Emergency Contraception Won’t Decrease Teen Pregnancies

It is often said that law is a teacher. As a thought experiment, consider what the following legal realities are teaching. First, no state in the United States of America requires parental consent or notification before a minor receives prescription drugs used for “reproductive health”–contraceptive drugs and devices, treatments for sexually transmitted diseases, or any related testing. Second, only 7 states require parental consent before a minor (over the age of 16) drops out of school, while two states require parental notification. Third, 39 states require parental consent before a minor can be married, and one more state requires that parents be notified.

Aquinas argued that law’s first precept is that good is to be done and evil is to be avoided. The above laws seem to give precisely the opposite message.

Against this backdrop, consider New York’s new public school contraception policy. The New York Post revealed last Sunday that a pilot program in New York City public schools was distributing Plan B emergency contraception and other hormonal contraceptives to minor students without telling their parents, so long as their parents had not found and returned an opt-out form at the beginning of the year. The program began in five city schools last year and expanded to thirteen schools this year. The program is “part of a citywide attack against the epidemic of teen pregnancy, which spurs many girls–most of them poor–to drop out of school.” (N.B.: New York is one of those states in which these pregnant girls do not need parental consent to drop out of school after they are 16.)

Nothing described here is illegal. If anything is new in this scenario, it is public schools’ active role in connecting adolescents to these services, to which they have every right of access under New York state law (the program is called CATCH–Connecting Adolescents To Comprehensive Health). Of course plenty of parents and other citizens find these policies outrageous, but there is not much legal recourse. There’s not much to do other than to make perfectly clear that the policy is stupid. In order to see this, only two questions need to be answered. First, is there an “epidemic” of teenage pregnancy, and second, is there any reason to think this policy will do anything to affect this “epidemic”? The answer to both questions is no.

A 2011 report from the New York City Department of Health and Mental Hygiene, titled “Teen Pregnancy in New York City: 2000-2009,” begins with this fact: “From 2000 to 2009, the pregnancy rate among New York City (NYC) residents ages 15-19 dropped 20%.” There was a more substantial drop among younger teens ages 15-17–26%–and a smaller decrease of 16% among teens ages 18-19, also known as adults. This information tracks very closely, according to the report, with national trends in these age groups, but with an important distinction: there is a much smaller decrease in the number of abortions in New York City than there is nationally, and there is a much larger decrease in the number of live births. In other words, in New York City, pregnant teens abort. Nevertheless, the facts are clear: teen pregnancy (especially minor teen pregnancy), teen abortion, and teen births are down in New York City and nationally over the last ten years. So naturally now is the time to ignore parents’ rights for the sake of addressing the “epidemic” of teen pregnancy.

It makes no sense. If there is already a trend of teen pregnancy decreasing, which doesn’t depend at all on any policy enacted by the bureaucrats at the City of New York because it is a national trend, it is silly to ignore the data, overreact about some isolated statistics taken out of the context of the trend, and deploy an army of educrats to distribute potentially hazardous drugs to hundreds of teenagers. This is the work of religious fanatics, and their religion is sexualityism.

But let’s assume, implausibly, for the sake of argument, that this is not the work of sexualityist fanatics, and that serious, concerned, rational people considered the trend, approved, and pursued proven means to accelerate the national trend in New York City. Is it plausible that an objective observer could consider the data and conclude that mass distribution of emergency contraception is the secret to further decreasing teen pregnancy, teen birth, and teen abortion? Not at all.

A recent study titled “Emergency Contraception: A Last Chance to Prevent Unintended Pregnancy,” by James Trussell of Princeton (and formerly of the Guttmacher Institute and NARAL Pro Choice America) and Elizabeth G. Raymond, recent Guttmacher awardee and current Senior Medical Associate at the Gynuity Health Project, primarily addresses the effectiveness of emergency contraception (EC) at preventing pregnancy, but also considers the “population effects” of EC’s wide availability. The research on effectiveness, it should be noted, is substantially more convoluted than you might imagine, drawing caveats like this: “Calculation of effectiveness, and particularly the denominator of the fraction, involves many assumptions that are difficult to validate.”And this: “This estimate makes no assumption about the number of pregnancies that would have been observed in the absence of treatment.”

