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Teen Mom: Problem or Symptom?


Abortion advocates say condoms will cure teen pregnancy, but a
leading gynecologist argues they ignore the root cause.

Vol. 12/No. 10

“Every minute a woman dies from maternal causes,” proclaimed Dr. Yves Bergevin of the UNFPA, as he took the podium on the opening day of the United Nations 2010 Commission on the Status of Women.  

“Rigid, moralistic abstinence-only programs of the type promoted under previous federal policy … are a failed experiment,”1 the Guttmacher Institute chorused in a recent news release, citing the 3% increase in teen pregnancy in the U.S. during 2006 as proof.

Inflated maternal mortality and teen pregnancy statistics—especially from countries where data is scarce—were in vogue during the next two weeks among feminist activists pushing for universal use of family planning, globalized legal abortion, and a new multi-billion dollar UN “women’s” super-agency as the maternal mortality panacea.

“You can’t die of pregnancy if you aren’t pregnant,” Dr. Bergevin announced, “so universal access to family planning is our most immediate, effective impact to reducing maternal mortality.”

Adolescent pregnancy is the problem behind most maternal mortality, according to UN organizations, and the essential and most effective solution, they eagerly claim, is family planning—candidly defined by Dr. Bergevin as “the classic package, which includes condoms, oral contraceptives, injectables, Depo-Provera, the long term methods, implants, and, once a family has decided they are no longer interested in having children, the permanent tubal ligation and vasectomy.”

Joining the UNFPA’s chorus, UNICEF’s report asserts, “It is estimated that up to 100,000 maternal deaths could be avoided each year if the need for contraception was effectively met.”2 It goes on to claim that in countries where birth rates are high, “family planning, in line with national policies, could prevent about one third of maternal deaths.”3 

“Each year, nearly 70,000 girls aged 15-19 die from pregnancy-related complications,” the UNICEF report declares. “Mothers younger than 15 are at even greater risk, being five times as likely to die in childbirth as women in their twenties.”4

But, “Is adolescent pregnancy the problem, or the symptom of the problem?” Dr. Monique Chireau asked a table of UN delegates. At the invitation of the Population Research Institute and hosted by the Mexican UN Mission, Dr. Chireau, a Duke University expert in Obstetrics and Gynecology, brought a fresh and scientific voice to the UN debate on solving maternal mortality and adolescent pregnancy.

“I am putting forth the idea that adolescent pregnancy is a symptom of a decline within a society.” Dr. Chireau continued, arguing for a new methodology in the UN approach. “We have to take a step back and look at the societal risk factors for why young women become pregnant.”

There is insufficient comparison of the greater risks unmarried teens in war torn and dangerous environments face throughout pregnancy than those of married, adolescent mothers in stable societies, Dr. Monique Chireau explained. Medical studies show that “girls in the 11-14 year old range have the highest risk” of dying during or after pregnancy. Further, teen pregnancy is an economic issue, as pregnant adolescents tend to drop out of school, have incomes at or below the poverty level, and are rarely able to achieve educational and economic parity with their peers.5 

A frequent argument for the expansion of abortion is that it prevents maternal mortality and adolescent pregnancy, Dr. Chireau explained, “But though Chile has very restricted abortion laws, it has one of the lowest maternal mortality rates in the world.” Incidentally, Chile has excellent data records and good primary maternal health services.

“Adolescent pregnancies are high in areas with low birthrates, with the exception of South Africa,” Dr. Chireau pointed out, comparing a series of world maps. “Rates of adolescent pregnancy, male and female suicide, homicide, and depression overlap.”

“England,” Dr. Chireau continued, “has the highest rates of adolescent pregnancy in western Europe.” Despite 10 years of intensive efforts by the Labor Party, “using typical prevention strategies including expanding sex education, increasing availability of contraception, and increasing access to abortion (without parental consent), the teen birthrate has continued to rise by 5 to 10 % per year and 50 percent of teen pregnancies in England end in abortion.” As a developed nation with prevalent primary health care, maternal mortality remains low in Britain, but put the same 5 to 10 % increase in adolescent pregnancy, as caused by sex education, abortion, and contraception, into a developing nation and their maternal mortality might easily skyrocket.

In fact, published medical papers call into question the current sex education and abortion strategies for reducing adolescent motherhood, but—oddly enough—these studies are virtually ignored. A paper published in the British Medical Journal in 2002 did a careful systematic review in meta-analysis (a method detecting small differences in benefit or harm) of 12 electronic databases, 10 key journals, and contact with the authors and found that primary prevention strategies—standard sex education and family planning—“do not delay the initiation of sexual intercourse, improve use of birth control among young men and women, or reduce the number of pregnancies in young women.”6 Also, the same meta-analysis “show that some interventions increase pregnancy and STD rates.”

