According to a Feb. 14 report in the Independent the Bridgend area of south Wales has one of the highest teen-age pregnancy rates in Europe. Girls will now be able to request the morning-after pill, free of charge and without seeking parental permission. Doctors backing the scheme, which is primarily aimed at teen-agers, have acknowledged that girls aged 12 or younger may have access to the service. With the falling age of the onset of puberty, it is possible that youngsters of 9 or 10 could soon demand the pills.
This announcement comes a month after the United Kingdom launched a national scheme whereby women over 16 can obtain morning-after pills, although they have to pay £20 ($29). In the Bridgend scheme, pharmacies have been given what is in effect an open prescription to give the contraception to girls who fulfill certain criteria.
Another trial involving the dispensing of the morning-after pill to young girls started recently in some areas of England. Nurses in state schools in east Kent, Oxfordshire, Derbyshire and South Yorkshire are to dispense the pill to girls under the age of consent without their parents´ knowledge, the Sunday Times reported Jan. 7.
The move, largely focused on areas with high teen-age pregnancy rates, provoked controversy. Anna Lines, of Family and Youth Concern, said: "It´s a quick fix that will give youngsters the go-ahead to engage in sex at an even earlier age."
While Stuart Horner, professor of medical ethics at Central Lancashire University, was concerned not only about the ethics, but also the potential impact on health: "We are not talking about Smarties here, but significant doses of female hormone which can and does cause problems when it is administered. We do not know the long-term effects, particularly from regular use."
In Canada, too, authorities have approved the distribution of the morning-after pill without the need for a prescription. Saskatchewan is taking steps to be among the first provinces in Canada to make the pill known as Plan B available without a prescription, the Globe and Mail reported Feb. 1.
Plan B is to be available in the province as early as April, without a prescription but through a pharmacist. Since December, women in British Columbia have been able to get Plan B with the written approval of a pharmacist, and some areas of Toronto are expected to make it available without a prescription on a limited, trial basis in June.
Yet, sales of Plan B, according to figures from IMS Health, an independent organization that tracks drug sales, have been slow, with only 665 Canadian prescriptions written for it from July to December, reported the Globe and Mail. That´s roughly one-third of the prescriptions written for Preven during its first six months on the market. Since it came on the market 16 months ago, Preven sales have been so poor that Shire Canada Inc. plans to discontinue it.
In Australia, meanwhile, the family planning body in the state of Victoria wants to distribute among teen-agers a new implant that lasts for three years. The matchstick-shaped implant, Implanon, has been approved for use in Australia and is likely to become available shortly, according to a Nov. 16 report in The Age newspaper.
However, a senior medical officer with the organization, Family Planning Victoria, Dr. Kathleen McNamee, admitted that the disadvantage of the implant for teen-agers was that they would expose themselves to sexually transmitted infections if they failed to use a condom at the same time. The implant also caused irregular bleeding as a side effect.
The national secretary of the Australian Family Association, Bill Muehlenberg, said the use of such contraceptives in teen-agers sent a confusing message about risks. Sexual abstinence was the safest option of all, he said.
Is contraception the answer?
In spite of all these efforts to lower the teen-age pregnancy rates by means of contraceptives, often abortive in their action, not all officials are in agreement with this approach. For example, Trevor Stammers, tutor at St. George´s Hospital Medical School, London, published an article in the Dec. 16 issue of the British Medical Journal in which he affirmed that "contraception as the cornerstone of sexual health promotion for adolescents has manifestly failed."
Stammers noted that in almost 15 years of general practice he had never seen a single case of unplanned pregnancy resulting from ignorance about or unavailability of contraception. In fact, studies show that up to 80% of unplanned pregnancies result from failed contraception. Data from 1975-91 show a positive correlation between increasing rates of use of condoms at first intercourse and higher rates of teen-age conceptions.
He also pointed out that the younger the age of first intercourse, the greater the risks involved: "Early teen-age sex is associated with poor use of contraception as well as multiple sexual partners and increased rates of depression and suicide, and it is often part of a wider spectrum of harmful behavior that includes substance abuse, smoking, and excessive alcohol consumption."
A better solution, he says, is the promotion of abstinence. Recent evidence from the United States confirms that abstinence programs are having a positive effect. The Associated Press reported Jan. 4 on a study that found teen-agers who publicly pledged to remain virgins until marriage delayed having sex about 18 months longer than other teens.
Among those who formally promised to avoid unmarried sex, about 50% remained virgins until about age 20, said Peter S. Bearman, a Columbia University sociologist and co-author of a study in the American Journal of Sociology. "The average delay among pledgers is 18 months," Bearman said. "That is significant. And that is a pure pledge effect."
Bearman and his co-author, Hannah Brueckner, a sociologist at Yale University, analyzed the effect of virginity pledges on the behavior of teen-agers enrolled in the National Longitudinal Study of Adolescent Health, a federally funded survey of children in the seventh through 12th grades.
Data from the study suggested that by 1995, a church-led, voluntary effort had prompted about 2.5 million teen-age boys and girls to make spoken or written pledges to refrain from sex until marriage.
Yet, Bearman warned in a report published Jan. 25 by Conservative News Service, "The pledge is not a magic bullet. ... It is a very successful thing for some kids" but not for others.
Chances are that with Republicans in power in Washington, D.C., funding for abstinence programs will receive strong support. The New York Times reported Dec. 28 on an amendment to the Welfare Reform Act of 1996 that stepped up federal financing to promote chastity, which had totaled $60 million since 1981. The new law set aside $250 million for five years.
Federal and state governments will pay $100 million during 2001 to teach chastity as the only realistic strategy for avoiding disease and pregnancy. That might signal to governments in other countries that condoms and morning-after pills are only Band-Aids and not a real solution.