Abstinence Talk Not Enough, Pediatricians Say — Teens Need Access To Birth Control

U.S. teen birth rate remains highest among industrialized nations, according to report.

Abstinence-only sex education is not the best way to prevent unwanted teenage pregnancies, says a leading group of pediatricians that also recommends providing all teens, not just those who are already sexually active, with access to birth control, including emergency contraception.

The American Academy of Pediatrics' updated teen-pregnancy policy report, which appears in the July issue of Pediatrics, amends the group's 1998 report by scrapping the statement that "abstinence counseling is an important role for all pediatricians." The new draft instead asserts that while doctors should encourage their young clients to hold off on sexual activity, they should also ensure that all teenagers have access to birth control, including emergency contraception such as the morning-after pill.

The academy notes that while adolescent pregnancy and birth rates have steadily declined over the past 13 years, many teens are still becoming pregnant. More than 45 percent of high-school females and 48 percent of high-school males report having engaged in sex, according to the report. The average age of their first such experience was 17 years for girls and 16 years for boys.

"Even though there is great enthusiasm in some circles for abstinence-only interventions, the evidence does not support [that] as the best way to keep young people from unintended pregnancy," Dr. Jonathan Klein, chairman of the academy committee that wrote the report, told The Associated Press.

The most successful prevention programs, the report says, include multiple and varied approaches to the problem, including abstinence promotion alongside information about, and availability of, contraceptives.

But Wade F. Horn, assistant secretary for children and families at the U.S. Department of Health and Human Services, said teaching teens the abstinence-only approach to sex is best because it sends a clear, consistent message. Teens who are sexually active should have access to contraception, Horn told the AP, but making birth control available to teens who aren't having sex sends a conflicting message.

While birth-control methods such as the pill are not 100 percent effective in preventive pregnancy, they can reduce the risk of pregnancy by up to 92 percent, according to Planned Parenthood, a national source of reproductive healthcare services. With the exception of condoms, however, birth control does not protect against sexually transmitted diseases.

Emergency contraception, available for more than 25 years, could prevent 1.7 million unintended pregnancies and 800,000 abortions each year in the U.S., Planned Parenthood estimates. Nearly half of America's 6.3 million annual pregnancies are accidental, while as many as 80 percent of teen pregnancies are unintended.

The academy also noted that teen birth rates in the U.S. are much higher than in comparable industrialized nations with less-restricted access to contraception. As of 2004, the U.S. teenage birth rate is the highest in the developed world, Planned Parenthood says. It is twice as high as Canada's, four times as high as Germany's, seven times as high as the Netherlands', and nearly nine times as high as Japan's.