Contributing Factors to Teenage Pregnancy in Barking & Dagenham, UK

This dissertation investigates the contributing factors to teenage pregnancy in the UK, with a specific focus on the Barking and Dagenham boroughs. Through a systematic literature review and thematic analysis, the study identifies socio-demographic factors, low education, disrupted family structures, reproductive health knowledge, risky health behaviors, and service accessibility as key determinants. The research highlights the need for early sex education, improved access to reproductive health services, parental support, and community interventions to reduce teenage pregnancy rates and improve the well-being of teenage mothers and their children. The study emphasizes the public health implications of teenage pregnancy, including its impact on maternal and child mortality, educational attainment, and socio-economic disadvantage, and suggests policy and program interventions to address this complex issue.

Running head: TEENAGE PREGNANCY IN UK
Teenage pregnancy in UK
Name of the Student
Name of the University
Author note

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Abstract
The following dissertation focuses on the contributing factors to teenage pregnancy in UK. There
are high pregnancy rates in UK where it is considered a major contributor to high maternal and
child mortality and morbidity increasing the burden of disease. This has emerged as a major
public health and social issue having dire consequences for the teenagers of the age 13 to 19
years. Adolescence is considered to be crucial phase where they undergo maturity. During this
phase, pregnancy becomes a serious issue having negative health outcomes for the early mothers
and their infants. There is need to prevent unwanted pregnancies so that teenagers lead a healthy
life with attainment of major milestones in their career development. Therefore, the aim of the
dissertation was to study the contributing factors to teenage pregnancy in UK. For this, a
systematic literature review was performed to explore the predisposing factors that result in
teenage pregnancy. Thematic analysis was performed as data analysis and six themes were
deduced for fulfilling the research aim. Socio-demographic factors, low education, disrupted
family structure and stability, reproductive health knowledge, attitude and behaviour,
engagement in risky health behaviours and service accessibility are the major contributing
factors to teenage pregnancy in UK. Therefore, early sex education in school, access to
reproductive and sexual health services, parental support and community services interventions
are required to prevent teenage pregnancy in UK that can be helpful in reducing high unwanted
pregnancies among teens of the age 13-19 years.
Table of Contents
Chapter 1: Introduction to the research...........................................................................................4

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1.1 Introduction............................................................................................................................4
1.2 Research problem..................................................................................................................6
1.3 Justification............................................................................................................................7
1.4 Significance...........................................................................................................................8
Chapter 2: Literature Review...........................................................................................................9
2.1 Introduction............................................................................................................................9
Social and Economic factors.....................................................................................................10
Family relationships...................................................................................................................11
Gender Dynamics......................................................................................................................14
Early menarche, age at first sex, contraception.........................................................................15
Summary and Research gaps.....................................................................................................16
Theoretical framework...............................................................................................................17
Chapter 3: Methodology................................................................................................................18
3.1 Introduction..........................................................................................................................18
3.2 Research design...................................................................................................................20
3.3 Research strategy.................................................................................................................20
3.4 Data collection and analysis................................................................................................21
3.4.1 Keywords..........................................................................................................................22
3.4.2 Bibliographic aids.............................................................................................................22
3.4.3 Inclusion and exclusion criteria........................................................................................23

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3.4.4 Secondary research...........................................................................................................24
3.4.5 Search outcomes...............................................................................................................25
3.4.6 Methods of data analysis..................................................................................................25
3.5 Ethical considerations..........................................................................................................30
3.6 Limitations of the study.......................................................................................................31
Chapter 4: Research findings.........................................................................................................31
Socio-demographic factors........................................................................................................31
Educational factors....................................................................................................................32
Family structure.........................................................................................................................33
Reproductive health knowledge, behaviour and attitude..........................................................34
Risky health behaviours.............................................................................................................35
Service accessibility...................................................................................................................36
Chapter 5: Analysis and Synthesis................................................................................................37
Implications for social work..........................................................................................................40
Chapter 6: Conclusion and recommendation.................................................................................41
References......................................................................................................................................44

