The girls present a unique challenge to healthcare professionals. Most are older ? aged 17 or 18 ? have left school, are unemployed, uninsured and, more importantly, lack the support system often provided to younger pregnant girls.

"Young girls who get pregnant generally have a tremendous support system provided for them," explained Brenda Davidson, Senior Medical Officer with the Health Department.

"Generally, they attend Teen Services and continue their education and they have good support from their families, the Health Department and schools.

"Most don't make that choice a second time. But girls who are 17 or 18 fall into a completely different category. They're often acting out; they're rebellious and their parents are not as supportive."

Statistics taken from King Edward VII Memorial Hospital last year, found 76.6 per cent of all teens who became pregnant were 17 or 18 years old.

Between April 2000 and March 2001, total teen deliveries formed 6.3 per cent (52 out of a total of 774) of all deliveries, and 19.8 per cent (48 out of a total of 194) of all abortions. In the same period, teen deliveries of age 16 and under, counted for 0.6 per cent (five out of 821) of all deliveries and eight per cent (18 out of 224) of all abortions.

"The number of teenagers giving birth has decreased dramatically in recent years and the number of terminations has gone down as well," Dr. Davidson added. "We're very pleased with our teens.

"While no firm data is available on the long-term outcome for teens who become pregnant, most younger teens appear generally to do quite well and seem to benefit enormously from various interventions . . .

"Girls 17 years and over who become pregnant have different lifestyle issues from younger girls, as well as different social, interpersonal and economic needs and problems. They often appear to have more limited support systems, may have left home and be alienated from their family and dropped out of the education system.

"They are generally unemployed and are no longer covered by a health insurance policy."

Thus the challenge for professionals hoping to educate teenagers on pregnancy prevention was to find a means of reaching those no longer in the educational system, Dr. Davidson said.

In May of this year, then-Health Minister Nelson Bascome announced the launch of a new initiative to educate young girls. The programme, called "Safety Net", was designed to better educate young girls on such issues as pregnancy, sex, motherhood and the usual after-care programmes.

None of the agencies this newspaper spoke with could verify that the programme was still, if ever, in place. All agreed, however, that there are programmes which teenagers can rely on for sound information.

"Teenage pregnancy is something that's always on the front burner," Dr. Davidson said. "As far as continuing education in clinics and schools, I guess there has been an increase in the levels somewhat."

The Government department refers all girls who decide to give birth to Teen Services, a not-for-profit programme which offers shelter and counselling and continuing education to those in need out of its two locations, Bay View Haven and Teucer House.

At Teucer House, participants work towards their General Education Diploma (GED) or the Bermuda School Certificate (BSC) ? the existing school leaving certification for students in the public system.

A lack of capital almost saw the programme lost last year until the Ministry of Education stepped in and agreed to provide financial support for the programme which costs around $250,000 a year to operate.

"Teenage pregnancy has pretty much stayed the same for the past six or seven years ? by our estimates, between 45 and 55 girls each year," explained Teen Services director Michelle Wade-Johnson.

"That number relates to those who become pregnant and conceive. It doesn't take into account those who terminate."

An Unplanned Pregnancy Survey of 166 teens carried out in 2000 found that while 87.8 listed their pregnancy as accidental, only 35 per cent had been using contraception.

"Reasons given included 'taking chances' (41.6 per cent); 21.1 admitted they had stopped using contraception; 10.8 per cent had 'messed up' on their method of contraception and 10.2 per cent thought they couldn't get pregnant," said Dr. Davidson.

"Sadly, two women in the series became pregnant when intercourse had occurred against their wishes.

"This indicates a great need for ongoing education, even for girls who have left school. At present, our efforts at the Department of Health include presentations in schools, participation in Teen Pregnancy Month and Public Health Week, and displays at public events."

Because of such need, the education component of Teen Services ? both pregnancy prevention and general studies ? is very much "alive and busy", according to its director.

"We are still open and we have a full house of students. We have 13 students enrolled in our education component and they're doing well. We've stepped out of the box and are now also taking young ladies who are unable to continue (in traditional education) because of a lack of credits."

The future could see all of Teen Services' programmes housed under one roof at Bay View Haven.

"We anticipate that will happen soon," Mrs. Wade-Johnson added.

According to Dr. Davidson, it is important that the issue of teenage pregnancy be addressed according to the age and the circumstances of each individual.

"In my mind, part of the problem when we talk about teenage pregnancy and the numbers of teenage pregnancies, is that an 18 year old or a 19 year old who is pregnant may not be an ideal situation, but it's because our judgment (comes into play.)

"The peak child-bearing years for women are the late teens and early twenties. Our deep concern is when we see 13, 14, 15 and 16 year olds who are pregnant. Nobody could argue that's a good thing. Today, we don't see much pregnancy with the very young ones; there's not a lot. It's just that each one is an individual tragedy."