Teenage pregnancy in South London

Abstract

The increasing proportion of teenage girls of West Indian origin presenting for legal NHS abortions at the two teaching hospitals in a district of South London prompted the setting up of this study (1979--81, funded by the DHSS).

The study's main aims were to ascertain whether, in fact, the proportion of girls of West Indian origin was higher than would be expected in the district, which has a sizable population of long-settled West Indian immigrants; if so, to identify the most important contributory factors and to make appropriate recommendations for changes or improvements in the services, in order to bring about a reduction in the number of unwanted pregnancies.

In all, 550 teenage girls were interviewed: 220 after termination of their pregnancies, and 217 after the birth of their babies; a small comparison group of 113 teenagers who had never been pregnant was recruited in the district's hospital and community family planning clinics.

Interviews were conducted using a semi-structured questionnaire and the results compared, where possible, with other similar studies. This survey data, together with systematic and non-systematic observations made throughout the period of the study, were used to give support to the hypotheses.

About a third of both groups of pregnant teenagers were of West Indian origin. This was higher than anticipated. Since socio-economic differences did not provide immediate explanations, certain hypotheses were tested which derived from the apparent importance of types of inter-personal relationships (specifically, mother-daughter and boy-girl) as predictors of the risk of a teenage girl experiencing an unplanned and initially unwanted pregnancy.

The method of contraception (if any) used by a teenager at the time of her first sexual experience, provided a useful indicator of the type of relationship a young couple had. Girls of West Indian origin appeared to find themselves when they became sexually active, in "segregated" relationships with their partners (as opposed to "integrated" relationships), relationships typified from the study's viewpoint, by the non-use of any form of contraception, at least in the relationship's initial stages.

Once having identified what seemed to be a key to the problem (exemplified in the classification of relationship types devised) the question of how best to utilise this knowledge arose. It was suggested that the study's classification of relationship types could provide a useful frame of reference for those health professionals most closely concerned with young women and young men. Recommended changes in the services centred upon changing the attitudes of service workers towards young people, in the hope of improving their image and making them more approachable. It was suggested that a lay visitor on the wards who would also be available to give advice during those family planning clinic sessions directed specifically at young people, would provide invaluable support for teenage girls who had experienced an unplanned pregnancy.