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Chapter 1: Introduction to the research
1.1 Introduction
Adolescence is a crucial and vulnerable phase in the process of human development as it
represents the transition from childhood to adulthood through physical, emotional and
psychological maturity. During adolescence, they learn and gain skills, knowledge so that they
are able to deal with the critical aspects involved in health and development while maturation
takes place. Therefore, pregnancy during this vulnerable stage can make teens face the wrath of
premature pregnancy and childbirth. Indeed, every year around 16 million girls of the age 15 to
19 years and around 2 million girls below the age of 15 give birth (Ganchimeg et al. 2014).
On a global scale, about one in five girls of 18 years age give birth. Of all the adolescent
pregnancies, 95% occur in low and middle income countries especially among poor and
marginalized populations (Mmari and Sabherwal 2013). The statistics highlights the fact that
over the past few decades, teenage pregnancy is a major contributor in child and maternal
mortality to vicious cycle of poverty and ill health. Adolescent pregnancy has become a serious
health issue that has severe consequences for the pregnant adolescents in terms of health for both
the girls and their infants. There are severe complications from teenage pregnancy and early
childbirth being the major cause of death among teenage girls aged 13 to 19 years.
According to statistical data 2015, about 21 million girls aged 15 to 17 years became
pregnant in the developing countries every year. About 13 million children are born to the girls
below the age of 18 years worldwide and more than 90% of this occurs to the girls belonging to
developing countries (McKay and Barrett 2010). Every year about 20,000 girls under the age of
19 years give birth in developing countries that contribute to 7.3 million births in a year. Various

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factors contribute to teenage pregnancy like vulnerability to poverty and social exclusion, lack of
health information or healthcare as outlined by United Nations Population Fund (UNPF).
Teenage pregnancies result in irreparable consequences that lead to violation of rights (World
Health Organization and Unicef 2015). These pregnancies are not a deliberate choice as early
pregnancies have severe consequences on their sexual and reproductive health. Government is
taking initiatives to support comprehensive sex education and reproductive health so that
teenagers are able to avoid pregnancy, lead a normal life and reach to their full potential.
Early motherhood is closely linked to human rights issues as a pregnant teenage is forced
to leave school and denied right to education. Moreover, teenage pregnancy hinders them from
acquiring reproductive health information and denied right to health and contraception. At the
same time, poor girls living in rural areas are at great risk of adolescent pregnancy and about 3
million girls every year resort to unsafe abortions that risk their lives (Gruskin et al. 2008).
On a global scale, United Kingdom (UK) has the highest percentage of teenage
pregnancy with highest number of abortions. The teens are highly engaged in sexual intercourse
and about one-third of this population does not use any contraception contributing to teenage
pregnancy. Barking and Dagenham Boroughs in UK face the highest teenage pregnancy rates
despite of continuous government efforts. Office for National Statistics (ONS) released data
revealing that around 27 girls in every 1000 below the age of 18 years got pregnant during the
year 2016. About 108 young girls across this borough conceived and these figures are of great
concern to the government (Brown 2016). There is need for closing the gap in these boroughs;
however, the figures have reduced since 2015. Therefore, the following dissertation will focus on
the factors that contribute to teenage pregnancy in UK.

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1.2 Research problem
Teenage pregnancy is a public health issue rather than clinical problem because
coordinated action is required for helping young women in avoiding unwanted pregnancy and
dealing with the consequences. The healthcare system need to play a crucial role that is
undeniable that not only comprises of offering sexual health services, but also provision of
termination and maternity services for the girls who wish to end or continue their pregnancy. The
reason why adolescent pregnancy is precisely considered a major health issue in UK, as there are
serious negative consequences of unwanted pregnancy. The problems of smoking, obesity, poor
diet and isolation also need to be considered if the situation needs to be prevented rather than
treating the consequences (Banerjee et al. 2009). Adolescent conception and early motherhood
are strongly linked to poor physical, mental and sexual health (both mother and child), poor
educational achievement and poverty. These factors recognize the fact that socio-economic
disadvantage is a cause and effect of adolescent pregnancy. In addition, teenage pregnancy is
always an area of policy interest as three sexual health indicators need to be focused concerning
teenage pregnancy conception, child poverty and social impact on teen mothers.
The increase in teenage pregnancies and birth rates in these London boroughs is an
indication of lack of family support. Social problems like anti-social behaviour and family
breakdown are considered the causes of unwanted teenage pregnancies. Barking and Dagenham
boroughs in London are the most deprived with highest teenage pregnancy percentage. The
council is in greatest need for health services that offer targeted family support services in these
boroughs (Mahavarkar, Madhu and Mule 2008). There are also potential negative outcomes of
teenage pregnancy as baby born to a teenage mother may have low birth weight and life
expectancy, congenital anomalies, increased likelihood of infant mortality, developmental and

