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December 01, 2006

Abstinence or Contraception?

A report out that cliams to show that contraception is the way to reduce tennage pregnancy rates, not abstinence.

Sexual abstinence as an effective tool in reducing teenage pregnancy is a complete "myth", the Government's advisory body on the issue claimed yesterday.

The Independent Advisory Group on Teenage Pregnancy said that research from the United States showed that contraception was the way to bring down rates. Researchers from Columbia University and the Guttmacher Institute examined the relative roles of abstinence and contraceptive use in the "remarkable decline" in US teenage pregnancy rates, which dropped 27 per cent from 1991 to 2000. They said that 86 per cent of the decline in teenage pregnancy was due to improved use of contraception.

Only 14 per cent of the drop amongst 15- to 19-year-olds was linked to reduced sexual activity, according to the study, published in the latest edition of the American Journal of Public Health.

Gill Frances, the chairman of the British advisory group, said: "Providing young people with good information, advice and contraceptive services, is the way to reduce teenage pregnancy.

"It is a myth that abstinence is a better approach and this US study confirms it."

That is, of course, entirely bollocks. All forms of contraception have failure rates and minus for one well known and remarked upon exception abstinence has never made anyone pregnant.

What they mean is that educating teenagers to be abstinent is a bloody site harder than teaching them to use contraception properly  (or better, perhaps) but that's really rather a different thing from what they've actually said, isn't it?

December 1, 2006 in Sex | Permalink

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Comments

I don't see this, unless it's meant to be a smart-alec joke. You might as well say that a diet of nothing but lettuice is a foolproof way of losing weight - it might be, but the fact that it would be more or less impossible to stick to such a diet means that it's actually a very ineffective diet. Abstinence is a strategy, and the fact that it's very difficult to commit to it is one of the things you should take into account when rating it as a strategy.

Posted by: dsquared | Dec 1, 2006 8:24:23 AM

This report entirely misses the key factor - incentives (or negative incentives) and family pressure.

The Netherlands famously has a teenage pregnancy rate that is a fraction of ours. The key difference? Anyone under 18 is deemed to be the responsbility of their parents if they get pregnant - no state benefits, no housing benefits. So there is a negative incentive and teenagers parents have a key role in discouraging teenage pregnancy.

Note that this doesn't penalise teenage pregnancy - it just doesn't subsidise it. Natural negative incentives are allowed to prevail.

Posted by: HJHJ | Dec 1, 2006 8:25:32 AM

dsquared, Tim is being a pendant again.
The trouble is that while you are right to say that "Abstinence is a strategy, and the fact that it's very difficult to commit to it is one of the things you should take into account when rating it as a strategy" and I'm sure that is something the authors of the report would agree with; you do have to admit there is a fairly significant stench of political spin in the quotes etc, given the parentage of the abstinence lobby in the US.

Posted by: Steve | Dec 1, 2006 8:37:47 AM

How much of the drop came after welfare reform of the 1990s?

Posted by: J | Dec 1, 2006 10:22:33 AM

"You might as well say that a diet of nothing but lettuice is a foolproof way of losing weight - it might be, but the fact that it would be more or less impossible to stick to such a diet means that it's actually a very ineffective diet.."

Yep. Not having sex = not eating a balanced diet.

Of course.

The two are identical....

So tell me, what physiological changes in the body result from abstaining from sex that can be compared to abstaining from a balanced diet?

Posted by: JuliaM | Dec 1, 2006 10:46:27 AM

"The Netherlands famously has a teenage pregnancy rate that is a fraction of ours. The key difference? Anyone under 18 is deemed to be the responsbility of their parents if they get pregnant - no state benefits, no housing benefits. So there is a negative incentive and teenagers parents have a key role in discouraging teenage pregnancy."

That's a clear practical solution to the problem (well, except for the teenage parents - I think we have that here too & it doesn't appear to do much good).

Will it ever be implimented here? I wonder.....

Posted by: JuliaM | Dec 1, 2006 10:54:03 AM

HJHJ,

We've created (through benefits) a dishonourable underclass. People used to have numerous incentives in this country to "do the right thing". There was a stigma about being irresponsible in these matters which resulted in fathers leading their sons in what was the right thing to do, in part because it had added a burden to someone else.

