Teenagers find sex too much fun to stop having it, most schoolgirls who have babies wanted to get pregnant - and until the government faces up to these facts, says Ann Furedi, it has little chance of reducing the teenage conception rate
The shocking truth about teenage mothers
New Labour has launched another campaign to cut teenage pregnancies, after recent revelations that almost 9000 girls aged 15 and younger became pregnant in 1996. Public health minister Tessa Jowell paraded before the media pack with teen magazine agony aunts, to announce that she had recruited Sugar, Just Seventeen and the rest to help spread the moral message about sex.
Not so long ago, these same teen magazines were slammed by the old Tory government and its allies for encouraging teen sex by publishing irresponsible articles about 'blow jobs', 'wanking' and 'fingering'. The magazines protested, with some justification, that their articles carried an implicitly responsible message - always reminding readers of the age of consent and encouraging girls not to rush into sex. Faced with parliamentary motions calling for their censorship, teen-mag editors countered that they were better placed to influence their readers than worthy 'experts'. Now it seems that the New Labour government has taken their point.
Unfortunately for ministers the recruitment of a few photogenic agony aunts is likely to make no impact on the rate of teenage pregnancy, and particularly not on the rate of teenage motherhood which, from the polit-icians' point of view, is a more serious headache. The widely reported plans to make sex education more relevant to the needs of modern youth are equally unlikely to curb the numbers significantly, nor is the extension of family- planning services targeted at young people - although of all the government's plans, this is the one with the most merit.
It is almost as though sexual health strategists have wilfully decided to focus their efforts on the ephemeral issues and ignore anything that could make a real difference. Perhaps this is because the measures required to tackle the problem are regarded either as too controversial or too 'difficult'.
To address the problem of teenage pregnancy you first have to face up to the fact that young people are having sex at a younger age, that they are enjoying it and are unlikely to stop. Today most teenagers have had sex by the time they are 18, at least a third by the time they are 16. They have sex because it is fun and it feels 'grown up'. Sex outside marriage is no longer stigmatised but seen as normal. Opinion has shifted even over the last 15 years. A study by demographer Kathleen Kiernan found that in 1983, 28 per cent of the public felt that pre-marital sex was always or almost always wrong. By 1991, Kiernan found this number had dropped to 19 per cent. If we do not expect people to wait until they are married what are we expecting them to wait for?
To dent the teenage pregnancy numbers, the government would have to accept that teenage sex is a normal and acceptable fact of life and address how to allow young people to enjoy sex without what family planning professionals refer to as 'negative consequences' or 'adverse outcomes'.
One way to do this would be to promote the most effective methods of contraception to young people, and in particular to encourage use of 'emergency after-sex contraception', a method ideally suited to teenage flings because it does not rely on pre-planning. These are two issues that neither ministers nor their minions want to confront. The government could also usefully advertise that when teenagers unintentionally become pregnant, if they want an abortion, they should be able to get one 'confidentially'.
But while the government has been dreaming up touchy-feely ways to relate to young people, nothing has been done to address these straightforward practical measures.
Little, if anything, has been done by governments to restore confidence in the contraceptive pill following several scares which have undermined young women's confidence in its safety. The most significant pill panic, almost three years ago, which linked certain pill brands to blood clots, was actually whipped up by the last government.
Brook Advisory Centres, Britain's largest network of young people's sexual health clinics, report that the proportion of their clients requesting the pill has been steadily falling for four years and has recently plummeted. The proportion of 16-19 year old women requesting the pill from Brook clinics in the year up to March 1997 dropped by 25 per cent compared with the previous year. Among younger clients the fall was even greater. Tessa Jowell could prob-ably persuade more young girls to protect themselves against pregnancy by stating unequivocally that the pill is safe and beneficial to the health of most of them, than she will by a photo opportunity with agony aunts. Yet the government has, it is rumoured, shifted resources away from emergency contraception campaigns and continues to stigmatise abortion as a problem rather than the solution to a problem.