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behaviour problems. Therefore, teenage pregnancy poses severe challenges and issues to the teen
mothers as well as to the newborns as compared to older mothers.
1.3 Justification
Teenage pregnancy is not only biologically harmful, but also has severe mental and
psychosocial issues. Teen mothers are socially isolated as compared to other teenagers with
mental health issues, fewer employment and educational opportunities. This fact is not supported
and fails to consider that teen mothers belonging to low and middle income are subjected to
disadvantaged life trajectories regardless of the fact that they become pregnant (Gaudie et al.
2010). Many teenagers are sexually active and unaware of contraception use and other sexual
health related information. Moreover, counselling and referral regrading abortion is not available
to them in case if teenagers want to terminate pregnancy.
Majority of teen parents and their newborns lives in deprivation and experience multiple
risk factors like poor health, poverty, economic and social outcomes along with inter-
generational deprivation (Cook and Cameron 2015). Teen mothers are forced to leave school that
results in missing a major phase of education resulting in low education attainment, insecure jobs
or no employment. In addition, teenage mothers are subjected to raise their children in poor
housing or temporary accommodation. In addition, their partners are poorly qualified and likely
to experience unemployment. There is no sort of monetary assistance from their families for their
children upbringing creating financial burden on the teenage mothers. In addition, girls who are
subjected sexual violence and abuse at the ages 13 to 19 years are at high risk of adolescent
pregnancy. This condition also increases health inequalities resulting in poor health outcomes for
the teen parents and their children. There is also poor mental and emotional health wellbeing
among the teenage mothers with increase in post-natal depression and risk of mental health

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issues. There is lack of self-esteem that greatly affects a young mother’s ability to tolerate peer
pressure, unwanted sexual intercourse, abusive relationships and ability to negotiate
contraception use (Trenholm et al. 2008). Therefore, there is urgency to identify the underlying
factors that contribute to teenage pregnancy in UK for improving physical, mental and emotional
wellbeing of teenage mothers and their children.
1.4 Significance
The significance of exploring the contributing factors to teenage pregnancy in UK will
help in preventing the public health issue. As a result, the negative outcomes of teenage
pregnancy can be avoided offering quality life to the teenage mothers and their children. Sexual
education can also be provided to the teenagers regarding contraceptive use and in overcoming
the social barriers that hinder good sexual health (Kohler, Manhart and Lafferty 2008).
Moreover, teenage pregnancy is violation of their social rights that make them vulnerable to
abuse and violence with poor health, education and abstinence to maternity services (Copping,
Campbell and Muncer 2013). The ill consequences of teenage pregnancy can be disseminated to
the young mothers through this research.
The factors that influence teenage pregnancy can be helpful in designing interventions
and programs that can be effective in reducing this public health issue. The investigation of
contributing factors can be placed to reduce the rates of teenage pregnancy while improving the
range of outcomes for the young individuals. Educational programs can also be designed through
identification of factors paving the way for teenage pregnancy prevention along with social and
biological aspects (Mueller, Gavin and Kulkarni 2008). This will also help in developing policies
and programs that can focus on providing sexual health education with increase in contraception
use correlating with adolescent pregnancy. Teenage pregnancy prevention is the most effective