Take away the burden, and people will look at the situation differently.

Posted by: Tim Almond | Dec 1, 2006 11:48:04 AM

How pointless can you get? Certainly "abstinence" in "myth that abstinence is a better approach" refers to teaching and advocating abstinence as opposed to teaching use of contraceptives, and I really see no reason to expliticitly state that.

If someone actually does say a cross-OECD study that statistically links incentives and teenage pregnancy rates, not that hard to do, I might take the notion of wellfare state causing (some percentage of, again something that could be inferred from the data) teen pregnancies seriously. Until that I stick to the common-sense view that teenagers are hormon driven, and thus will have sex, and thus pregnancy rate is highly dependant on use of contraceptives.

Posted by: teme | Dec 1, 2006 1:49:16 PM

> what physiological changes in the body result from abstaining from sex that can be compared to abstaining from a balanced diet?

Massive growth in the muscular tissue in the upper (noramlly) right limb and shoulder area. Foot tapping behavour.

Posted by: AntiCitizenOne | Dec 1, 2006 2:11:22 PM

So tell me, what physiological changes in the body result from abstaining from sex that can be compared to abstaining from a balanced diet?

Failure to reproduce.

Posted by: Charlie (Colorado) | Dec 1, 2006 2:39:49 PM

educating teenagers to be abstinent is a bloody site harder than teaching them to use contraception properly

In other words: it is more difficult to ensure that people employ "abstinence" reliably and consistently than it is to do so for normal contraception - leading to a higher failure rate and more unplanned pregnancies.

Or: abstinence has a "practical efficacy" lower than its "theoretical efficacy" . . . just like every other form of contraception - with the difference that its theoretical efficacy (a bit under 100%) is only 1% higher than the theoretical efficacy of the most reliable form of normal contraception (99% for hormonal contraceptives), while its practical efficacy is vastly lower.

Or: abstinence can be rationally evaluated in respect of its theoretical and practical efficacies, just like every other method of contraception, and when it is, it fails miserably - as well as being a product of a perverse sex phobia that has no place in healthcare or sex education to begin with.

Thanks for confirming.

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Posted by: Daniel DiRito | Dec 1, 2006 5:30:57 PM

"abstinence can be rationally evaluated in respect of its theoretical and practical efficacies, just like every other method of contraception, and when it is, it fails miserably - as well as being a product of a perverse sex phobia that has no place in healthcare or sex education to begin with."

A bit of a misunderstanding, I think.

No one is suggesting that they abstain from sex forever. Just while they are under the age of consent and/or unable to support a child......

Posted by: JuliaM | Dec 1, 2006 6:08:02 PM

No one is suggesting that they abstain from sex forever.

That isn't really responsive.

My point is that abstinence advocates constantly insist on evaluating it by a different set of rules from those universally used to evaluate real contraception. They claim that abstinence "never fails", because people who have sex, by definition, aren't using abstinence. But the failure rates of every contraceptive method include large proportions of people who did not follow the recommended regimen reliably. It's disingenuous to ignore such failures of abstinence but count failures to use condoms or take pills. Abstinence has a failure rate just like every other method of contraception - it's just higher than in most other cases. People who claim they are "practicing abstinence" get pregnant with dreary regularity, and more often than do people who plan ahead responsibly.

To asses abstinence's actual success rates, it should be evaluated like all contraceptives are, in respect of both its theoretical and practical efficacies. And the simple truth is that, at best, abstinence has a theoretical efficacy hardly better than the most-reliable real contraceptives, and a practical efficacy far worse than most. People who rely on "abstinence" to avoid pregnancy wind up pregnant far more often than those who rely on real contraception - that's the fact.

Worstall dismisses that fact by saying it's "harder to teach abstinence" - but that's simply an explanation of why it fails, not proof that it doesn't fail. (And in fact, it's perfectly easy to teach abstinence - it's just very hard to get people to consistently do something so pointless, self-denying, and ultimately degrading to their true, healthy sexual natures.) Of course's it's hard to get compliance - that's a good reason not to promote abstinence in favor of other methods that are (a) easier to use consistently, (b) used more consistently in practice, and (c) provide a better, healthier, and more enjoyable lifestyle.

