The Law Reform Commission must not overlook the influence of parents on young people, asks BREDA O'BRIEN
PROF DAVID Paton is a British economist and, unlikely as it may seem, one of his areas of expertise is what does and does not reduce teenage sexual activity and pregnancy. As he cheerfully announced in Dublin this week, economists are not interested in right and wrong, only in what works. He was in Dublin at the request of the Iona Institute, of which I am a patron.
He is a member of New Labour, but is trenchantly critical of its attempts to reduce teen pregnancy. Some £300 million has been spent on strategies to reduce teen pregnancy, and the results? Very, very little.
The British under-16 conception rate in 2008 (the latest available year) was about 5 per cent higher than when the strategy was launched in 1999, while the under-18 rate was about 10 per cent lower.
However, the drop started before the strategy kicked in, and continued in the early years when very little was spent. In fact, it could be argued that increased funding for the strategy caused the drop in figures to level off.
The teenage pregnancy rates in Britain remain among the worst in Europe. Ireland’s teenage pregnancy rate is among the best, comparable to the much-lauded Netherlands. Yet the Law Reform Commission is suggesting we follow the British example.
The commission's consultation paper Children and Law: Medical Treatment, sets out proposed criteria under which health professionals could provide children with healthcare and medical treatment, including contraception.
Children aged 16 or 17 would be presumed to have capacity to consent to such treatment. Children aged 14 or 15 would be regarded as capable of giving consent under certain conditions, including that the medical professional should encourage the child to inform his or her parents.
Finally, treatment could also be provided to children aged 12 or 13 under the condition that the parents are notified and their views taken into account. (Parents, how likely is it that any “encouragement” will persuade 14 year olds to inform you?) In a presentation that ranged widely through research, Prof Paton concluded the likely results if this policy is implemented are no change in the pregnancy rate, but an increase in early sexual activity, and increasing pressure for abortions.
Access to family planning, whether from schools, pharmacies or clinics, is not associated with lower pregnancy rates among minors. There is overwhelming evidence that ready availability of the morning-after pill has no impact whatsoever on rates of unwanted pregnancy – references available for download from www.ionainstitute.ie. On an individual level, contraception will decrease the chances of becoming pregnant. Ready availability of contraception has little or no effect, and in some cases, shows negative effects.
In the UK, birth control is widely available in schools, and schools where it is not available must “signpost” availability of contraception elsewhere. However, the pregnancy rate in Ireland in under-16s is 0.9 per thousand, while in Britain it is 5.5. Current Dutch figures are 1.1 per thousand. Rates of sexually transmitted infection (STI) diagnoses (among both all teenagers and under-16s) have increased dramatically in England. The rate of STI diagnoses among Irish teenagers, although rising, is just one-quarter of the rate in England.
Humorously, Prof Paton said that instead of following the British example, perhaps we should be holding seminars in Britain to discuss what we are doing right. It makes sense that increased access to contraception is likely to increase a false sense of safety and therefore, risky sexual activity.
Also, young people are not aware of the high failure rate of contraception. For example, the latest evidence from the US suggests over 8 per cent of all pill-users and 17.4 per cent of condom-users will experience pregnancy over a 12-month period. The failure rates are likely to be much higher among adolescents. In Britain, the famous Gillick ruling provided a very convenient case study. For one year, 1984-1985, minors could not access contraception without parental consent. Unsurprisingly, the rates of accessing birth control fell by one-third, but what is rarely highlighted is that pregnancy rates did not increase, and may even have declined a fraction.
The premise is always that young people are going to have sex, no matter what we say, so we should make contraception readily available. It is ignored that one possible consequence of enshrining parental consent is that young people may delay having sex.
It may not fit the teenage stereotype, but young people are often very glad to be relieved of the pressure to have sex. If we want to delay sexual activity, we certainly won’t achieve it by aping British policies, which merely normalised early sex.
What helps to reduce rates? No right-winger, Prof Paton says that what does work are things that governments should be doing anyway, such as reducing poverty and increasing educational access. In addition, strong religious affiliation has a protective effect, as does family stability.
Research shows that the lower a girl’s self-esteem, the more likely she is to be sexually active at a young age. The younger a girl is sexually active, the more regret she is likely to experience. We need to reconnect sex, love, and commitment. The commission should provide guidelines for practitioners that emphasise parental consent and reinforce parents’ role in teenagers’ lives.
In a Red C poll conducted for Iona, 77 per cent of people agreed parental consent should be necessary before giving contraception to 14-15 year olds. It would appear that the response to Prof Paton’s last slide, which simply read, “Do you really want to copy the English?” is a resounding No.