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ss triple helix - summer 2002,  Family Planning Services are Ineffective - But When Will Those Responsible Admit it?

Family Planning Services are Ineffective - But When Will Those Responsible Admit it?

'Teen sex advice ineffective.' The BBC News website [1] could not report it without using inverted commas. Anne Weyman, the Chief Executive of the Family Planning Association, blustered about it on the Today programme with noticeably less self-confidence than usual. However, The Observer, which normally avoids covering such news altogether, was uncharacteristically the most frank in its coverage. 'Abortions rise in under-age sex crisis - Morningafter pill, lessons in family planning and early puberty are all blamed for soaring pregnancies.'[2]

The cause of all this press furore was the publication by a prestigious journal of a paper by Dr David Paton indicating that family planning services have no positive impact on reducing the rate of pregnancy or abortion among schoolgirls and may in fact be having the reverse effect.[3]

Using a mathematical model of rational choice, Paton suggests that improving access to family planning has an ambiguous impact on underage conceptions. Teenagers who will engage in sexual activity in any case have a reduced risk of pregnancy but increased access raises the likelihood of engaging in sexual activity for those who otherwise would not have done so. Thus the overall effect may be to increase or decrease underage conceptions. Paton tests these competing hypotheses using UK regional data from 1984-1997 in two ways.

First, he examines the effect of the 1984 Gillick ruling,[4] which severely reduced the attendance of under-16s at family planning clinics for some time, until it was overturned in 1985. Using data for over-16s (who were unaffected by the ruling) as a control, Paton concludes, 'There is no a priori evidence in the raw data that the Gillick ruling had the effect of increasing underage conceptions'.[3]

The second approach estimates conception and abortion rates for under -16s as a function of attendance at family planning clinics. Again Paton finds 'no evidence that greater access to family planning clinics has reduced underage conceptions or abortions. Indeed there is some evidence that greater access is associated with an increase in underage conceptions in our sample.'[3]

I have argued elsewhere in this journal (pp10-11) the reasons why increasing provision of condoms in particular may be counter-productive. The sad thing is that Paton's research was immediately rejected out of hand by the FPA whose spokesperson Juliet Hiller 'rejected the suggestion that giving young people advice was ineffective'.[1]

The vested commercial interests of contraceptive manufacturers and providers are as powerful as that of the tobacco industry in blinding their eyes to the evidence of the harm they are doing. Jesus had strong words to say both to those who led young people astray[5] and those who rejected clear evidence because of ulterior motives.[6] It has taken decades for a tobacco executive to declare publicly for the first time ever recently that smoking harms health. It will probably take decades more before those who promote the false security of the 'safer sex' message as the primary answer to declining teenage sexual health actually admit they are wrong, but Paton's important paper does bring that day a little nearer.

  1. Teen sex advice 'ineffective'. . 4 March 2002
  2. Ahmed K. Abortions rise in under-age sex crisis. The Observer 2002; 17 March
  3. Paton D. The economics of family planning and underage conceptions. Journal of Health Economics 2002; 21:207-225
  4. In Dec 1994 the UK Appeal Court ruled in favour of Mrs Victoria Gillick in Gillick vs West Norfolk and Wisbech Health Authority, that contraceptive advice should not be given to those below the age of 16 without parental consent. The ruling was eventually overturned by the House of Lords in the autumn of 1995.
  5. Matthew 18:6
  6. John 5:44-47
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