It's not a question of what happens to people after they've stopped using abstinence as birth control. The problem is that abstinence is a lousy method of birth control while they're using it. Just ask their kids.

Tim adds:You misunderstand me. I argue about the meaning of words here, nothing else. I am not a promoter of abstinence (or any other method) as a way of reducing teenage, or indeed any other, pregnacy rates. All I want is that when we say that 'abstinency fails' or 'condoms fail' or 'the pill fails' is that we actually agree that abstinence does not fail, but that those who attempt to use it as a method of contraception ofen fail.

I want us to be clear in our terminology, that's all. Rather like relative and absolute poverty. The former is better described as inequality. We have two things, and I'd like us to discuss them as two separate things, not alllow the language to conflate them.

Posted by: Kevin T. Keith | Dec 1, 2006 6:36:44 PM

"People who rely on "abstinence" to avoid pregnancy wind up pregnant far more often than those who rely on real contraception - that's the fact."

Well, possibly that's because people who rely on "abstinence" and get pregnant are having sex....

What you are arguing is that people don't want to stick to it. They 'fall off the wagon' so to speak.

"The problem is that abstinence is a lousy method of birth control while they're using it. Just ask their kids."

If they have kids, they aren't using it.....

Posted by: JuliaM | Dec 1, 2006 7:02:14 PM

"it's just very hard to get people to consistently do something so pointless, self-denying, and ultimately degrading to their true, healthy sexual natures..."

And it's very hard to get alcoholics to swear off drink. So AA should allow their members small, pure doses of alcohol in a controlled environment?

And I repeat - no-one is suggesting they do it forever. That is a response. It's one whose conclusion you may not like, but it's there....

Posted by: JuliaM | Dec 1, 2006 7:05:47 PM

Abstinence carries no negative consequences, such as single parenthood, unwanted pregnancies etc. Economically it has to be the best option. So why would any government or population not want to promote it? Answer: they want to have recreational or consequence-free sex and don't like the thought that they should refrain from doing so (abstinence). The problem is, they don't like the consequences that sex brings - so they need to find a way of providing this. In general, they can't. In the meantime though they attack abstinence - incredible, and logically bananas.

Posted by: Terry | Dec 1, 2006 8:14:26 PM

Where's the great British tradition of compromise? Teach them buggery.

Posted by: dearieme | Dec 1, 2006 8:32:52 PM

Terry,
"So why would any government or population not want to promote it?"

That's not the problem. The problem is abstinence-only education, which might work with some children, but not with others. The idea that it's best not to tell kids about contraception, because that way, they won't want to have sex.

Posted by: anon | Dec 1, 2006 10:23:52 PM

When it comes to a contest between "Don't do it!" and teenage hormones, I know where my money's going!

Posted by: pogo | Dec 2, 2006 12:36:04 AM

What's not noted often is that comprehensive sex education (including contraceptive information) generally present abstinence as the preferred alternative. There are very few people, least of all educators, who think it's a good idea for teens to be having sex.

Here in the US, the real problem with abstinence programs is that their purpose is not to reduce teen pregnancy or STDs - they've become a way for religious groups to tap into federal money through the "faith based initiatives" program, and the point is very much proselytizing. In a stunning example of this, documented in Michelle Goldberg's recent book on the rise of what she terms "Christian nationalism" in the US, a leading abstinence educator at a religious political conference came right out said that she's not interested in whether the programs work - her job is get the kids to be born again.

By any rational evaluation, comprehensive sex education works better at preventing pregnancy and infection. The problem is that here we have a group of advocates who are actually working on a different goal.

Posted by: John | Dec 5, 2006 1:21:15 AM

Contraception is the better choice because nowadays about 90% of the teenagers have sex before they get 16.And that's the reason for the high rates of teenage pregnancy.The more teenagers use condoms the better for themselves.

Posted by: Cara Fletcher | Jun 8, 2007 6:16:48 PM