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by Susan E. Wills
March 19, 1999
A group in Colorado recently made news by abandoning its abstinence-only sex education program, explaining: "Abstinence-only does not work in our community that well. ... It did not teach students responsible sexual behavior." Teens were not responding to the "stern message" (Denver Post, March 13).
Those few words speak volumes about why their program failed. Abstinence is not a "stern" message. It's positive, self-affirming, self-empowering: You can control yourself. You are worth waiting for. And what exactly is "responsible sexual behavior" for students? No sex after 10 P.M. on school nights? The ideology that sees abstinence as unworkable and credits sex-ed-plus-contraception with the declines in teen pregnancies and births is so prevalent in the public health community that these views have achieved the status of conventional wisdom.
But now these "truisms" have been shattered. A ground breaking report entitled "The Declines in Adolescent Pregnancy, Birth and Abortion Rates in the 1990s: What Factors Are Responsible?" by the Consortium of State Physicians Resource Councils confirms that abstinence, not increased contraceptive use, is the "primary reason for the decline in teen pregnancy and birth rates throughout the 1990s." Here's a look at some of the myths the research has debunked.
MYTH: Teens are using more and better contraceptives. "Increased contraceptive use especially condoms was a major factor in the decline of unintended pregnancies" (National Adolescent Reproductive Health Partnership, Winter 1998 Update).
REALITY: Condom use did increase 33% among teens between 1988 and 1995, but this did not help reduce teen pregnancy rates. Increased condom use was outweighed by a striking 45% decline in the use of the more effective oral contraceptives (OCs) among females age 15-19. The net decrease in use of either method is 14.5%. Worse, from the standpoint of "pregnancy prevention," OCs are far more effective in preventing pregnancy than condoms. So sexually active teenage girls are far less protected from pregnancy today than they were in 1988. But how can it be that teen pregnancy rates are down more than 9% between 1992 and 1995 alone, if teens are using less and less effective contraception?
MYTH: Pregnancy/birth rates for teens are declining, so the safe sex message must be working.
REALITY: Pregnancy/birth rates are not declining among sexually experienced (ever had sex) and sexually active (sex in past 3 months) girls age 15-19. In fact, they are rising sharply. The government calculates the birthrate for teens by dividing the total number of births to teen mothers by all female teens. This is highly misleading. Abstinent females do not become pregnant. Their rates of pregnancy/birth remain steady at zero/1,000. Subtracting abstinent girls from the formula (and 5.7% more females age 15-19 were abstinent as of 1995 than in 1988), the non-marital birthrate among "experienced" teens rose almost thirty percent.
The birthrate among sexually "active" females age 15-19 is even worse: The percentage of girls who are sexually active dropped about 6% (1988 vs. 1995), but the birthrate during this period increased over 31% to 112 births per 1,000 unmarried girls.
MYTH: Abstinence is unworkable and unrealistic. Teens are going to have sex anyway so we need to teach them "safe" sex.
REALITY: Not so. There's been an almost 20% drop in the percentage of high school boys age 15-19 who have ever had sex, to a low of under 49% in 1997 from almost 61% in 1990. High school-aged boys have also become less sexually active, with only 1 in 3 reporting intercourse in the past 3 months (a 21% decline between 1990 and 1997) and less promiscuous, with a 34% decline in those having had four or more partners (18% in 1997).
The Consortium's report points to a combination of factors as contributing to greater abstinence among teens: the AIDS epidemic, generational changes in attitudes (including greater "religiosity" and parental disapproval of premarital sex and contraceptive use), increased cultural acceptance of abstinence and the growth of abstinence-only education programs. To obtain a copy of this ground breaking report call the Consortium at (877) 236-5772.
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Mrs. Wills is assistant director for program development, NCCB Secretariat for Pro-Life Activities.