweden, by contrast, every parent of a teenager is sent an imaginative and comprehensive booklet that is designed to help parents talk to their children about alcohol, smoking, drugs, sex and relationships.

So as to help parents talk to their children schools and/or local education authorities should be encouraged to produce local booklets aimed at helping parents address these issues, which should be sent to all parents on their child’s 11th birthday.

4. Improve Sex and Relationships Education in England and Wales and put it on a statutory basis

Although some people argue that sex education is to blame for the rise in sexual activity of teenagers in the early 70s and 80s, the truth is that sex education in England and Wales has remained rudimentary at best, with many schools solely teaching the biological aspects of sex, as stipulated in the science curriculum. Whilst this covers contraception and STIs, it does not allow for sex to be placed in its proper context. Nor does it provide youngsters with the full range of skills they need to steer a steady course through puberty and teenage years. In the vast majority of cases it starts far too late – once puberty or sexual activity has already begun.
Ofsted has rightly argued that ‘the public debate on issues such as sex and relationship education (SRE) is often ill informed and does not take account of the real pressures on young people. Just as with drugs, young people need to be equipped to make informed choices about relationships and to be able to resist pressures to have sex, but a minority response to Ofsted’s last report on SRE was a call to consider introducing ‘abstinence-only’ programmes as the only option for unmarried people of any age. There is no evidence, however, that ‘abstinence-only’ education reduces teenage pregnancy or improves sexual health. There is also no evidence to support claims that teaching about contraception leads to increased sexual activity. Research suggests that education and strategies that promote abstinence but withhold information about contraception can place young people at a higher risk of pregnancy and sexually transmitted infections (STIs).’

Many have argued that this problem will only be properly resolved when Sex and Relationships Education (SRE) is put on a statutory basis so that all schools have to provide more than the mere biological facts. An NOP poll in 2006 showed that 86% of the public agree that it should be a compulsory part of the curriculum and that 81% of parents think schools should teach young people about the emotional aspects of sex and relationships. Childline and the NSPCC are both keen to see SRE placed on a statutory basis.

I agree. SRE should be put on a statutory basis in England and in Wales, with an opt-out for individual parents. But that is not enough. It has to be effective. That means:

• SRE should start young and certainly (at an age-appropriate level) before the onset of puberty so that no child leaves primary school aged 11 without having had a series of
• SRE lessons and so that no girl starts her periods without an understanding of what is happening to her. Programmes that start after children become sexually active are likely to be useless.
• Sex should be placed in the proper context of relationships and emotional development, giving young people the personal confidence that it is “OK to say no”. Role-play, open discussion and assertiveness education should all be an important part of giving youngsters a sense of their own self-worth. It should also equally emphasise the positive aspects of sex and sexuality, the value of delaying first sex and the enormous responsibilities of parenthood.
• Any school based programme should not only teach about contraception services, but should provide access to local services, so that a class might for instance visit local services so as to improve self-confidence and break down anxieties.
• SRE has to be well taught, by specialist staff – and as part of a modular programme so that youngsters can acquire confidence to ask difficult questions. In many areas it will be necessary to provide additional training for existing staff – or for health professionals to be trained in SRE.

5. Improve non-school advice services for young people

Surveys of young people suggest that health advice services are rarely thought of as welcoming or accessible. This is certainly true in the Rhondda where there are part-time clinics in Ynyswen, Ferndale, Tonypandy and at Llwynypia hospital. All of these are in doctors’ clinics, where there is negligible anonymity for youngsters and in a clinical environment that feels inaccessible for youngsters. Again this reinforces the impression that sex is a largely biological and medical matter rather than an emotional one. Summoning up the courage to visit such a clinic – either to seek contraception or once one is pregnant – can be tough for all but the most confident teenagers. School visits as part of SRE could help, but all schools and colleges should seriously consider hosting sexual health clinics where students can access information, advice and contraception.

