Contraceptive implants for 13 year olds a Four for One mythbust

As the groundwork is laid for an attack on young people’s access to contraceptive advice, we offer this myth-busting Monday special - busting four of the many myths that have been asserted following publication of this article last week.


13 year olds are all running around having contraceptive implants


In fact most younger teenagers are not having sex at all. When Dorries raised the issue of 13 year old girls being given secret implants she chose an eye catching, but relatively rare example to get press attention – it worked!


The under 16 conception rate for England is 7.5 per thousand (7,100 13-15 year olds got pregnant in 2009). Of these, the vast majority are conceptions to 15 year olds and relatively few to younger girls. This statistic has fallen over the 10 years of the teenage pregnancy strategy which means either that the strategy and its emphasis on good Sex and Relationships Education (SRE) which encourages thoughtful decision-making about sexual activity (including delaying sex) has paid off and resulted in less sex OR that young teenagers are having as much sex as the media sometimes claims, but being pretty successful in using contraception to prevent pregnancy, or maybe both. Either way the fact that this rate has fallen (not by enough, but still fallen) should not be ignored. Analysing the statistics more carefully you can see that some of the more dramatic reductions have taken place in the areas that originally had the highest teenage pregnancy rates. This is significant because these are often the areas that invested the most in SRE and tailor-made sexual health services for young people. 


Parents are always the best people to make decisions about their children’s health choices


We would love to think that parents are all able to have supportive, constructive conversations with their teenagers about all aspects of health and lifestyle, but we know that parenting and adolescence don’t always work this way. Some of the most loving, caring and competent parents struggle to communicate with their teenagers effectively, but there are also the parents who don’t attempt to communicate with, care for, or nurture their children. Then there are young people in the care system where the local authority has taken over parental responsibility because there parents simply can't or won't keep them safe.


Parents are not a homogenous group of caring, loving, competent, infallible, sexual health experts. At their best they provide love, nurture and a values framework that they hope their children will follow, but often they cannot provide objectivity or expertise, something that young people need and value when making important decisions about their health and lifestyle. 


Providing contraception encourages/increases under-age sexual activity


This assertion does not reflect sexual health practice at all. Although sexual health providers would probably prefer under-16s not to have sex at all, the fact is that many of them are choosing to. A conversation about contraception with young teenagers is an opportunity health workers use to find out more about their lifestyle, sexual behaviour and relationships; to check for coercion, pressure or abuse within their relationships; to explore sexual decision-making with them; to signpost them to services that will help address additional needs young people often present with; and to establish whether they are currently having, or imminently going to have, sex. While many people - parents and professionals - may feel conflicted about providing contraception to a young teenager, what we know is that NOT providing contraception will NOT prevent young people having sex, because the presence of one or more of adolescent sexual desire, love, adrenalin, alcohol, and culture are often irresistible even in the face of the law, and the risk of pregnancy and STIs.


The law says that 16 is the age of consent so surely giving contraception to under-16s is breaking the law. 


The law is intended to protect young people and is implemented in this spirit. It is unlikely that similarly-aged adolescents who have both consented to sex would be prosecuted even if one is underage, but a sexual relationship entailing a large age gap or a very young person would be subject to safeguarding procedures and further investigation.
Alongside the age of consent, The Fraser Guidelines which govern sexual health advice for under-16s  allow nurses and doctors to have a confidential consultation with a young person of any age and to provide them with contraception or abortion. In this situation their legal duty is:


• to decide whether there are any safeguarding issues and whether information about this young person must be shared with other professionals in order to protect him/her/other young people;
• to assess the competency (or ability) of a young person to understand the risks and benefits of any treatment they ask for; 
• to assess on balance of risk whether providing contraception will be beneficial (for example what is the likelihood of the young person becoming sexually active whether or not they are provided with contraception); 
• to encourage the young person to consider talking to a parent or carer and to help them assess the risks and benefits of doing so.

