Saturday, 23 February 2013

Another unworkable proposal from NHS ‘experts’ on morning-after pill

An influential group of NHS experts is urging the Scottish Government to allow the morning-after pill to be handed out in schools (See reports by BBC, Scotsman and Scottish Herald)

But the push has faced criticism from the Roman Catholic Church in Scotland for being irresponsible. The parliamentary officer John Dieghan said it ‘pours more fuel on the flames.

In a written submission to a Holyrood committee, the Scottish Sexual Health Lead Clinicians Group (SSHLCG) accused ministers of ‘running scared’ of its critics over contraception in schools.

The group said: ‘Why is emergency contraception not available in schools? Why are condoms and contraception not accessible? Why can’t pregnancy and other STIs be prevented?’

The Scottish parliament’s Health and Sport Committee are looking into the high rate of teenage pregnancy in the country, which is one of the highest in Western Europe.

Ministers had hoped to cut the pregnancy rate for under 16s to 6.8 pregnancies per 1,000 girls by 2010 but the pregnancy rate for that year was 7.1 per 1,000.

But according to the evidence John Dieghan is quite right.

An American study which I highlighted last December showed that making emergency contraception available free over the counter without prescription leads to an increase in rates of sexually transmitted infections and does not decrease pregnancy or abortion rates. 

These results were almost identical to those of a British study published in the Journal of Health Economics (full text) in December 2010 and reported in the Daily Telegraph in January 2011. 

This latter research, by professors Sourafel Girma and David Paton of Nottingham University (See my previous blogs on this here and here) found that rates of pregnancy among girls under 16 remained the same, but that rates of sexually transmitted infections increased by 12%.

In fact, in a systematic review published in 2007, twenty-three studies published between 1998 and 2006, and analyzed by James Trussell’s team at Princeton University, measured the effect of increased EC access on EC use, unintended pregnancy, and abortion. Not a single study among the 23 found a reduction in unintended pregnancies or abortions following increased access to emergency contraception (see also fact sheet here).

The phenomenon whereby applying a prevention measure results in an increase in the very thing it is trying to prevent is known as ‘risk compensation’. 

The term has been applied to the fact that the wearing of seat-belts does not decrease the level of some forms of road traffic injuries since drivers are thereby encouraged to drive more recklessly.

In the same way it has been argued that making condoms readily available actually increases rather than decreases rates of pregnancy and sexually transmitted infections because condoms encourage teenagers to take more sexual risks in the false belief that they will not suffer harm. 

Whilst condoms offer some protection against sexually transmitted infections the morning-after pill offers none. 

Britain has the highest rate of teenage pregnancy in Western Europe. In 2008, the latest year for which figures are available, more than 7,500 girls in England and Wales became pregnant. Nearly two thirds of these pregnancies ended in abortion.

Rates of sexually transmitted diseases are also rising. In 2009 there were 12,000 more cases than the previous year, when 470,701 cases were reported. The number of infections in 16-to 19 year-olds seen at genito-urinary medicine clinics rose from 46,856 in 2003 to 58,133 in 2007.

International research has consistently failed to find any evidence that emergency birth control schemes achieve a reduction in teenage conception and abortion rates. But now there is growing evidence showing that not only are such schemes failing to do any good, but they may in fact be doing harm.

Making the emergency contraceptive pill available free, without prescription, is sadly an ill-conceived knee-jerk response to Britain’s spiralling epidemic of unplanned pregnancy, abortion and sexually transmitted disease amongst teenagers. It is also not evidence-based.

The best way to counter the epidemic of unplanned pregnancy and sexually transmitted disease is to promote real behaviour change. The government would be well advised to enter into dialogue with leaders of communities in Britain where rates of sexually transmitted diseases and unplanned pregnancy are low, especially Christian faith communities, to learn about what actually works.

Church-based programmes such as Love for Life (Northern Ireland), Love2last (Sheffield), Challenge Team, Romance Academy or Lovewise (Newcastle) are getting great results and have much wisdom to pass on. How about financing some serious research into examining them in more depth?

1 comment:

  1. >> The government would be well advised to enter into dialogue with leaders of communities in Britain where rates of sexually transmitted diseases and unplanned pregnancy are low

    Good point.

    What are the rates of sexually transmitted disease and unplanned pregnancy in the Asian (Indian, Chinese) communities in Britain, for example?

    How is it *they* manage to persuade their children to abstain until married, and WE seem unable to do this?


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