How Britain Beat Its Teenage Pregnancy Epidemic

"When I got pregnant, no one said 'congratulations'," says Lucy V Hay, who had a baby at 17. "They'd suck their breath in and say 'oh,' at best. I remember my doctor's referral to the midwife read 'unfortunately Lucy is pregnant'. I felt very lonely and even imagined I was in 'confinement' like a shamed woman in olden times."

Lucy was one of 100,000 teenagers who got pregnant in 1998. It was this figure, among the highest in Europe, along with the fact that 8,000 of the girls were under 16, which spurred the then Labour government into action. A 10-year plan was drawn up—the Teenage Pregnancy Strategy—aimed at halving teenage pregnancy rates. These kinds of targets are normally plucked out of thin air to show ambition, then revised when it gets closer to the date, but last week, the Office of National Statistics (ONS) announced that the target of halving teen pregnancies has been more than just met: they have dropped by 51 percent. The shift in behaviour is huge.

Basically, the Teenage Pregnancy Strategy was about improving sex and relationship education (SRE), improving access to contraceptives, getting information out via a media campaign and creating support for young parents. At the heart of it was attitude change.

"To begin with, you'd hear 'oh people have always got pregnant at 16 around here'," says Alison Hadley, director of the Teenage Pregnancy Knowledge Exchange at the University of Bedfordshire. "In some areas, there were incredibly low aspirations for young people, particularly girls. But we found that where the strategy was implemented rates were coming down. Over the course of the strategy, that fatalism about teenage pregnancy went away."

On the ground, teachers and school nurses were being primed on how best to deliver information about sex to unruly classrooms. Practical advice was given acknowledging, for instance, that "teachers and other staff may need to overcome their own anxieties and embarrassment." The biggest stumbling block, however, wasn't cheeky questions from pupils or blushing teachers but the failure of successive governments to make SRE statutory.

This failure, Hadley says, was fuelled by inflammatory headlines about "sex education for five-year-olds" and similar, which mask the fact that SRE is always age-appropriate: five-year-olds learn about body parts, not blow jobs. The result is that, while some schools have great SRE, others really don't.

There is work still to be done. The UK still has the highest teenage birth and abortion rates in western Europe. "There has been a small improvement with more young people rating their SRE as good or very good," says Lucy Emmerson of the Sex Education Forum. "But there are still too many young people describing their SRE as bad or non-existent."

Alongside SRE improvements, a media campaign was launched as part of the Teenage Pregnancy Strategy. Leslie Sinoway, a long-term teen magazine editor and agony aunt, remembers a government briefing at which magazine editors were asked how best to reach a previously ignored demographic, teenage boys, with messages about safer sex. In her role as an agony aunt, Sinoway says teenage readers got bolder in their questions as time went on. "We still got asked whether you can get pregnant from a toilet seat though. There were clearly gaps in SRE."

Some commentators point to wider social shifts that may lie behind the fall in teenage pregnancy. "We've witnessed significant changes in teenage lifestyles," says Katherine O'Brien, Media and Public Policy Manager at the British Pregnancy Advisory Service (BPAS). "Alcohol use among young people has fallen dramatically, and given the known associations between heavy drinking and unprotected sex, it seems likely that this is reflected in these statistics."

Whatever else has played a part—the rise of the internet, fewer tabloid scare stories about the pill, a general trend towards later motherhood—the government strategy has undoubtedly worked. More deprived areas, which tended to receive more investment during the campaign, showed the greatest rates of decline in teenage pregnancy.

A constant through it all, however, has been the stigma attached to young motherhood itself. In Scotland, which has its own strategy in place and has likewise seen conception rates falling, Kathleen Neil says that despite the odds, having a baby as a teenager, in the mid 90s, was the best thing she ever did.

"When I got pregnant, my school told me I couldn't stay there because I was spoiling its reputation," she says. "That wouldn't be legal these days." Kathleen was sent to Edinburgh's Young Mums' Unit at Wester Hailes Education Centre. She says this was a positive experience, although "there was a sense that you'd been sent away."

"The unit was in a very socially deprived area of Edinburgh. A lot of the girls had had concealed pregnancies—no one knew they were pregnant until the moment they gave birth. They were all trying their best to make a go of it though.

"You could go to school there and sit your exams and your baby could go to the crèche. That was really integral to my getting a couple of qualifications and without those I wouldn't have been able to go to college."

Today, Kathleen is a teacher and Lucy is a writer. They've both done well and are glad they had their babies when they did. Both women, however, say they've experienced stigma as a result of being a young mum.

"We close women and young parents down all the time," Lucy says. "When I tell my story, I'm told I'm 'glamourising teen pregnancy' or that I'm the exception. I'm not the exception. I know countless teenage mums who are doing a great job."

Writer and photographer Jendella Benson, the woman behind the Young Motherhood Project, agrees. Benson says she rolls her eyes at media coverage of the issue which by default paints teenage mums as a problem to be dealt with.

"When you're a young mum, no one expects you to do well," Jendella says. "But lots of young mums are great mothers. There are so many ingrained stereotypes about young mothers; assumptions about their promiscuity or their backgrounds."

The aim of reducing teenage pregnancy can be reconciled with the desire not to demonise young parents by focusing on the issue of choice.

"If what's changed is that women are becoming more informed and better able to protect themselves from unwanted pregnancies, that's great," Benson says. "Pregnancy itself isn't the problem; it's whether women have enough information and power to make decisions their bodies."

Hadley says this was always the goal of the Teenage Pregnancy Strategy; not to stigmatise teenage pregnancy but to make sure it didn't happen through neglect or lack of options.

"The underlying message we wanted to get across was that this should be a proper informed choice," she says. "Choice about when you have sex, who you have sex with, choice of delaying pregnancy and choices when you do become pregnant."

In the end it's been this twin strategy of information and acceptance that has led to one of the biggest public policy successes in recent history. Not just reducing the number of unwanted teenage pregnancies, but allowing teenage mothers, and their children, have happy successful lives.

@FrankieMullin