But EC is effective when taken properly, so why are its overall impacts so hard to measure? The answer lies in the way that EC changes sexual behavior. Here, Trussell and Raymond deserve to be quoted at length (with some emphasis added):

One objection to making ECPs more widely available is the concern that women who know they can use ECPs may become less diligent with their ongoing contraceptive method. However, if used as an ongoing method, ECP therapy would be far less effective than most other contraceptive methods; if the typical woman used combined ECPs for a year, her risk of pregnancy would exceed 35% and if she used progestin-only ECPs, she would still have a 20% chance of pregnancy…. Another study demonstrated that educating teens about ECPs does not increase their sexual activity levels or use of EC but increases their knowledge about proper administration of the drugs. However, reanalysis of one of the randomized trials suggests that easier access to ECPs may have increased the frequency of coital acts with the potential to lead to pregnancy.Women in the increased access group were significantly more likely to report that they had ever used emergency contraception because they did not want to use either condoms or another contraceptive method. Increased access to EC had a greater impact on repeat use among women who were at lower baseline risk of pregnancy. This may explain in part why increased access to EC has had no measurable benefit in clinical trials. Regardless, even if ECP availability does adversely affect regular contraceptive use, women are entitled to know about all contraceptive options.

In the aggregate, then, increased access to emergency contraception has no effect on the rate of pregnancy, but a religious faith in sexualityism makes clear that all women are entitled to know about and have access to all contraceptive options, regardless of whether they are effective.

The situation is more disconcerting, though. Having seen what the committed advocates have to say, it is important to notice what more objective researchers have concluded. A 2010 paper by Sourafel Girma and David Patton, “The Impact of Emergency Birth Control on Teen Pregnancy and STIs,” finds, in agreement with Trussell and Raymond, that programs increasing access to EC do not end with any decrease in teen pregnancies, but do lead to increases in sexually transmitted infections.

The authors, as I have discussed elsewhere, used rates of sexually transmitted infections as indicators of whether teens were engaging in more frequent or more risky sexual activity. The data indicate that increased access to emergency contraception does in fact lead to increased risky sexual activity, and therefore an increase in the incidence of STIs. While Girma and Patton indicate that their conclusions should be interpreted cautiously, it is clear that everyone agrees that increased access to emergency contraception does not correlate with a decrease in the rate of pregnancy.

Alexandra Waldhorn, a health department spokeswoman, told the New York Times that the city is “committed to trying new approaches.” Distributing free Plan B is not a new approach. It has been tried for some time and in many places, and it has always been found wanting.

Both questions, then, are answered: there is no epidemic of teenage pregnancy, but rather an ongoing trend toward fewer pregnancies, and passing out Plan B in the schools wouldn’t help even if there was. This makes clear that this policy is, at best, simply senseless.

Parents should ask themselves whether a legal regime in which their children need no permission to obtain powerful pharmaceuticals, so long as they serve the sacraments of sexualityism, is a legal regime that has the best interest of their children or our society in mind. What this law is teaching is a destructive creed. We should fight back against the theocracy of the sexual emancipation of children while enough of us still have the sense to recognize the worship of false gods when we see it.

 

Greg Pfundstein is the Executive Director of the Chiaroscuro Foundation. He also serves on the board of the Patients Rights Council.

Greg Pfundstein

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Greg Pfundstein is President of the Chiaroscuro Foundation.

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  • Victoria

    Absolutely true. And in my state, my daughter needs permission to have her ears pierced, but can be taken for an abortion by the school nurse without notifcation to parents. This is terrifying. Any suggestions as to what we can do would be helpful.

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