Another, brand-new, published study, financed by the federal government and conducted by Dr. John Jemmott and a team of University of Pennsylvania researchers, found abstinence-only education programs to be markedly superior to sex education in delaying adolescent sexual activity. 662 African American grade-school students, mostly 12 years old, were divided into three programs, an abstinence-only program targeting reduced sexual intercourse, a safer sex-only program targeting condom use, and a longer combined abstinence and safe sex curriculum. In the next two years, 52 % of the kids in the safe sex program had became sexually active, followed by 42% of those in the combined program, and only 33% of those in the abstinence education had engaged in sexual activity.7 

The Guttmacher Institute, excited about Obama’s new Office of Adolescent Health and the $114.5 million dollar initiative for increasing sex education and condom use, was quick to say of Jemmott’s study: “The results of this trial should not be taken to mean that all abstinence-only interventions are efficacious.”8 (Emphasis added)

“90 % of parents want their kids to be taught to abstain from sexuality,” said Dr. Miriam Grossman, author of Unprotected, in her presentation during the CSW. Investors Business Daily reports that “teens who practice abstinence perform better academically and are nearly twice as likely to graduate from college.”9

Teen pregnancy increased almost every year when sex education programs were the norm in public and private schools. Only during the early 1990s with increasingly widespread abstinence education did adolescent pregnancy rates shift into the steady and significant 41% decline from the peak in 1990 to the all-time lows between 2000 to 2005.

Guttmacher prefers to claim, “The significant drop in teen pregnancy rates in the 1990s was overwhelmingly the result of more and better use of contraceptives among sexually active teens.”10 But they cited no proof for this claim and had no better teen pregnancy results to show from the 35 states that continued sex education in public schools or the several states that declined to participate in the abstinence education programs of the previous presidency.

Dr. Chireau called for a new paradigm from the U.N. and the U.S. that effectively deals with adolescent pregnancy by addressing the root causes of societal decline, poverty, teenage insecurity, depression, rape, and broken homes. She encouraged social programs that reintegrate troubled teens into society, foster responsibility, stable families, and abstinence education, provide primary health care for teens in developing nations, and in other ways obviate the risks of adolescent pregnancy.

“Sex education and reproductive health” Dr. Chireau concluded, “as a methodology shown to not solve the problem, should not be continued, and especially in countries where one peso spent for reproductive health care means that peso can’t be spent on primary health care.” Too bad Obama just scrapped more than $170 million in annual funding for abstinence education.

Endnotes

1 Heather D. Boonstra, “Key Questions for Consideration as a New Federal Teen Pregnancy Prevention Initiative is Implemented,” Guttmacher Policy Review, Winter 2010, Vol. 13, No. 1.

2 UNICEF Report Card on Maternal Mortality, September 2008, 13.

3 UNICEF Report, 15. “Wide
range of statistical uncertainty makes it difficult to calculate
trends in the maternal mortality ratio.” “Maternal
mortality is very difficult to measure, and few developing
countries know exactly how many women die in childbirth each
year.” A notable example of ill supported claims is the Sedgh
et al., Lancet, 2007 study on unsafe abortions (a touted factor in
maternal mortality) in which data were significantly adjusted if
official reports for the number of abortions were not available;
the average correction factor used was 1.4, which amounts to an
inflation of the official estimate by 40%.

4 UNICEF Report, 13.

5 Conde-Agudero et al, American Journal of OB/GYN, 2004; Padin et al., Journal of Adolescence, 2009

6 DiCenso et al, BMJ, 2002

7 John B. Jemmott III, PhD et
al., “Efficacy
of a Theory-Based Abstinence-Only Intervention Over 24 Months: A
Randomized Controlled Trial With Young Adolescents,”
Archives
of Pediatric and Adolescent Medicine
2010;164(2):152-159, and
“No surprise: Abstinence works,” Investors Business
Daily
, February 3rd, 2010. According to the APAM report:
“The model-estimated probability of ever having sexual
intercourse by the 24-month follow-up was 33.5% in the abstinence-only
intervention and 48.5% in the control group.” The control group
presumably is the safer-sex and combined programs, as IBD reported
results of sexual activity in 42% of combined and 52% of safer-sex
programs, the average of which is APAM’s 48%.

8
Boonstra, “Key Questions.”

9 Investors Business Daily, “No surprise.”

10 Rebecca Wind, “Following Decade-Long Decline, U.S. Teen Pregnancy Rate Increases as Both Births and Abortions Rise,” Guttmacher Institute.

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