As the controversy continues over the treatment of a 14-year-old girl who was sent home from hospital with the baby she had miscarried, Women's Editor Christen Pears looks at how society deals with teenage pregnancy.

WHEN Karen became pregnant at the age of 15, she thought her life was over. Still a child herself and with GCSEs looming, she had no idea what to do. She was frightened, confused and embarrassed.

"I thought that was it. If I went ahead and had the baby I knew my life would completely change. I was in shock. I think I cried for about a week," she says.

"I felt really stupid. I had only been with my boyfriend for a couple of months and he didn't want anything to do with it. I was really upset and thought about having an abortion but my parents were brilliant. They were shocked at first but after that they were really supportive, so were the midwives and health visitors. There's no way I could have done it without them. It's just too much to cope with."

Karen decided to go ahead with the pregnancy and now has a nine-month-old son, James. Although she has no regrets now, she says there were times when she wondered whether she had done the right thing.

Physically, she found it hard to cope with her schoolwork and the demands pregnancy was putting on her body. Emotionally, she swung between excitement and terror at the prospect of motherhood.

"Being pregnant is such a strange experience. You can feel overwhelmed. Sometimes all I wanted to do was sit down and cry. I would see all my friends going out and enjoying themselves and I hated it. They used to come round and see me a lot but it wasn't the same. I felt I was a lot older than them.

"I got seven GCSEs but I wanted to do my A-levels and go to university. I wanted to be a vet and it was hard to give that up. I would like to go to college, maybe next year, but once you have a baby, it's hard. James takes up so much of my time."

Karen lives with her parents and younger sister in Darlington and says she's very fortunate to have a built-in support network. Without it, she says she would have struggled to cope.

"Sometimes I feel isolated, especially when I see what other people my age are doing but my parents look after James a lot so I can go out. I did a computer course last month, which I really enjoyed because it made me feel I was getting on with my life again."

Not everyone's experience is as positive as Karen's. Michelle, who is just 16, and was forced to move out after she became pregnant, says: "My life has been pretty s**t and I had to leave home because of problems between my mam and me. But being 16 and trying to find somewhere to live is a nightmare. I have slept on the streets and have spent most of the time in and out of B&Bs.

"My boyfriend isn't allowed in because we can't have visitors, but what's worse is that some of the people in there are on probation and use drugs."

Fortunately, Michelle was put in contact with a teenage pregnancy advisor who has supported her both emotionally and practically, helping her come to terms with her family's reaction and finding her new accommodation.

Teenage pregnancy rates in Britain are the highest in Europe and in 1999 the Government established a teenage pregnancy unit, charged with halving the conception rates for under-18s by 2010. More than £100m has already been spent on the programme, which has included a campaign in teen magazines and on local radio, as well as a helpline.

It encourages a joined-up approach to the issue, involving statutory bodies as well as community groups and voluntary organisations, but the jury is still out on the success of this strategy.

Earlier this year, the Family Education Trust published a report that claimed the Government's efforts to reduce unwanted pregnancies were having the opposite effect. Increasing young people's access to family planning advice and emergency contraception simply encourages them to have more sex, it claimed.

The North-East has a higher than average number of teenage pregnancies - 50.5 per 1,000 girls aged 15 to 17 compared to a national rate of 42.9 per 1,000. But the good news is that rates are falling steadily. In this region, they fell from 55.3 in the period 1998 to 2000 to 50.5 in 2000 to 2002.

The most significant factor behind the figure is the region's history of social deprivation; it is well-known that incidents of teenage pregnancy are higher in areas of deprivation.

A report published earlier this month by the Joseph Rowntree Foundation showed that the district of Derwentside has a higher percentage of gymslip mums than anywhere else in Britain. The neigbouring districts of Wear Valley and Easington are also in the top 12 in the UK.

The study, which was compiled by researchers from the Centre for Sexual Health Research at the University of Southampton, also showed that abortion rates tend to be lower in socially disadvantaged areas, even though they have the highest rates of conception among the under-18s.

As well as improved sex education, efforts are being made to provide better support for pregnant teenagers. Pilot schemes in Tyne and Wear and Teesside were recently praised by inspectors from the Teenage Pregnancy Unit.

In Darlington, young parents are encouraged to attend the Sure Start centre, where they have access to a range of training and social opportunities, as well as advice and support.

Sharon Wade, a support worker for Sure Start, says: "Every case is different. Some people want to go back to college, others are happy as they are. Some want a lot of support and others don't. We just want them to realise that there is support there for them if they want it. No-one is on their own if they don't want to be."

The names in this article have been changed.