More on this:

Lisa's Comment is Free piece

Simon Blake in HuffPo

The Telegraph

10 ways to support your pregnant teenage daughter

Today I read this article about a mother’s response to the news that her 18 year old daughter is pregnant. I was saddened by the way in which this mother responded and started to think about what she could have done differently...


Ten ways to support your teenage daughter when you find out she’s pregnant:


1. However shocked you are, give her a hug.
2. Tell her how much you love her and reassure her that you are going to be there for her -  whatever happens.
3. Ask her how she feels...and listen to her answer. Do not try and project onto her what you are feeling, what you felt when you got pregnant at 16, or what you think she should be feeling.
4. Don’t tell her how you feel until you’ve had a chance to calm down and really think. This may help you avoid saying things you’ll later regret.
5. Ask how she knows she is pregnant (has she done a pregnancy test?); if she knows how pregnant she is (pregnancy is counted from the first day of a woman’s most recent period); and how long she has known.
6. Don’t make any assumptions about what she will choose to do about her pregnancy. Ask her what she thinks she might want to do (continue with the pregnancy and become a parent, or give the child up for adoption; or end the pregnancy). 
7. Remember – it is important that she takes responsibility for the decision, owns it, and feels confident that she is making the right decision. Even if you think she is making the ‘wrong’ choice it is, ultimately, her choice. If she feels judged for her decision she will find it hard to come to you for support when she needs it later on. Tell her you’ll support her even if you don’t agree with her decision.
8. Tell her that you will be honest about what you think when you've had a chance to think about it but that you will help her identify other people she can talk to as well because it is often helpful to speak to someone outside the family who can be more objective.
9. Ask her about who she got pregnant with, the status of their relationship, whether he knows about the pregnancy, whether they are in contact and, if so, what support he is offering and what support she is hoping for.
10. Roll up your sleeves and prepare for some hard work. Your daughter needs you now more than ever.

This is only the beginning. In the days to follow there will be lots more to do to help your teenager with making a decision, or if she has made one, finding out more about what her choice entails. 


Reliable websites:


Abortion
Education For Choice  (information about pregnancy decision-making and abortion)
Brook (young people's sexual health clinics and helpline)
fpa (information about abortion and local clinics)
Abortion providers bpas and MSI


Adoption
British Association of Adoption and Fostering

Healthy Pregnancy
NHS Choices  (how to eat well and stay healthy during pregnancy)
National Childbirth Trust (lots of information on pregnancy, childbirth and breastfeeding)


Parenting 
Gingerbread (information for single parents about available support)
Prymface (a personal and informative take on teenage pregnancy)
Girl-Mom  (a forum for young mums)


Miscarriage

Miscarriage Association

10 ways to support your son when his girlfriend is pregnant coming soon...

Myth-Busting Monday: ‘Rates of teenage pregnancy are rising’

Every Monday EFC busts myths and take names, cutting through the misinformation, disinformation, and straight up nonsense to bring you the facts.

You’d be forgiven for thinking the conception rate for young women has been consistently on the rise for the past 5, 10 or 20 years. Common wisdom (including some newspapers, media personalities and people at bus stops) presents ‘teenage pregnancy’ as a growing concern, with more and more women under 18 experiencing unintended pregnancy.

In fact, the latest statistics show that the under-18 conception rate for 2009 is estimated to be the lowest rate since the early 1980s. This reduction is a result of the last government’s Teenage Pregnancy Strategy launched in 1998 in an attempt to reduce levels of unwanted pregnancy amongst young women. Although the strategy did make steady progress this was not the case in all areas of the country and overall the target to reduce teenage pregnancy by 50% was not reached.

The ‘Teenage Pregnancy Next Steps’ document gives an overview of the strategy’s aims and achievements. It notes that what worked was 'provision of YP focused contraception/sexual health services, trusted by teenagers and well known by professionals working with them' and 'Strong delivery of SRE/PSHE by schools'. Government cuts to youth and sexual health services could threaten these positive steps forward. See this recent article in CYP Now for further comment.

