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Why teenage sex excites the Tories

Anne Burton sees a hidden agenda behind the concern about teenage pregnancies in the government's Health of the Nation report

Teenage pregnancy is a recurring concern of the authorities and the media. Barely a month goes by without some discussion of the problems of sex and teenagers, whether it's about the number of teenage births and abortions, or the influence of TV on young people's sexual appetites. Out of all the issues raised by the government white paper, The Health of the Nation, in July, the spotlight focused on teenage pregnancy.

Teenage pregnancy only took up a tiny part of the government report, but you could be forgiven for thinking otherwise by the deluge of items about it on the news and in the papers. The media are always keen to report on sex - it sells papers and attracts viewers. Any government initiative related to sex is an editor's dream. But to be fair, this time the press was not simply indulging its own taste for salacious reporting. It was pointed in that direction by the Department of Health itself.

Three days before the official launch of The Health of the Nation report, the Department of Health briefed the Sunday Telegraph and the Observer to the effect that sexual matters in general, and teenage pregnancy in particular, would be a key target in the drive to improve the health of the nation. The Sunday Telegraph dutifully ran a front-page feature declaring that 'the government is to declare war on teenage pregnancies...in an effort to counter the consequences of the permissive society'.

Why was the government at such pains to highlight the issue of teenage pregnancy in its health campaign publicity? After all, unlike other matters dealt with in The Health of the Nation, such as cancer and heart disease, teenage pregnancies do not constitute a major health problem. The mention of our old friend 'the permissive society' suggests that the Tories' concerns are more moral than medical.

In terms of the issue itself, there is no rational basis for the government to turn its guns on teenage pregnancy. Despite what you read in the papers, official figures show that the number of gymslip mums is not growing at an alarming rate. Health secretary and former teenage mother Virginia Bottomley claims to be disturbed by surveys of social trends which show that over a third of children are born out of wedlock, but that is a different issue altogether. The vast majority of these births are to women in their mid to late twenties, many of whom are in any case living with a partner.

In reality, the number of teenage mums has fallen in recent years. This is largely due to the fact that there are fewer teenagers around. The rate of teenage pregnancies (the number of pregnancies for every 1000 teenage girls in the population) is steadily increasing, but very, very slowly. For instance, in 1989 there were 117 499 teenage pregnancies, 67.6 for every thousand girls of that age. That was 3000 fewer than the year before, although the teenage pregnancy rate rose by one in a thousand.

Conceptions to the under-16s, which the white paper regards as a particular 'matter of concern', have also fallen in real terms. In 1989 there were 8500--a fall of a couple of hundred on the year before. As with older teenagers, the pregnancy rate has increased fractionally. In 1989 there were 9.5 pregnancies in every thousand girls under 16--an increase from 9.4 the year before, and 9.3 the year before that.

The government justifies its concern by arguing that early pregnancies constitute a health risk to young girls. However, once the girl has passed her fourteenth birthday there are few medical risks associated with the physical condition of early pregnancy itself. On the contrary, some might argue that teenage mums are taking advantage of their peak fitness, as well as their peak fertility. In many underdeveloped societies the teens are peak child-bearing years. Abortions (which end more than half of the pregnancies to under-16s) carry no more risk to teenagers than to older women. And while some studies claim that early experience of penetrative sex is associated with cervical cancer, the case is yet to be proven and other lifestyle factors may be equally significant.

The main argument employed by the Department of Health seems to be that if a girl is exposed to the risk of pregnancy, she is simultaneously exposed to the risk of sexually transmitted diseases, especially HIV. This does not necessarily follow. As we have pointed out many times in Living Marxism, the official line on HIV/Aids massively inflates the chances of contracting it through heterosexual contact in this country. And in any case, surveys into the sexual behaviour of young people show that teenage girls usually have sex with teenage boys with little, if any, sexual experience. Consequently these partners are highly unlikely to be carriers of anything other than sperm.

Teenage pregnancy may be undesirable, but it is not a significant health risk to young girls. Indeed the serious problems which are faced by gymslip mums are almost entirely due to social rather than medical factors. Teenage mothers are stymied at every turn by the way that society treats them. Their education is disrupted (or abruptly ended) because the education system will not adapt to suit the needs of a youngster with other demands on her time. Their job prospects are severely restricted by the state's refusal to provide adequate childcare and other welfare facilities.

Teenage pregnancy is sometimes tragic and almost always undesirable, because early motherhood closes down all the options that would otherwise be available to a girl as she matures into adulthood. But it is not a health risk in itself. This is extremely fortunate for young women because, despite the declaration of war, the government's white paper gives no indication that it is going to do anything practical to address the problem at all.

Compared to other medical conditions, the problem of teenage pregnancy should be easy to treat. Unlike a condition like cancer, we know what causes pregnancy (sex) and we know how to prevent it (contraception backed up by abortion). Consequently the means to meeting the Health of the Nation target - a 50 per cent reduction in unwanted pregnancies to the under-16s by the year 2000--would seem to be relatively easy to reach.