Most crucially, the government seems incapable of facing up to the simple truth that most teenage girls who become pregnant are not ignorant of what used to be called the 'facts of life'. Nor are they incapable of getting hold of contraceptives. Kilroy may be able to find the odd teenager who thought it would be alright if she 'did it standing up'. Editors of teenage mags can wave letters which illustrate the pathetic naivety of some of their readers. But most teenagers understand that sex can lead to pregnancy. They know what a condom is and where it goes. And many of them will know of a place where they can go to get the pill.
So why does Britain have the highest rate of teenage pregnancy in Europe? It is not because British teenagers are more ignorant about sex than the French, the Dutch, the Swedish or the Germans. Britain has a higher teenage conception rate because many of its teenagers are less motivated to avoid becoming pregnant. When girls are determined that they don't want a baby, they generally don't have one. The issue is, then, why do so many girls in Britain seem indifferent to whether they get pregnant or not?
A recent report by the Policy Studies Institute confirms that socioeconomic factors are the key determinants of whether a teenager will get pregnant. One Scottish study has shown that teenage conceptions are six times as likely in the most deprived areas as in the more affluent areas. The same pattern was evident in a report on London. The discrepancy is even more marked when it comes to the issue of how a teenage pregnancy ends. A girl from a middle class background is far more likely to request and obtain an abortion than a girl from a deprived area.
Teenage girls who grow up in economically secure and comfortable circumstances are more likely to develop ideals and aspirations similar to their parents. Their peers are likely to come from the same kind of families. Unplanned pregnancy is simply not part of their vision. They dream of university, gap years abroad, cars and careers - not nursing a baby. Motherhood is something distant, if it figures at all. When these girls have sex, they are highly motivated to avoid pregnancy and if they become pregnant they want to become unpregnant as soon as possible.
For girls who live in economically deprived circumstances, babies are often part of the life-plan from the start. Unplanned pregnancy does not seem such a disaster because it interrupts nothing they greatly value. They may have mothers, sisters or aunts who became pregnant in their teens and who see having a baby as one of their most rewarding experiences - certainly better than working in McDonalds. For some girls having a child becomes a way of achieving status as an adult, creating somebody to love them, making people take notice of them and their lives. In such circumstances teenage pregnancy and teenage motherhood is not stigmatised but seen as normal.
The more enlightened sex education programmes take account of this 'bigger' picture and focus their efforts on trying to illustrate to young working class girls how a baby will take away their social life, stop them from going out with their mates. But when you are 15 and you live on a sink estate in the middle of nowhere, you have not got any freedom, and there is nowhere for you to go. It is not difficult to imagine why changing nappies might seem satisfying by comparison. Sex educators talk about boosting 'self-esteem', but self-esteem cannot be boosted in isolation from the rest of a young girl's life.
The low teenage pregnancy rate in the Netherlands is often favourably compared with that in the UK, and the difference is put down to liberal Dutch sex education and youth contraception services. But, as one Dutch speaker explained at a recent international conference on abortion, his country's low teenage pregnancy rate has more to do with other factors: its greater overall affluence (in poor areas the unplanned pregnancy rate is equivalent to ours); a culture where young women are encouraged to use the pill to treat acne and period pains even before they start having sex; one where teenage sex is regarded as normal, teenage pregnancy is frowned upon and abortion regarded as the acceptable solution.
If government was honest it would admit that it is not anxious about the 17-year old A-level student whose mother makes an appointment with a BPAS abortion clinic the week after she misses her period. Rather its concern is about welfare-dependent teenage mothers breeding potential criminals on estates where social stability is fragile. To tackle these teenage pregnancies requires not a family planning or sex education policy but social and economic policies which allow working class girls to have aspirations beyond motherhood. But that is far more difficult than arranging a photocall with a couple of trendy journalists.
Ann Furedi is director of the Birth Control Trust
Reproduced from LM issue 110, May 1998