Access To Contraceptives Reduces Teen Pregnancy, Does Not Lead To Increased Sexual Activity

Birth control pills
Birth control pills

Many Americans who oppose making high quality contraceptives more accessible do so for explicitly religious reasons. While they may argue that their position is based in perceived safety concerns regarding certain contraceptives (as will be discussed further), they fear that the net effect of such ease of access would be an increase in premarital sexual activity (a big no-no among the abstinence-only crowd). In addition to taking a policy stance that is--in effect--an attempt to socially engineer the behavior of individuals to fit one's particular religious views, the main problem with this stance is simple: that anticipated net effect does not seem to be happening.

A recent analysis conducted by the Guttmacher Institute found that between 2007 and 2012, use of higher quality contraceptives (e.g. IUDs or the pill) among sexually active teenage women increased from 78% to 86%, corresponding to a 42% drop in teen pregnancies in the past seven years. Sure, that increase in contraceptive use was measured as a proportion of sexually active individuals, but what about overall sexual activity rates among all teenage women during that time span?

As it turns out, sexual activity among this demographic remained almost totally constant, and might actually be declining (more recent data will be needed to confirm this trend, if it exists). Put simply: an increase in contraceptive use does not appear to foster an increase in sexual activity.

So how can those opposed to making contraceptives more accessible (e.g. through laws allowing the purchase of contraceptives without a physician's prescription) continue to oppose these measures that have empirically been shown to reduce teen pregnancies?

To be sure, there are non-religious reasons that one might consider avoiding certain contraceptives. In addition to concerns that expanded access may result in fewer reproductive health preventative screenings, certain oral contraceptives have been found to slightly increase (~20%) a woman's risk for breast cancer while she is taking them (however, 10 years after cessation their risk drops down to that of a woman who never took oral contraceptives). This has resulted in oral contraceptives being listed as a Group 1 carcinogen by the International Agency for Research on Cancer. Increased risk for strokes and blood clots have also been attributed to certain forms of birth control.

However, that information alone can be very misleading: while slightly increasing a woman's risk for breast cancer, oral contraceptives reduce risk for ovarian and endometrial cancers. This is especially beneficial considering that breast cancer--because of routine screenings--is more likely to be caught at an earlier stage than ovarian or endometrial cancers. Because the absolute risk for these complications are so low in women of childbearing age, the benefit of contraceptives preventing an unplanned pregnancy greatly outweighs any increase in risk they might cause.

Given this broader context and years of research, it is no surprise that 76% of doctors support expanding access to contraceptives. But what about the staunch religious conservatives among us who will still oppose expanded access to contraceptives?

The unfortunate reality is that empirical data are not likely to convince these individuals to change their opinion. As the [paraphrased] expression goes, any belief that is accepted without facts will not likely be abandoned in the face of opposing facts. Religious conservative opposition to measures that make contraceptives more accessible is similar to that of the HPV vaccine: they want the threat of an unintended consequence of sexual activity (be it pregnancy or an STI) to act as a deterrent from engaging in such activity. To these people I implore: stop opposing common sense measures like expanded contraceptives accessibility in a thinly-veiled attempt to foist your religious morals upon the rest of us.