evidence: Access to safe and free abortion and contraception are key issues when it comes to teenage pregnancy. While abortion was made legal in England, Scotland and Wales in 1967, Northern Ireland legalised abortion only in October 2019. Here, we explore the number of abortions and rate of conception in women below the age of 18 in England and Wales over time. [...] Reducing the rate of under-18 conceptions was an ambition set in 2013 in the Department of Health's A Framework for Sexual Health Improvement in England. While this ambition has succeeded, there remain stark inequalities in the conception rate with a seven-fold difference in rates across different local authorities. The teenage pregnancy prevention strategy published a framework for local authorities to address this disparity and invest further resources in educational and contraceptive support for women at higher risk of early pregnancy. Another challenge is the change in use of Long Acting Reversible Contraception (LARCs), such as IUDs and the hormonal implant, which have been credited with reducing teenage pregnancy rates. However, due to changes in funding arrangements, there has been a 13% drop in their use as many women are no longer able to access LARC. The government recommends further access to LARC at all sexual and reproductive health services, especially because £1 spent on contraception is estimated to save the NHS £11 plus welfare costs.