Not a clue

However, there is not one solitary suggestion in the white paper as to how reductions in teenage pregnancy will be achieved. There are no targets for family planning clinics aimed at teenagers, nor targets relating to the availability of abortion, nor even targets related to sex education. In fact, the white paper appeared against a background of family planning clinic closures, abortion facility cutbacks, and a lack of adequate sex education in many schools. All of which makes it a little difficult to take the government's concern at face value.

The summary of the white paper acknowledges that some basic measures are required to make the teenage pregnancy target realistic:

'Reductions in unwanted pregnancies will...be dependent upon information and education and the development of local services. Family planning services should be appropriate, accessible and comprehensive, to meet the needs of those who use or may wish to use them.'

That all sounds well and good, but the rhetoric doesn't quite match up with the reality of the serious cuts which the authorities are now inflicting upon family planning provision. Indeed in the very week that the summary was mailed to every GP in the country, Kings Health Care Trust (formerly Kings College Hospital) in London had its family planning budget cut by £50 000, and lost a further £10 000 off its family planning training budget.

The Tories decided to include teenage pregnancy in the health white paper, and to highlight the fact that they had done so, for reasons that have far more to do with their own political concerns than with the problems of pregnant teenagers.

Decline personified

The issue is ideally suited to ramming home a moral message and promoting conventional values. By homing in on unsuitable mothers, the authorities can reinforce notions of what 'a proper family' should be. The pregnant teenager personifies what conservatives perceive as Britain's moral decline. She has acted in an 'improper manner'. Instead of doing homework, and helping around the house (as a nice girl should) she has been cavorting around with boys. This reflects as badly on her parents as it does on her. They should have supervised her more closely, imposed more discipline and provided a better model of a loving monogamous relationship for their daughter. A war against teenage pregnancy is a useful excuse for ramming home old-fashioned family values.

Of course, raising moral problems can backfire if they subsequently appear irresolvable. The government is acutely aware that having wittered on about the problem of gymslip mums for years, they now have to be seen to do something. But doing something practical about teenage pregnancy is hard for the Tories. Not only does effective contraceptive provision for the young cost money - it also causes controversy. Whenever health regions try to improve young people's access to contraception, the Department of Health is accused of condoning under-age sex. What Virginia Bottomley and the DoH need is to be seen to do something, without actually doing anything. White papers are a very good means of creating the required optical illusion.

Self-help health

The real reason why the government appears so keen to raise the problem of teenage pregnancy becomes clearer when you look at the philosophy behind The Health of the Nation report as a whole.

In the document, the government sets health targets which it intimates could largely be met if we each took more personal responsibility for our well-being, by eating, drinking and behaving in a more careful and respectable fashion. In a nutshell the principle is that people's chosen lifestyles, rather than social conditions, are largely to blame for bad health; so individuals need to assume responsibility for improving their own health, and to encourage their family and friends to do likewise.

A suitable case

Teenage pregnancy is a particularly suitable case for treatment because it's easy to present irresponsible individuals as the problem, and more personal responsibility as the solution. Health secretary Virginia Bottomley can sound convincing as she argues that contraceptives can be obtained by young people who require them, and that it's simply a matter of getting them to take advantage of what's on offer. Britain's youngest granny
--a woman of 29, whose parents failed to educate her in the facts of sex, and who subsequently failed to pass on the information to her own 15-year old daughter who has just given birth - is wheeled on as a 'typical' example of what young women are like.

The underlying message is: the government is aware of the problem, but there is little we can do when you, the public, behave so irresponsibly. And that message can be transposed on to other health issues. The philosophy of personal responsibility, expounded so forcefully in relation to teenage pregnancy, underlines every target area identified in The Health of the Nation.

'Avoid accidents'

As Dr Michael Fitzpatrick examines elsewhere in this issue of Living Marxism, the report's strategies for key health problems are largely reducible to ways that we can supposedly decrease our risk of illness. Unbalanced diet, smoking, raised blood pressure, alcohol misuse and lack of physical activity are the factors identified in tackling heart disease. The section on cancer concentrates on the need to improve uptake on screening projects and reduce smoking and excessive exposure to sunlight. The report says that we can often avoid accidents (wise words) and that our sexual health can be improved if we engage in safer sex. Mental health is the one area which is not reducible to self help - so here the government report has no strategy at all.

Because teenage pregnancy is not a major medical problem, the Department of Health's inability to provide a solution to it has few practical consequences for the nation's health. By contrast, cancers and heart disease are mortal threats to millions. And while the government uses health reviews to promote its own moral and individualist philosophies, rather than to develop the social healthcare we need, the bodies will continue to pile up.
Reproduced from Living Marxism issue 47, September 1992

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