Context How to respond to the challenge of reducing unplanned pregnancy rates in Ayrshire and Arran.

Objectives (1) To improve understanding of the educational needs of 11-15-year-olds regarding contraception which could be used to inform planning of future sex education in schools in Ayrshire and Arran. (2) To put this in context by reviewing contraceptive usage amongst 14-16-year-old pregnant teenagers.

Design (1) A questionnaire given to 11-15-year-olds during a sex education class. (2) A retrospective study of pregnant 14-16-year-olds.

Participants (1) School pupils aged 11-15 from an area of mixed social background (n = 80). (2) Pregnant 14-16-year-olds presenting at Ayrshire Central Maternity Hospital between September 1997 and March 1998 (n = 74).

Results (1) Ninety-nine percent of the teenagers said they would use contraception. Seventy-three percent of girls, but only 52% of boys, were aware of the services available. Ninety percent of girls knew about emergency contraception, but only 59% of boys. Thirty-three percent thought they received too little sex education at school. Thirty-two percent received no sex education from home, and 10% 'too little'. More information about sexually-related diseases, safe sex and having a baby was requested. (2) The study of pregnant teenagers showed that 69% went ahead with their pregnancies, that 71% were not habitually using contraception and only 4% were using contraception at the time of conception.

Discussion Teenagers said they would use contraception. However, boys were not aware of local services giving advice and help to young people, nor about emergency contraception. Teenagers felt they had no or 'too little' sex education at home. They felt too young to become a parent and be 'tied down'.

Conclusions (1) Teenagers at school want information about a wider range of sexual issues. (2) There is a gap between learning about contraception and its practical use, including emergency contraception. (3) Discussion and reinforcement of sex education at home may not exist for many teenagers. (4) Teenagers at school felt that they were not ready to be parents as this would restrict their social lives and disrupt their education. (5) It is recognised that young men are less well-informed than young women are, and this could impact on safe sex.