In addition, the work of the Youth Service should be significantly expanded, especially in areas with high levels of teenage pregnancy, so that youngsters can learn about sex in the context of personal development in a less formal setting.

6. Improve the availability of free contraception

Many youngsters in the Rhondda have told me that free condoms are hard to come by unless one is prepared to visit a clinic. For the poorest youngsters the cost of condoms either in a chemist or in the pub toilet can be prohibitive and if choosing between another bottle of beer and a pack of condoms many will forget the condoms.

In the gay community, by contrast, the continued campaign against HIV/AIDS has meant that free condoms are far more readily available, with most gay bars providing them. There should be a parallel national campaign to provide free condoms to youngsters, making them available in places where young people go, aimed at cutting STIs and pregnancies. This should start in the 150 wards in England and Wales with the highest levels of teenage pregnancy.

7. Improve young people’s understanding of contraception

Improved school-based SRE can help increase young people’s understanding of the relative effectiveness of different kinds of contraception, but we also need to target the under 18 population with more accurate information, encouraging the double protection model (‘belt and braces’) of oral contraception and condoms. A sustained campaign in young people’s magazines, akin to the campaign on HIV/AIDS, that provides a consistent message and does not shift contraceptive use from the pill is vital. It should also address young people’s other concerns around the use of the pill.

8. Improve access to and information about emergency contraception

Several Local Health Boards in Wales and PCTs in England have introduced schemes whereby chemists can dispense emergency contraception for free. This should be extended across the country.

In addition clearer information about emergency contraception should be provided online, in chemists, in school nurses’ clinics and in youth centres, so as to counter the misinformation of recent years.

9. Provide more supported housing

The majority (90%) of teenage mothers live in other people’s homes, most normally that of their parents or their boyfriend’s parents. Many, however, are thrown out of their parents’ home or may have been in care. Whilst it is very rarely true that a girl will deliberately get pregnant so as to acquire a Council flat, it is true that local authorities do have to house many young mothers every year. In some areas, local authorities provide supported housing where several young mothers may live in close proximity, with a range of educational and medical facilities on hand. Experience in Boston, Massachusetts, suggest that supported housing where girls share cooking facilities and have a robustly supportive and challenging environment where their responsibilities as well as their rights are stressed has helped individuals better survive the rigours of early motherhood and cut local teenage pregnancy rates.

Many areas in England and Wales, including teenage pregnancy ‘hot-spots’ like the Rhondda, have no supported housing for teenagers at all. All too often this means that a young girl, often on her own apart from her baby, will be living in a wholly unsuitable flat. Although the appeal of such independence might be strong, many suffer from acute levels of depression due to the isolation this can involve.

Every local authority should develop proper programmes of support so that no under 18 year old mother is housed in isolation.

10. Extend educational (though not necessarily academic or school based) opportunities for teenage mothers

The Books and Babies project I visited in Nantgarw is a prime example of the kind of unit that can help teenage mothers cope with the problems they face and improve their educational opportunities. The girls themselves clearly valued it and all had ambitions for the future. However, the project only works with teenagers up until their 16th birthday and many colleges have very limited childcare. The advent of Flying Start in Wales, with its 5 times 2½ hour sessions of free childcare a week will make a significant difference, but if we are to help teenage mothers make different choices other than a second teenage pregnancy, we need to make it far easier for them to reenter school or college. All colleges should have readily accessible and affordable (or free) childcare.

Every teenage mother should be ensured an individualized programme that enables her to be in education, employment or training.

11. Give the dads a stake

One significant complaint by several of the young people I have spoken to in the Rhondda is the fact that it is not just that the girls may deliberately exclude the fathers form their lives as young mothers, but that the support systems for teenage mothers often exclude the fathers. So for instance one young couple (16 and 19) were not able to apply for a council tenancy jointly, but the 16 year old mother would be guaranteed a place if she applied on her own. This despite the fact that they were staying with the father’s parents in a three-bed house with seven people. As Antony put it, ‘It’s really stupid. There’s all this support for teenage mums, but nothing for teenage dads. It’s as if we don’t count, we’re not wanted.’ Suitable educational support should be provided for teenage fathers, with an emphasis on financial management, educational opportunities, sexual and personal health and contraception. Housing rules should be changed so that the presence of a father does not automatically rule a teenage mother out of a successful application.

