Postnatal Contraceptive Planning, South Tyneside
| Description | The aim of the project is to reduce the number of second unintended pregnancies for teenage parents. |
|---|---|
| Setting | Out of the 20 wards in South Tyneside, nine have been identified as a “hotspot” area: wards that have an under-18 conception rate for 2000-2 among the highest 20% in England. |
| Populationting | South Tyneside has approximately 90 to 100 teenagers (aged 15-17) continuing with their pregnancy each year. |
| Intervention summary | Contraceptive planning both in the antenatal and postnatal period, offered to all young women under the age of 20 accessing the Young Women’s Pregnancy Service. |
| Outcome Summary | The number of young women experiencing second unintended pregnancy within the first postnatal year. |
| Startup Cost | The project cost has been subsumed into current service provision. |
| Running Cost | The project cost has been subsumed into current service provision. |
| Funding | Teenage Pregnancy Local Implementation Fund and mainstream service funding. |
| Started | 2004 |
| Ended | Ongoing - this project has been integrated into young women’s antenatal and postnatal care. |
| Location | Contraceptive planning both in the antenatal and postnatal period. |
| Contact |
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Background
The project was set up to provide a dedicated service to pregnant teenagers in South Tyneside, an area with high levels of deprivation.
What is the problem you are trying to solve?
The project aims to reduce the number of second unintended pregnancies for teenage parents.
What local organisations are involved?
The project is largely a partnership between the Primary Care Trust and the Foundation Trust and involves midwifery and contraception services. Specialist young parent advisers and health visitors are also involved in aspects of support including accessing postnatal contraception]
How many people are running this project and who are they?
A pregnancy options adviser and the Young Women’s Pregnancy Service (including one co-ordinator midwife and one additional half-time midwife)
What local population are you targeting?
South Tyneside has approximately 90 to 100 teenagers (aged 15-17) continuing with their pregnancy each year. The service is offered to all young women under the age of 20 accessing the Young Women’s Pregnancy Service which is a dedicated maternity provision for this specific age group.
How many people are you targeting?
Around 105 young women per year under the age of 20
Interventions
What interventions are you using to address the problem?
A dedicated Young Women’s Pregnancy Service which arranges for information and discussion about contraception to routinely take place with pregnant teenagers during the antenatal period and to be implemented postnatally. A pregnancy options advisor will send text message reminders to clients about the chosen method of contraception and appointment reminders postnatally, if necessary.
Is the project design based on evidence? If so, please state reference.
Local evidence of increased contraceptive use when discussion and provision was integral to termination of pregnancy services, was taken as a basis for the piloted service. Furthermore, an audit of take up of contraception and reduction in second pregnancies has resulted in further local evidence to reinforce the approach.
Research by Walton et al suggested women were more receptive to information about contraception in the antenatal period although a later review by Smith et al suggested no effect. 1 2 However, the National Institute for Health and Clinical Excellence (NICE) postnatal care guidelines and the Department for Children, Schools and Families’ Teenage Pregnancy: Next Steps Guidance, (2006) both support this approach. 3 4
Outcome
What outcomes or planned outcomes are you measuring?
Process outcomes: The number of young women accessing the planning opportunity and the number of young women taking up the contraceptive method after delivery.
Outcome: The number of young women experiencing second unintended pregnancy within the first postnatal year.
Do you have any outcomes or results yet? If so, what are they?
On average, over 150 patients are annually seen to discuss contraception/sexual health. In 2006, 95% patients enacted their chosen method within the optimal postnatal timeframe. Forty five percent of patients who delivered, implemented a long-acting reversible method of contraception.
Is your project relevant to a government target or guideline?
Public Service Agreement: To reduce by 50% the number of teenage pregnancies by 2010.
Feedback
What obstacles did you have to overcome to set up this project?
No real obstacles. The initial collaborative discussion and agreements supported the role out of the service.
What have you learned about the project so far?
Young people and their partners have been very receptive to informative discussion around available methods of contraception and, with support, are motivated to enact their decisions.
What would you do differently?
Increase either the time available or personnel available to provide the service to include a greater input during the antenatal period and provide more face-to-face support and follow up further into the postnatal period including a six-week and nine-month follow up to ensure compliance.