Thursday 7 February 2008

Britain's failing teen pregnancy strategy

The British government's teenage pregnancy strategy aimed to cut the conception rate among under-18s by 15% between 1998 and 2004, and to halve that rate by 2010. It has spent more than £250 million yet has only achieved an 11.5% reduction. The most significant reduction in the rate from its high point in 1998 was in 1999 before the strategy was implemented. The pace of reduction actually slowed down once the strategy was implemented. Central to the strategy has been the availability and promotion of birth control - both "contraception" which may work abortifaciently and abortion via the Abortion Act 1967.

The human cost of this policy is incalculable. While the conception rate in 1998 for England and Wales was 47.1 per thousand, only 42% of those conceptions led to abortion. The conception rate in 2005 was 41.4 per thousand, but 46.4% of these ended in abortion.

Britain now has the highest rate of teenage pregnancy in western Europe. [Daily Mail, 6 February] The government wants teenagers to use long-term birth control methods such as injections, implants and intrauterine devices. [Daily Mail, 6 February] However, contrary to the government's claims justifying its policy, the availability of birth control is not a factor in teenage pregnancy rates.

The social causes of teenage pregnancy

Professor David Paton of Nottingham University (pictured) found that teenagers in poor areas were more likely to visit birth control clinics, yet those areas had higher teen pregnancy rates. Teenagers in better-off parts of England were less likely to go to clinics even though the rate was lower there. [The economics of family planning and underage conceptions, Journal of Health Economics, March 2002] Professor Paton found that social deprivation was a factor in teenage pregnancy. More recently, he has said: "An improvement in general education levels appears to be the most significant factor in reducing teenage pregnancies."

Although politicians want to throw yet more birth control at this problem, they do also acknowledge the social factors. Ms Beverley Hughes MP, the children's minister, speaks of "tailored support for all teenage parents to reduce future teenage pregnancies." A ministry statement says that such support: "… would also tackle the underlying causes of early pregnancy such as low aspirations, disengagement from learning, poor educational attainment and poor emotional health." [Department for Children, Schools and Families, 29 January]

Mr Chris Bryant, Labour MP for Rhondda, recently told parliament: "The map of teenage pregnancy in Britain is the map of poverty and deprivation. Last week, I put together some statistics, which, for the first time, were done by constituency, rather than by local authority. They show that the map is a consistent line of the poorest communities in this country". [Westminster Hall Hansard, 29 January]

Mr Bryant's report, based on extensive interviews with teenage mothers, said that in 2005 there were 39,804 conceptions among under-18s in England - a rate of 41.3 per thousand. Teenage pregnancy was linked with deprivation, leading to a: “vicious cycle of underachievement, benefit dependency, ill health, lack of aspiration, poor parenting and child poverty.” Press coverage refers to Mr Bryant's warning that some teenage girls were getting pregnant to get a council flat. This may or may not be true, but no amount of sex-education or free condoms is likely to prevent a girl who wants a baby from becoming pregnant.

The relationship between household-type and poverty

Social disadvantage is directly associated with family breakdown. Children raised by two married parents do better financially, academically and socially. Children raised outside a stable family structure find it harder to form stable, committed families for their own children.

National government surveys in the US show that, in families where the parents have always belonged to each other and to their children, there is the lowest level of child poverty (12%) and in stepfamilies it is 13%. The level of poverty in divorced, single-parent families is 31% and, with cohabiting parents, it is 39%. Separated, single-parent families have a poverty-level of 41%, while always-single mother households are at 67%. [Dignity of the child from conception and its right to life, home, and family, Dr Patrick Fagan, World Congress of Families IV, Warsaw, Poland, 12 May 2007]

Therefore, the biggest single contribution government could make to reducing social deprivation, child poverty and, consequently, teenage pregnancy, would be to ensure that children were raised by both biological parents in a married relationship.

Undermining parental rights

The teenage pregnancy strategy actually undermines families by removing the parents' rights to decide the nature of the sex-education their children receive and when they should receive it. A Council of Europe document states: "In exercise of any functions which it assures in relation to education and to teaching, the State shall respect the right of parents to ensure such education and teaching in conformity with their own religious and philosophical convictions." [article 2, Protocol to the Convention for the Protection of Human Rights and Fundamental Freedoms, as amended by protocol 11, Paris, 20 March 1952.]

