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Conception and the state of child health


conception, abortion, #stateofchildhealth, RCPCH, report, health inequality, The UK still falls behind comparable high income countries in Europe and beyond.

The Royal College of Paediatrics and Child Health (RCPCH) published its State of Child Health 2020 report this week.

This is the largest ever compilation of data on the health of babies, children and young people throughout all four UK nations.

It brings together 28 measures of health outcomes, ranging from specific conditions – such as asthma, epilepsy, and mental health problems – to risk factors for poor health such as poverty, low rates of breastfeeding, and obesity.

The report shows that for many measures of children’s health and wellbeing, progress has stalled, or is in reverse – something rarely seen in high income countries.

Some indicators have improved since the last report in 2017.

The rate of conceptions among those aged under 18 years for example has consistently been decreasing over the past decade in England, Scotland and Wales.

Teenage pregnancy is associated with poor outcomes for young women and their children. For mothers, there is a higher risk of poor educational attainment, social isolation and poorer mental and physical health, while their children are more likely to be born preterm or with low birthweight.

While not all teenage conceptions are unplanned, teenagers remain at highest risk of unplanned pregnancy, and over 50 per cent of under-18 conceptions in England and Wales in 2017 ended in abortion.

There are individual and social risk factors for teenage pregnancy, including: adverse childhood experiences; socioeconomic deprivation; attention, behaviour and conduct problems; poor educational attainment and engagement; and family history of teenage pregnancy.

Reducing teenage pregnancy requires comprehensive relationships and sex education and access to effective contraception in youth friendly services. And dedicated coordinated support for young parents helps improve outcomes for them and their children.

Key findings from this report, on conceptions, which includes those ending in livebirth, stillbirths and where the pregnancy was terminated:

The last ten years have seen a sustained decline in conception rates for 15 to 17 year-old females in England, Scotland and Wales;

From 2008, conceptions per 1,000 have significantly reduced, with declines reported in England of 39.7 to 17.3 in 2018, Scotland 40.0 to 16.3 in 2017, and Wales 43.7 to 19.5 in 2018.

Conception data for Northern Ireland are not available, because of the difference legislation there around termination of pregnancy compared to the rest of the UK. Live birth rates for 15-17 year-old females show a declining trend from 10.5 births per 1,000 in 2008 to 4.7 in 2017.

Under-18 conception rates remain considerably higher among young women living in the most deprived areas, although there have been reductions across all deprivation subgroups between 2014 and 2016.

But even in areas of improvement the UK still falls behind comparable high income countries in Europe and beyond.

Inequality continues to blight the lives of children and young people in the UK and is a recurring theme throughout several of the indicators across the report.

Child poverty has increased for those in working families. And inequalities in some health outcomes have widened since the last report: infant mortality in England has risen, particularly for those living in the poorest areas, for instance.

Among the new indicators, it is worth noting the prevalence of mental health disorders in England, and a particularly high – 23 per cent – prevalence of emotional disorders among young women aged 17-19.

Click here to read the full report.

How you can help

Like and share the #StateofChildHealth content on your social networks. Search the hashtag or click through to RCPCH Twitter and Facebook accounts.

Email your MP, forward them this report, and ask them what they are doing to prioritise child health. You can find your MP here.

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