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way to reduce early age pregnancies and identification of contributing factors can be helpful in
tackling this complex health issue using the best evidence available and designing best practices.
Therefore, exploring the root causes of teenage pregnancy can be helpful in supporting teenager
girls in preventing unwanted pregnancy.
Chapter 2: Literature Review
2.1 Introduction
There is a growing concern about teenage reproductive health since last three decades. It
is the core issue associated with the adolescent sexual health and academic injury. UK has not
been spared from the complications and challenges presented by the teenage pregnancy. Inquiry
into this issue has begun since 1980s. To control the increasing prevalence of teenage
pregnancies in UK the policy makers have developed various strategies and polices. Despite
these strategies targeted at teenagers, teenage pregnancy in UK remains a topical issue (Craine et
al. 2014). In this section, studies that have been undertaken on teenage pregnancy in UK are
reviewed.
The literature review will help provide the rationale and context for the study. It is mainly
focused on the factors contributing to the teenage pregnancy in UK. It will help deviate from
the “traditional knowledge, attitude and perception” studies or KAP. It is because these studies
do not consider the social, cultural and economic factors that influence the human behaviour.
These studies are descriptive and lead to discrepancies, as they do not address the gap between
the knowledge, attitude and perception (Taffa 2017). In the literature review, the focus is mainly
on the non-pregnant teenagers and their attitudes, knowledge and perception towards pregnancy
in teenage instead of the pregnant teenager’s perceptions and knowledge. It is important to

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understand how the teenagers perceive pregnancy trough their attitude, knowledge and
perceptions. It is considered important if it is viewed through the factors contributing to the
teenage pregnancy such as family relations, economic status, and others. The factors responsible
for the teenage pregnancy apparent in this literature review are-
Social and Economic factors
In underdeveloped and developing community and especially those that are poverty
stricken the issue of teenage pregnancy is predominant and is related to social problem.
Teenagers in poor families are highly likely to engage in risk sexual behaviour to meet both
ends. Lack of resources due to poverty, girls are forced to engage in sexual practices, for material
gains. In both rural and urban areas, the families with poverty have contributed to the teenage
pregnancy of their children. On the other hand, the young people from low socio-economic
background are less likely to use condoms. It has been found to be associated with the less access
to the reproductive health information and health services. The poverty and low educational
attainment are contributing factors for the teenage pregnancy due to poor support structures from
other social institutions (Moffitt et al. 2011; Hadley et al. 2018). Forced child marriage is also
seen in the economic context. In economically disadvantaged section of the society, the
daughters are treated as a source to pay off the debt. The consequences include physiological and
psychological devastation of the daughter. It leads to early termination of the girls’ education and
lack of employment. These girls have no protecting laws to escape the violence. Some of the
marriages are unregistered and illegal. Stigmatisation and lack of support from the family is the
other risk factor for the teenage pregnancy (Cook and Cameron 2015).
To avoid jeopardising the economic goals the teenagers in the intergenerational
relationships, fail to negotiate the safe sex practice. Many teenagers in lure and crave for luxury,

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lavishness and comfort in addition to money or other basic needs engage in risky sexual
activities. Poor economic stand by the parents and lack of adult supervision leads to high
engagement of the teenagers in risky sexual behaviour. In addition, peer pressure to engage in
risky sexual practices for economic gains among those belonging to financially disadvantaged
backgrounds, contributes to teenage pregnancy (Evans and Kim 2010). In several qualitative
studies it was also found that some girls resist having the transactional sex talk and also showed
low preference for the intergenerational and transactional relationships with older partners for
economic benefits. Some of the girls have showed power to say no to unprotected sex. Many
teenage girls also did not found that sex is synonymous with love. Teenage girls with such
attitude and perception were found to resisting manipulation and normative submission
(Wellings et al. 2011; Chaaban and Cunningham 2011).
Family relationships
In teenage pregnancy rates, the important aspect is the family relations. It is the important
tool for socialisation and is the means to construct the societal norms by sharing of the ideas and
beliefs. Teenagers with the single parents are highly likely to indulge in the risky sexual
behaviour. This is the reason for high rate of teenage pregnancy in this group of people when
compare to the teenagers with both parents. It may be attributed to the shared responsibility in
case of presence of both parents when compared to the responsibility vested on single parent. A
girl of a single parent has to struggle for means of survival and is at greater risk of pregnancy.
The survival is usually achieved through intergenerational relationships (Commendador 2010).
Teenagers engage in intergenerational relationships because engaging with older men or women
gives them means to have status symbols such as jewellery, and flashy cell phones. At the same
time the girl can have her basic needs fulfilled. In this process the health of both the people is