Ms Beverley Hughes recently said to parliament: "What that strategy has been designed to do is, first, encourage parental engagement." [Westminster Hall Hansard, 29 January] However, in the field of sex-education, Ms Hughes's government has removed parents' rights. It is now threatening to target children in primary schools, and to make sex-education mandatory. Government policy has also assailed parental authority by secretly supplying birth control and abortion to underage children.

Moral hazard and contraceptive failure

People are more likely to avoid risks when there is no safety-net. Teenagers engage in risky sexual behaviour if they think they can get birth control without their parents finding out, and a secret abortion if contraception fails. Insurance companies call this moral hazard. [Professor David Paton, Faith, July-August 2007]

Contraception is much more likely to fail than people generally believe. A report published on the 29th of last month by Marie Stopes International in Australia shows that some 43% of women who became pregnant unintentionally were using oral contraceptives when they conceived and another 27% reportedly used a condom. This highlights the foolishness of a sexual health strategy which is founded on the assumption that children will be more efficient in the use of contraception than adults.

Health risks of hormonal birth control

The evidence shows use of birth control (especially by those under 20) is associated with significant risks. The teenage pregnancy strategy could actually be contributing to the human and economic costs of sexual ill-health. Hormonal birth control such as the pill is associated with cancer. Despite news stories suggesting the pill can reduce the risk of ovarian cancer, there is a well-established link to an increased risk of cancer of the breast, cervix and liver. These effects are even more dangerous when exposure to pill is begun before physical maturity, and goes on for many years.

Cervical cancer

The connection between cervical cancer and the pill, has been under investigation since 1964. Since then studies have confirmed a heightened risk, particularly to teenager users. In 1988, research on 47,000 women published in The Lancet showed the connection between use of the pill and genital cancers.

Breast cancer

This probably presents a greater risk to pill-users than cervical cancer. Research in the Netherlands in 1994 showed a heightened risk associated with long term use. In 1995 The Lancet cited research which concluded women who had started oral contraceptive use at between 20 and 24 years of age had three times the risk of developing breast cancer before the age of 46 than those who had never used it.

Further studies have concurred with this and the Netherlands Cancer Institute reported the particular danger of use before the age of 20. In 1996 research conducted by Malcolm Pike showed a 50% increase of breast cancer in women who started on the pill before the age of 20. The results of tamoxifen, the anti-oestrogen drug, in the prevention of breast cancer confirms the role of oestrogen (and therefore the combined pill and morning-after pills) in the development of cancer. Bringing a pregnancy to full term safeguards against breast cancer.

Blood clots

The risk of death from clots can begin within one month of starting on the pill. In 1968 hospital admissions for blood clots were shown to be nine times greater in women who used the pill than those who did not.

Despite the development of the low-dose pill, this risk remains four times greater in users of the pill. Women with hereditary high cholesterol are advised not to use the pill. Users with a hereditary defect of the clotting factor in their blood face a 30-fold increased risk of developing clots compared to normal non-users.

Liver tumours

These are rare and, although not usually malignant, such tumours can cause death if they rupture.

Minor side effects

These include depression, raised blood pressure (with an increased risk of stroke even in girls as young as 14), and conditions such as eczema and chloasma.

Sexually transmitted diseases

While the discussion of teenage sexual health has focused on teenage pregnancy, the rise in the rates of sexually transmitted diseases has been alarming. There are serious implications for the future fertility of children and teenagers who contract such diseases.

Conclusion

The teenage pregnancy strategy is not working. While the conception rate has fallen slightly, the number of recorded abortions continues to rise, without even including early abortion caused by birth control drugs and devices. (The manufacturer's description of the Norgeston mini-pill concedes that it can stop young embryos from implanting in the womb (nidation).)

The government stubbornly insists that what is needed is even more birth control, yet this has been shown not to be a factor in teenage pregnancy. The government pays lip-service to the social factors which do lead to teenage pregnancy yet undermines the traditional family which is more likely to give children an emotionally stable and materially adequate upbringing. In all this, we are scarcely told about how birth control can fail and can threaten women's health.

For further information on anything mentioned here, or on what you can do in your area to counter the government's failed teenage pregnancy strategy, contact me at johnsmeaton@spuc.org.uk