Teenage pregnancy: more than meets the eye

The photograph of young women taking a break at Riverside Young Mothers' Unita is a particular snapshot of the experience of having a baby under the age of 20 years.1 When we saw it we thought of many other images of teenage pregnancy, from our experiences as young mothers (Kathleen, Diane, Sarah and Michelle), and professionals who have worked on Tyneside in education and community development (Ann, from the 1980s) and primary care (Chris, from the 1970s). A view, for example, through the door of the Riverside Unit showing the young women studying, celebrating examination results, filling in job applications …

There is much that is positive about teenage pregnancy.2 When we saw the photograph, we shared anxiety that an audience of GPs would ‘see’ this group of young women only as a primary care problem: pregnant and smoking. We felt that the photograph was likely to add to negative media representation of young pregnant women, in the absence of words from the young women themselves, background information about the Riverside Unit, and any reference to the impact of inequalities on being able to give up smoking,3or using primary care sexual health services as a young person.4 As Kathleen said: ‘They need to know where we come from, and not just point the finger’. Pointing the camera without letting people know where the young women in the photograph come from, does not provide important contextual information.

Kathleen, Diane, Sarah and Michelle have designed a Teenage Pregnancy Workshop for medical students at Newcastle University. In an exercise at the beginning of the workshop, they each talk about one or two words that mean something to them in their everyday lives: money, love, stress, learning, health, support, future, worry, confidence, achievement. Their personal stories are at the heart of the workshop that they have delivered since January 2003. It has been consistently well evaluated and students comment every time on the effective use of personal accounts in making them think about the complexity of teenage pregnancy.

Kathleen has recently started work as a Sure Start link worker in the area she grew up in, which is similar to Riverside in terms of socioeconomic disadvantage.a She is making use of skills she developed bringing up three children with her partner, on a low income. Ann met Kathleen and Diane when she job-shared the Newcastle and North Tyneside Teenage Pregnancy coordinator post. When she was asked to talk about teenage pregnancy with medical students, she knew that she could present a competent statistical picture, and that the young women would be able to provide much more. Chris is currently supporting them to write about developing the workshop. Kathleen and Diane have already written about work they do in local schools, encouraging young people to ‘think twice’ about rights and responsibilities in sex and relationships. Sarah and Michelle work with them now, in schools and in the university.

We are pleased to have had an opportunity to write about our response to the photograph. We would point everybody in the direction of the website: http://www.dfes.gov.uk/teenagepregnancy, where there are many examples of young people being part of the action, in terms of work contributing to a downward trend in teenage pregnancy rates.

• © British Journal of General Practice, 2005.