2007 abortion data were published by the Department of Health on 19 June and show increases in the abortion rate for all women aged under 20, most markedly for those age under 18. These data highlight that many PCTs need to significantly improve performance for the Public Service Agreement target to reduce under 18 conceptions by 50% by 2010 to be delivered. Reducing teenage conceptions is a Tier 2 Vital Signs indicator (national priority for local action). Between the 1998 baseline year and 2006 (the latest year for which data are available), the under-18 conception rate has fallen by 13.3% and the under-16 rate has fallen by 13.0% over the same period. Within the overall reduction in all under 18 conceptions, the rate of births has fallen by 23%, whilst the rate of abortions has stayed stable. While teenage pregnancy rates are at their lowest rates for over 20 years, most areas are not on trajectory to meet their planned contributions to the PSA target.
The Teenage Pregnancy Strategy is multi-faceted and is based on the best international evidence on what works. One of the priority actions identified in the strategy is to ensure equitable access to the full range of contraception methods and provision of high quality advice and support. There is increasing evidence that contraception can have a significant impact on teenage conceptions:
Some methods of contraception are more effective at preventing pregnancy than others. The effectiveness of oral contraceptive pills depends on their correct and consistent use. A NICE guideline was published in 2005 which highlights that if 7% of women switched from the contraceptive pill to Long Acting Reversible Contraceptive (LARC) methods (defined at the intrauterine device (IUD), hormonal injection, intrauterine system (IUS) and contraceptive implant) the NHS could save around £100 million through reducing unintended pregnancies by 73,000.
In February, the Public Health Minister, Dawn Primarolo, announced £26.8m new funding for 08/09 from the Comprehensive Spending Review to improve access to contraception. In 2008/9, the money will be allocated as follows:
Further funding will be available in 2009/10 and 2010/11. More detailed Best Practice Commissioning Guidance for Reproductive Healthcare is currently being finalised and will be published later this summer.