‘Single mother benefits are better if the father is not there.’ ‘Women are so independent these days that they want to do without the dad.’ - Students at Treorchy Comprehensive

In a related issue, the Government is consulting on whether the law should presume or insist that a birth will be registered in the name of both parents. At the moment a girl cannot register the father’s name, unless they are married or unless he is physically present. Clearly, there are reasons for this, but unless fathers are given a stake in their children’s future – and given support so that they can be good fathers, the cycle of teenage pregnancy is likely constantly to be repeated.

12. Make it easier for teenage mothers to go to work

Employment is not only the best route out of household poverty, it gives a single mother a chance to socialise and provide a secure home for her child. And in nearly every case it improves the likelihood of the child avoiding a teenage pregnancy as well as the mother’s mental and physical health. Recent evidence from the Joseph Rowntree Foundation and the Head of Policy Research at One Parent Families (Lone Parents and ‘mini-jobs’) suggests there is a real need to help mothers who wish to work around 10 hours a week as a gateway into employment.

They argue, ‘A lone parent on Income Support can earn up to £20 a week before Income Support is reduced pound for pound for all earnings above this level… The gain to working at the minimum wage for a lone parent with one child who is eligible for Housing and Council Tax Benefit is around £20 a week for four hours' work, around £24 a week for 15 hours' work, but around £44 a week for 16 hours' work (all before paying for childcare and other work-related expenses). Given these incentives, the low rate of lone parents who do mini-jobs at present (4 per cent) is not really surprising.’

Government should do everything it can to provide active incentives for teenage mothers to engage in education, employment or training and it should actively seek to make ‘mini-jobs’ in the range of 10 hours financially attractive. It should therefore consider an increase in the Income Support disregard, accompanied by an increase in the disregard within Housing Benefit and Council Tax Benefit.

13. Promote a positive responsible attitude towards alcohol

The problem of British under age drinking and teenage drunkenness is much debated in the media, but the irony of the many contradictory messages sent out on alcohol is not lost on many young people. As one boy put it to me at Treorchy Comprehensive, ‘It’s the booze culture here in the Rhondda. Your parents tell you it’s wrong to get drunk and then spend every weekend pissed out of their minds. And everyone just laughs about it.’

Tackling the booze culture, especially the binge-drinking trends amongst young girls, would take a lengthier exercise than would be appropriate here. But education about alcohol should be a core part of PSHE in all schools and local authorities should take active steps in coordination with the police to close down off-licenses and pubs that sell (and often rely on their sales) to under 18s.

Government should also stop irresponsible alcohol marketing practices, many of which are directed at young people, including ‘drink as much as you can’ and ‘happy hour’ campaigns – as well as crack down on supermarkets selling alcohol at bargain rates designed to get customers into the store.

14. Provide consistent messages on sex and relationships

Government at every level is limited in what it can achieve against a media background that sexualises people at an ever younger age. But parents, schools and government need to provide consistent messages that accept that youngsters may not share precisely the same values as they do, but that stress not just the biological or medical aspects of sex, but the emotional as well. A harsh or judgemental attitude is unlikely to be effective with most young people and youngsters are quick to spot hypocrisy. But the responsibilities and the emotional and financial cost of parenthood – and the consequences of early and unprotected sex – should be a core part of what young people learn through their school, their youth group and the subliminal messages society sends out. It is right that society provides real support to teenage parents. The costs of not doing so will be paid by the next generation. But no youngster should be under the illusion that the choices they make are without consequences.