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.
6 comments:
This all stands to reason, of course. If the Nursing Times has got it, will the Lancet follow>
I read a lot of work by David Paton for an essay I wrote for a PGCE course and it is worth checking out some of his other articles:
Paton, D. (2002) The Economics of Family Planning and Underage Conceptions, Journal of Health Economics, Vol.21(2), 19pp. 27-45
Philip Levine supports this research and the view that low expectations are at the root of the problem claiming that "measures which improve the educational and work prospects of those groups most at risk seem likely to help achieve the stated aim of reducing underage conceptions"
Levine, P. (2003) Parental involvement laws and fertility behaviour, Journal of Health Economics, vol.22, 18pp. 861–878
I also found the research of Joost Van Loon to be very interesting as it looks at "The Dutch Model" of Sex education (which is held by many to be an example of how liberal and explicit sex education coupled with easy access to contraception and abortion can produce low levels of STIs and teenage pregnancies) and concludes that the most significant factor in teenage pregnancy is family structure: the children of single-parent and non-traditional homes are more likely to be sexually active at a younger age. British children are five times more likely to be in single-parent families than their Dutch counterparts and more likely to be in third party care or to find their mothers out when they get home from school.
Van Loon, J (2003) Deconstructing the Dutch Utopia: Sex Education and Teenage Pregnancy in the Netherlands, Family Education Trust
Professor Sir Al Aynsley-Green, The Children's Commissioner for England, suggests that Britain has produced a generation of young people who are "unhappy, unhealthy, engaging in risky behaviour, who have poor relationships with their family and their peers, low expectations and don't feel safe". This is where the crux of the problem lies and greater access to contraception and abortion cannot and will not address it.
Many thanks indeed for taking the trouble to post those useful references.
What gets me is that it took this long for them to see this!
Some saddening statistics
According to Jarvis (2008) the rates of teenage motherhood in the UK (15%) are almost twice those of Germany (8%), three times those of France (6%) and four times those of Sweden(4%). The implementation of the teenage pregnancy strategy (Social Exclusion Unit, 1999) has made some contribution to reversing this trend but only by around 2% a year in its first 5 years of implementation. More concerning, however, is the fact that between 1999 and 2005, the overall number of 16–17-year olds becoming pregnant actually increased from 39 247 to 39 804 and when 13–15- year-olds were added the figure rose from 46 666 to 47 277, more than when the pregnancy strategy was launched in 1999 (Donnelly, 2007). The rate of pregnancies ending in abortion, and therefore the emotional and psychological consequences to young girls and their families, has also risen. In 2005, 47% of pregnancies among 16–17-year olds were terminated compared to 42% in 1998.
DONNELLY, L. (2007) Sex education failing to halt teen pregnancy. The Daily Telegraph. http://tinyurl.com/6ap8m7 (accessed 23 February 2009)
HAND, H. (2009) Contraception advice for under-16s: An overview. British Journal of School Nursing. 4(2), pp. 58-64.
JARVIS, S. (2008) Should the contraceptive pill be available without prescription? British Medical Journal. 337: a3056.
SOCIAL EXCLUSION UNIT (1999) Teenage pregnancy. London: The Stationery office.
Catherine - many thanks for those references. Sadly, the number of pregnancies is probably underestimated since those "terminated" by the MAP are not known.
(I would also want to challenge the idea that it is pregnancy that is the problem as opposed to precocious sexual activity, whether or not it results in pregnancy.)
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