This site is intended for health professionals only

NICE: Improve contraceptive services to reduce unwanted pregnancies

New guidance from the National Institute for Care and Health Excellence (NICE) calls for improved contraceptive services to reduce unwanted pregnancies. 

Although under-18 conception rates have fallen, England still has one of the highest teen pregnancy rates in Europe.

Recommendations for under 25s include: 

 - Providing contraceptive services for young people: Doctors, nurses and pharmacists should provide information about the full range of contraceptives available, including emergency contraception (both oral and intrauterine) and long-acting reversible contraception, and the benefits and side effects.

 - Providing contraceptive services after a pregnancy: Midwives should discuss with pregnant women what type of contraception they intend to use after their pregnancy. They should provide information on the full range of options and should advise them (and their partners, if appropriate) on an effective method that best meets their needs. They should also provide information on how and where to obtain it.

 - Providing contraceptive services after an abortion: Before - and as soon as possible after - an abortion, discuss contraception and explain the full range of contraceptive methods available. GPs and those working in contraceptive or abortion services should help young women and their partners identify and obtain the most effective method that best meets their needs. They should dispel the myth that there is no need for contraception after an abortion and explain that women are fertile immediately following an abortion.

 - Providing school and education-based contraceptive services: Governors, teachers and youth workers in schools, as well as nurses, doctors and counsellors working in contraceptive services should ensure accurate and up-to-date contraceptive advice, information and support is readily available to all young women and men. Information on the location and hours of local services should be available.

 - Providing emergency contraception: Suitably qualified nurses and pharmacists should be given the ability, through patient group directions (PGDs)  to dispense free oral emergency contraception to young women. Ensure young women (and young men) know where to obtain free emergency contraception. 
Young women should be informed that an intrauterine device is a more effective form of emergency contraception than the oral method and can also be used on an ongoing basis. Young women should have timely access to emergency contraception using an intrauterine device.

 - Providing condoms in addition to other methods of contraception: Those working in contraceptive services, social care professionals and public health specialists should advise all young people to use condoms consistently and correctly, with a water-based lubricant, as well as other contraception. Condoms should always be provided along with other contraception because they help prevent the transmission of STIs.

Anne Weyman, OBE, Chair of the independent committee that developed the guidance and former Chief Executive of the Family Planning Association, said: “Most of the young women who become pregnant while still a teenager do not plan to do so. Nearly half of all pregnancies among 15 - 18 year olds end with an abortion. The new guidance aims to reduce unwanted pregnancies by ensuring that young people have access to a full range of contraceptive methods, not just pills and condoms, but the longer acting methods, such as contraceptive injections and implants. We also need to make sure that young people get good contraceptive advice so that they can choose and use the right method for them.

“As well as the unnecessary heartache for these young women, unwanted pregnancies also have a financial cost, with abortions for young women under 25 costing the NHS approximately £53 million each year. Investing in contraceptive services is a good use of money. Not only could modest investment have health benefits for young people, it could also potentially result in reduced financial cost in the longer term."

The full guidance is available to view on the NICE website