Trends in teenage pregnancy in England and Wales: how can we explain them?

Teenage pregnancy is associated with adverse social and physical outcomes f or both mother and child. We drew on various sources-birth and abortion sta tistics from the Office for National Statistics, data from the National Sur vey of Sexual Attitudes and Lifestyles, and routinely collected data from f amily planning clinics-to identify trends in England and Wales and their po ssible determinants. The rate of teenage sexual activity has increased steadily and consistently over the past four decades, whilst the rate of teenage fertility has shown greater variation. When the teenage fertility rate is calculated against t he denominator of sexually active women, rather than the total sample of te enage women, the underlying trend in teenage fertility over the past four d ecades has been downwards, though not consistently so. Fluctuations in the teenage fertility rate seem to track intervention-related factors such as a ccess to, and use of, contraceptive services and the general climate surrou nding the sexual health of young people.