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The Abstinence Debate
By Bob Reha
June 7, 2000
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According to the Guttmacher Institute report on public policy, 900,000 teens become pregnant each year. Young people today deciding whether or when they will become sexually active face other concerns: HIV and numerous other sexually-transmitted diseases. Sexual education has addressed the issue, but now a change in focus is being advocated, from contraception to abstinence.

WHAT ARE THE TRENDS?
Since the early 1990s, teenage pregnancy rates, birthrates and abortion rates have declined dramatically; pregnancy and abortion rates have reached their lowest points since they were first measured in the early 1970s, and birthrates are similar to those that prevailed between the mid-1970s and mid-1980s.8

The decreases in pregnancy and abortion rates have been especially steep. In 1986, some 107 pregnancies occurred per 1,000 women aged 15-19; by 1990, that rate had climbed 11% to 117 per 1,000. Within the next six years, however, the rate fell by a striking 17% to 97 pregnancies per 1,000 teenagers, 9% less than the 1986 rate.

The teenage birthrate followed a similar trend, although the recent decrease has been less rapid. From a level of 50 births per 1,000 women aged 15-19 in 1986, the rate rose rapidly to 62 per 1,000 in 1991, an increase of 24%. The next five years saw a turnaround, and in 1996, 54 births occurred per 1,000 teenage women; a rate still higher than that in 1986, but 12% lower than the peak reached in 1991.

A somewhat different pattern is seen in the teenage abortion rate, which varied little during the 1980s and then began a steady decline. By 1996, the rate was 29 abortions per 1,000 young women - 31% lower than teenagers' abortion rate a decade earlier.
- From the Alan Guttmacher Institute publication Why is Teenage Pregnancy Declining? The Roles of Abstinence, Sexual Activity and Contraceptive Use.
 
FOR THE PAST 16 YEARS, Susan Richard has counseled people at the AAA pregnancy clinic in Fargo. Richard has counseled thousands of teenagers facing an unwanted pregnancy. She says the work has led her to some definite conclusions.

"You might be able to reduce your risk if you do certain things, but if you're having sex and you're doing it outside the context of marriage and you think contraception is the answer you are wrong," she says.

Three years ago the clinic began an abstinence education program. Recently the project received a $127,000 grant from the Dakota Medical Foundation, a Fargo-based organization that funds health-care initiatives. The money will be used to continue the abstinence program.

"What we're into here and the reason we teach abstinence is that we're into risk elimination, not risk reduction," Richard says.

The program offers counseling, and provides speakers to local schools for presentations. There are videotapes with celebrities, including former North Carolina basketball coach Dean Smith.

A recent survey conducted by the Centers for Disease Control found 52 percent of teenagers are choosing to be sexually abstinent. College junior "Jacki" is a participant in the program who wants to point out the range of problems facing her sexually-active peers. "Pregnancy is just one of the side effects and they don't think about the other side effects such as STDs, which are very common now," she says. "A lot of them don't have any symptoms, so you can get them without even knowing it and pass them on without knowing that you have them and it's a lot more dangerous than having the possibility of becoming pregnant."

That's the main point, according to Dr. William Toffler. He's the co-founder and national director of Physicians for Compassionate Care Education Foundation. He says a contraceptive approach to sex education has failed and that the emphasis should be on abstinence. "The mantra was, 'Kids are just going to do it, they're like animals in heat, they're victims of raging hormones and all we can do is sheath the world in latex to keep them so-called safe.' The truth is we might keep them safer in some limited situations, but the evidence is really weak that we even keep them safer in many cases with that strategy."

Doctor Toffler says abstinence is the only sure way teenagers and young adults can avoid sexually transmitted diseases and pregnancy.

But some worry the "just say no" abstinence approach isn't enough. "Half of our teens are deciding that, and that's a good thing, but half of them are not," says August Galloway, the community educator for Planned Parenthood for the states of Minnesota and South Dakota. She agrees abstinence should be taught as the first choice, but she says education efforts cannot ignore the young people who do choose to be sexually active.

She also says there can be a downside to some of the messages given in abstinence education. "If you're teaching that condoms don't work, that they break, and therefore you shouldn't use them, you're also teaching kids not to use them. So if kids and adults are told that condoms do not work anyway, they're not going to use them, and therefore we're not going to help prevent the spread of sexually-transmitted infections among our sexually-active people."

She points out the Centers for Disease Control says that while using contraceptives is not fail-safe, it is safer than not using any at all. She says that until all teenagers decide to become abstinent, they should at least be taught there are options available to them to reduce risks.