Friday, 27 March 2009

Nursing Times article questions teenage pregnancy strategy

At the Lancaster Diocesan website I found a link to an article by David Paton in the current issue of The Nursing Times: Teenage pregnancy and access to contraception: what does the evidence show?

Paton refers to the Government's Teenage Pregnancy Strategy (TPS), launched in 1999. this has involved millions of pounds being spent on access to "confidential sexual health services" for young people. As he says,
"many nurses are uncomfortable with providing such services to children under 16, especially without parental knowledge, but do so believing that they are helping to reduce the risks of early pregnancy."
He continues
"Unfortunately, the latest data shows that pregnancy and abortion rates for under-sixteens are higher now than when the Strategy started."
Professor Paton is an economist at at the Nottingham University Business School and has published widely on the economics of teenage pregnancy. As well as drawing attention to the empirical evidence, he suggests reasons for the observed results of the TPS:
When policy interventions have unexpected impacts which subvert the aim of the policy, economists often refer to the ‘Law of Unintended Consequences’. In this case, by lowering the pregnancy risk, easier access to birth control may encourage more young people to engage in sexual activity. If so, numbers of pregnancies decrease amongst those who would have had sex anyway, but increase amongst those who have sex when they otherwise would not have done. Overall, we end up with a similar number of pregnancies but with more underage youngsters being sexually active. Even worse, many birth control methods offer no protection against sexually transmitted infections (STIs). Indeed, research in the Sex Education journal suggests that increased access to EBC may be associated with higher teenage STI rates.
He points out that although current guidelines permit nurses to provide teenagers with access to abortion and contraception without the knowledge of their parents they do not require nurses to do so. He concludes:
Further, all health professionals (and indeed taxpayers) should question the wisdom of PCTs spending scarce resources on measures such as school-based provision of EBC that, at best, are ineffective and, at worst, may actually be contributing to poor sexual health amongst teenagers.
It is very heartening to see such sound common sense offered in a leading journal for nurses.
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