Laws limiting teenagers’ access to contraceptive services and information fail to reduce sexual activity and increase the risk of unintended pregnancy and sexually transmitted diseases (STDs), according to two studies released this week and soon-to-be-published data discussed in a January 18 audio news briefing sponsored by The Alan Guttmacher Institute. During the briefing, adolescent health experts and policy analysts urged legislators to consider these findings before voting to require parental notification for contraception or supporting additional funding for abstinence-only education programs.
According to new nationally representative data published in the Journal of the American Medical Association, roughly one in five teenagers would have unsafe sex if their parents had to be notified when they got birth control at a family planning clinic. Researchers surveyed more than 1,500 female adolescents under age 18 seeking sexual health services, including contraception, at publicly funded family planning clinics in 33 states. They found that three in five had parents who already knew about their clinic visit--typically because teenagers told them or their parents suggested it. But among those whose parents were unaware, 70% would stop coming to the clinic, and a quarter would continue to have sex but would either rely on withdrawal or not use any contraception. Only 1% of all teens surveyed said they would stop having sex. Click
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"It’s good news that most teens are talking to their parents about sexual health and birth control, but that doesn't make it good public policy to force them into it," said Rachel Jones, Ph.D., Senior Research Associate at The Alan Guttmacher Institute. "Mandating parental involvement for contraception could backfire, driving young people to have unprotected sex and putting their health and lives at increased risk."
Already, two states (Texas and Utah) require parental consent for state-funded family planning services, and a similar restriction is in place in one Illinois county where research has found an increase in teen birthrates while other counties experienced declines. Last year, bills to impose new requirements for parental consent for adolescents seeking contraception were introduced in Congress and several states, including Kentucky, Minnesota and Virginia. Click here for more information
"As a pediatrician, every day I see firsthand what happens to teenagers when they can’t get contraception and can't discuss it with their parents," said Vinny Chulani, M.D., Director of the Division of Adolescent Medicine at the Orlando Regional Medical Center. "We have to face the reality that a majority of teens will have sex by age 18, so we need to do more to help prepare them to have healthy relationships--including providing information on how to talk to their parents and their partners about condoms and birth control and how to use these methods effectively," Dr. Chulani continued. "If we don’t, we have no one but ourselves to blame for our nation’s high rates of teen pregnancy and STDs."
Teenagers' risks of pregnancy and disease are also affected by what they think about sex, contraception and pregnancy, researchers reported. According to a study just published in Perspectives on Sexual and Reproductive Health, the more positive sexually experienced teens' attitudes about birth control, the more likely they are to use it and the less likely to become pregnant. But sexually experienced teens' attitudes toward pregnancy are not associated with whether they become pregnant. The authors--Yale University's Hannah Bruckner, Ph.D., and Columbia University's Peter Bearman, Ph.D.--conclude that programs promoting positive attitudes toward contraceptive use, rather than ones focusing solely on the negative consequences of becoming pregnant, may be most effective at reducing teen pregnancies.
Dr. Bearman also reported on an analysis of young adults who had pledged as teenagers to remain virgins until marriage, a type of program that is supported by federal policy. The researchers found that young adults who took virginity pledges as teenagers had the same rates of STDs as other young adults once they became sexually active--even though pledgers had shorter periods of sexual activity and fewer sexual partners. Virginity pledgers are also less likely to know their STD status--increasing the chances they will infect a partner or suffer long-term health consequences. This is of particular concern since nearly nine in 10 virginity pledgers have sexual intercourse before getting married.
Dr. Bearman noted that young people's views are increasingly shaped by programs that teach them they must stay abstinent until marriage, while discussing contraceptives only in terms of failure rates. Federal law prohibits government-funded abstinence-only programs from providing information about the health benefits of using contraception, including condoms. "It's truly shocking how little medically accurate information teens are getting about how to protect themselves from pregnancy and disease," he said. "The scare tactics and negative messaging used by today’s abstinence-only sex education programs put young people in harm’s way."
According to a December 2nd report by Rep. Henry Waxman (D-CA) and the minority staff of the House Committee on Government Reform, the most widely used curricula in federally funded abstinence-only programs are rife with medical inaccuracies, fear-based messages and religious overtones. Click here for more information. The U.S. Department of Health and Human Services also released new national data last month showing that while more teens are waiting to have sex and using birth control when they do, many say they are not learning about contraception at school or at home. Click here for more information.
Analysts are predicting that social issues--including policies related to teen sexual behavior and reproductive health--will be high on the legislative agenda in the wake of the 2004 elections. "Several new members of the U.S. Senate have built their reputations on being aggressive advocates for restricting government funding for family planning and limiting birth control information," said Cynthia Dailard, J.D., Senior Public Policy Associate at The Alan Guttmacher Institute. "In recent years, opponents of family planning have also increased their ranks in state governments, and many have already announced their plans to introduce a wide range of bills that would restrict access to reproductive health services."
As the new Congress and state legislatures get to work in the coming months, policymakers are expected to grapple with the contentious issue of whether teenagers should have confidential access to reproductive health services--including contraception. And debates over what teens should be taught about sex and contraception will continue in many communities across the country. These new findings add to a growing body of evidence that supports making family planning services available to teenagers and providing them with medically accurate, age-appropriate instruction on both how to delay first sex and, for those teens who are sexually experienced, how to consistently, correctly use contraception.
Although the rate of teen pregnancy has dropped over the last decade, The Alan Guttmacher Institute estimates that nearly 850,000 teenagers still get pregnant each year--and the vast majority of these pregnancies are unintended. Nationwide, roughly half of all unintended pregnancies occur among the small proportion of women who are not using any form of birth control. Teenagers also remain at relatively high risk for STDs, accounting for approximately four million new cases each year, despite recent declines in teen sexual activity and increases in the use of condoms and other contraceptives among those who are sexually active.