family planning: teenage pregnancy the author plans to critically appraise the role of the family planning nurse in relation to unplanned teenage pregnancy. Firstly the uk has the highest number of teenage conceptions in western europe social exclusion unit 19 and this has driven the government to implement measures to decrease the number of teenage pregnancies. They have set targets and devised strategies nation wide to address the issue and the targets are being achieved. The health of the nation report department of health 1992 highlights sexual health as a key area including the recording of teenage conceptions.

Teenage health is an area that the scottish executive 2003 is also interested in promoting through its improving health in scotland document. The issue of teenage pregnancy is a topical subject, which gets lots of media coverage, however it is usually shown in poor light or sensationalised coleman and roker 1998. The report will address three main areas: covering 1 sex education and influences on young people, 2 access to sexual health services and associated problems and finally 3 how the family planning nurse addresses these issues. The author will analyse both negative and positive aspects throughout and provide a personal evaluation. education and influences there has been much debate over the reasons why the uk has the highest teenage conceptions rate in europe department of health 1992. There is also much blaming as it is felt by others that there are enough services directed at young people for them to make the right choices in regards to having sex and using contraception sherman jones 2003.

Factors such as sexual knowledge, media and peer pressure, deprivation or family relations and expectations can all contribute to sexual activity and subsequent pregnancy. There is pressure placed on young people who have physically developed but lack the emotional maturity to go with this chapin 20. Not understanding how their body works can prevent teenagers from realising they are in need of advice. Knowledge of their own fertility and body changes is required as this can help the individuals to adapt as the changes happen winn et al 1998. Education is needed at an earlier age than other generations because the average onset of puberty is one month earlier per decade of this century coleman and roker 1998. They not only need educated about their own bodies but also on contraception and how to use it. According to green and tones 20 in adolescents, contraception use is seen as priority over protection from hiv.

Kane et al 2003 describe how young people might not know how to ask for information but this does not mean they do not want to know. In order for young people to make informed choices they have to have knowledge as, according to winn et al 1998 this enables teenagers to protect themselves. Knowledge is also a useful tool for assessing and evaluating education programmes and services naidoo and wills 20. Being educated about relationships, love, assertiveness, sexually transmitted infections sti's , pregnancy and abortion should lead to delaying the onset of sexual activity and an increase in contraceptive use. Glasier and gebbie 20 propose this should promote equality and minimise prejudice.

Often young people feel they have to have sex to fit in with the crowd, though they may not fully understand the implications, they proceed because they believe the exaggeration of others winn et al 1998. There are so many myths surrounding sex and pregnancy that its not surprising young women end up becoming pregnant. The age of first sexual intercourse correlates to contraceptive use wellings and mitchell 1998 , which increases the risk not only of pregnancy but sti's.

Other influences come from the media who are continually advertising the sexualisation of girls. Girl's magazines are full of make up tips, how to appeal to a sexy guy and make a sexy t shirt. Boy's magazines on the other hand are full of football tips and playstation cheats. Girls are probably more aware of the implications of this one sided aspect than boys, who are still seen as the dominant sex but do not have the same knowledge chapin 20. The perception is that for boys, sex in the media is innuendo and smutty jokes but little actual fact. They are not actively targeted the same as girls and early sexual activity is seen as manly. Therefore information should be aimed equally at boys and girls, as health professionals believe that sex education and services are often viewed specifically as women's issues kiddy 2002, sherman jones 2003.

The view is that young people prefer to get advice from professionals within the same age group and of the same sex, meaning boys often only have their gp to talk to sherman jones 2003. Certain teenagers feel there is little hope for them to get a good education or decent job and feel they need somebody to love who will love them unconditionally in return. Perhaps this is why such a high number of girls leaving local authority care find themselves in this situation department of health 2001. Poor prospects and poverty contribute to why significant numbers come from deprived areas flowerdew 2003. Some youngsters mirror their parents and being the daughter of a teen mum means they are more likely to become a teen mum too glasier and gebbie 20. There is little talk of teenage fathers even though the majority of young people do attend to register the birth of their child together one parent families scotland 2001. Teenage pregnancy is often viewed negatively by the media as they sensationalise many teenage health articles with headlines such as ' teen mums told stay in school' and 'teen lifestyle health timebomb' bbc 2003a and 2003b.

What is not reported is the majority of teenagers' who appear to be extremely responsible, by waiting until they are older to have first sexual intercourse. The average age of first sex is 17 which is still above the legal limit of 16 years and approximately only 3% of all pregnancies in england and wales occur in under 16's national statistics office 2001. However defining teenage pregnancy is difficult because many people have different interpretations of it, some feel that it refers specifically to those under 16 or under 18, or even under 20 as the title implies. The government defines teenage pregnancy as under 18 and under 16 and includes live or still birth and legal abortions in their conception data teenage pregnancy unit 2002. There are ongoing debates about changing the age of consent to adapt to changing sexual health needs bbc 2001, sawyer 2003 , however critics believe that rebellious teenagers are always going to do whatever they have been told not to.

access and services much research is being commenced to find out what problems young people actually experience and how these can be overcome counterpoint 2001, kane et al 2003, sherman jones 2003. One major area is confidentiality which is an aspect both the professionals and the teenagers pinpoint sherman jones 2003. The royal society of general practitioners rcgp 2001 introduced the confidentiality toolkit to clarify some of the problems surrounding confidentiality. It seeks to invent a national minimum standard for dealing with teens and those under the age of consent.