Why Canada's on Top in Teen Pregnancy

What's going on? Are Canadian teens just more inhibited -- did the girls-gone-wild craze not get this far north? Or is it just too much effort to get the parkas off up here?
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Teen births are up for the second year in a row. But when Bill Maher, on his show Real Time, asked his guest panel why that might be the case, or what could be done about it, the trio became suddenly mute. Only one panel member, Carrie Washington, murmured something about Bristol Palin not finding much success with abstinence-only education.

All they had to do was ask a Canadian. Despite Canadian and American women aged 15 to 44 declaring that they want the same number of kids (about 2.2), American women end up having 2.09 and Canadian women have about 1.6, and 30 per cent of that difference is due to teen births in the U.S., almost 90 per cent of which are unwanted.

What's going on? Are Canadian teens just more inhibited -- did the girls-gone-wild craze not get this far north? Or is it just too much effort to get the parkas off up here?

It turns out, when it comes to both banking and babies, Canada's policies might actually be beacons of sustainable light, not dull, lead weights.

First, here's the situation. In the U.S., the overall birth rate for those aged 15 to 19 rose for the second year in a row, from 41.9 births per 1,000 last year to 42.5 this year. That's not a huge jump, but it's still significant because until two years ago, it had declined every year for 14 years.

Predictably, many on the far right like Valerie Huber of the National Abstinence Education Association, are calling for even more abstinence-only education that would "provide skills for teens to avoid sex," even though scientific study, and Bristol Palin, have both proved that doesn't work. (And I'm not sure what they teach in abstinence classes that could be characterized as "skills.")

As Bristol Palin told Greta Von Sustren just a few weeks ago, "I think abstinence is like... everyone should be abstinent, but it's not realistic at all... [Sex] is just more and more accepted now among kids my age."

After a decade and 1.5 billion U.S. federal dollars spent on abstinence-only programs, a Congress-authorized, rigorous scientific study reported no real difference in the age at which program participants first had sex, whether they had sex before marriage, or in their number of sexual partners.

I might actually have to use the "duh" word here. Abstinence-only education is about as effective at decreasing teen pregnancy rates as creationism education is in raising scientific knowledge levels. Abstinence is a legitimate religious doctrine, and sometimes an individual personal choice, but it's not sex ed.

Some U.S. experts have been quoted saying that the funding should be shifted to programs that include educating young people about contraceptives -- efforts that have been shown to be highly effective. Like the ones Canada has had for decades, and like some programs that were in place in the U.S. during C. Everett Koop's tenure as surgeon general (1982-1989), which lead to the 14-year decline in teen pregnancy. After the first reported cases of the virus in the early 1980s, Koop promoted HIV education, which led to a big increase in condom use. Then during the Clinton years, abstinence-only programs started, promoting the virtues of chastity. And voila, teen births.

This week, Salon interviewed a Texan-chastity-pledge-devotee-turned-sex-ed-youth-advocate Shelby Knox, who said, "If you spend $1.5 billion to spew shame-filled garbage to young people and then pass laws that limit their access to good information, contraception, emergency contraception and abortion, then you shouldn't be surprised when the health outcomes aren't to your liking."

Knox indirectly outlines Canada's approach. According to StatsCan's comparative study of fertility trends in Canada and the U.S., no other industrialized country has juvenile birth rates as high as those observed in the United States. The birth rate of American teenage girls is more than double that in other industrialized countries, including Canada, and 10 times greater than in Japan and the Netherlands.

The difference is not solely due to the ethnic composition of the U.S. population: the white population also has higher birth rates than other countries.

And it's not due to a higher abortion rate in Canada. In fact, unwanted pregnancies and births are more frequent in the U.S., as is the use of abortion.

No, the main reason is that Canadian teens of all social classes get comprehensive information about contraception and about how to avoid unwanted pregnancies. They get more sex ed in school, and can access high-school-based family planning counseling though the nurse. They can also always access universally free medical services, including visiting a family doctor and special health clinics. And at all levels, there's a more positive attitude towards the pill, and either cheap or free prescriptions for it.

As a result, young Canadian women use more effective pharmaceutical methods (i.e. birth control pills) rather than less effective ones (condoms, or the so-called withdrawal method).

The Washington Post reported the story of one teenager, Yasmin Herrera, 19, who learned a month ago that she is pregnant with her second child, an unwanted pregnancy. She had a new prescription for birth-control patches but not enough money to fill it. That kind of case is avoidable here.

It's important to point out there are other factors involved: the U.S.'s earlier average marriage age and higher levels of religious practice (which can bring more traditional, pro-abstinence-only ideas) also contribute to the higher rate. But there are no policy implications for either of those.

So the role institutions can play is one of providing information about the pill and condoms, rather than telling kids they shouldn't have sex.

And really, who can blame kids who do? Adult culture glorifies and even flaunts sex, then educators tell kids they shouldn't try it because of the consequences: both social and moral. I don't know about you, but when I hear that kind of double standard, age-ist nonsense, I almost feel a teenage-style huff coming on.

And it's not just me. When adults treat teens as intelligent beings capable of making informed decisions when armed with good information, then they do. That's backed not just by belief, but by actual numbers and science.

This piece first appeared on The Tyee

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