We're not scared of talking about sex. SRE...NOW

With the announcement of the new SRE council, consisting mainly of those opposed to comprehensive sex and relationships education and a new bill being presented to Parliament calling for abstinence education for *girls*, it may be timely to print this transcript of a presentation EFC Director, Lisa Hallgarten made to a health conference in March 2011.


'Education for Choice works primarily to ensure that all young people are enabled to make informed choices about pregnancy prevention, pregnancy options and abortion and we have been delivering sex and relationships education for nearly 20 years now. 


Last week I attended a conference where the Public Health Minister affirmed her support for sex and relationships education and I was really delighted about that as I think everyone at the conference was...but she couldn’t provide any concrete commitments as to funding or policy. One of the things that was said was that making SRE statutory doesn’t in and of itself ensure quality.  I think that’s something we can all agree on. Just getting a school to tick a box saying it does it is not enough; just getting a school to provide a couple drop down days a year is not enough; just getting a form tutor who is overworked, under-skilled and unconfident to deliver a couple tutorial sessions on sex and relationships education is not enough. But actually, after 10 years of the Teenage Pregnancy Strategy, Healthy Schools, Sex Ed Forum briefings and more, there's been a kind of flourishing of innovative practice all around the country, and we do know what good SRE looks like now.  Nobody is suggesting that when English, Maths and Science aren’t taught well we should pull them from the curriculum. What we say is we need to invest in workforce training to make sure that teaching and learning of these subjects is improved. I would like to argue that we should be investing in workforce training to make sure that the delivery of sex and relationships education is improved. 


Something else that I heard last week from the Minister and that really, really bothers me, is that we are all scared of talking about sex with young people and that’s the real obstacle to progress.  There’s this common wisdom that everyone in Britain is culturally incompetent, that we all go beetroot at the mention of sex and that we are just tongue-tied around the whole issue. This simply isn’t true. There are hundreds of people out there who are brilliant communicators about sex and relationships, who are experts at talking to young people about sex and relationships and whose profession it is to talk to young people about sex.  Personally I am not in the slightest bit coy or anxious about talking about sex with young people or anyone else.  If you put me in front of a class and asked me to talk about the periodic table, I would be in serious trouble, but talking about periods... piece of cake.  If you ask me to talk about international relations to a history group, I would be paralysed with fear, but intimate human relationships... yes please.  If you want me to analyse the text of Romeo and Juliet with an English class I couldn’t do it, but I can talk about teenage romance... I think you get the picture.  There is an expertise, it’s not rocket science, but there is an actual set of skills and knowledge educators can acquire. What we need to do is get the people who want it to do it and  train them and give them the skills, information and confidence to do it.  For example, my organisation is the acknowledged authority on talking to young people about pregnancy decision making and abortion, that’s a subject that lots of people think is just too difficult to tackle, but actually we do it, and we do it every day in schools.  Teachers like it, students love it, and we have trained about 500 nurses and teachers all around the country to do that every year. Really the cost of that is relatively small when you think how many young people those professionals then reach, it’s a very cost effective way of improving the sex and relationships education people get, in fact you could say it’s a no-brainer.  Young people want it, professionals want to do it, professionals want training to do it and there are people out there like Education for Choice and a load of other agencies who can train them to do it. WIN!


Like most people in this room, I’m not really that worried about the small print, I could even accept that SRE isn’t going to be statutory, I don’t care whether it’s called sex and relationships education, or relationships and sex education, what I do care about is that there will be universal provision of good quality sex and relationships education which means evidence-based information, which means supporting young people to access local health services and knowing which professionals they can talk to about what, where, and how? This means that whoever the child is, wherever they are, whether they are in a community comprehensive school, an academy school, a Faith school, a free school, a private school, a public school, or whether they are being educated at their mum’s kitchen table, that they all have access to evidence-based information which, after all,  is an entitlement; which is a need; and which we know contributes to a whole range of wellbeing outcomes, including reduction in unintended teenage pregnancy.