Opt-out contraception for all girls overkill

Health researchers have suggested long-term contraception be provided for all teenage girls before they become sexually active:

In an article in the British Journal of Obstetrics and Gynaecology Dr Neil Pickering and Dr Lynley Anderson from the university’s Bioethics Centre and Dr Helen Paterson from its Department of Women’s and Children’s Health say teen pregnancy places significant costs on the individual and society, and is associated with higher perinatal mortality.

“We also know the children of teen pregnancies do poorly in statistics related to poverty, imprisonment and teen pregnancy.

“In a worryingly large number of cases, pregnancy in the teenage years is bad for the teenager, is bad for the child of the teenager and it is bad for both of them during the whole pregnancy. Obviously that also impacts on society.”

That isn’t controversial but the suggested solution is:

Dr Paterson says teenage pregnancy and abortion rates in New Zealand have improved recently, possibly since the LARC (long-acting reversible contraceptive) Jadelle became funded by Pharmac five years ago.

“If you use withdrawal as a method, pregnancy rates are 22 per cent per annum. If you use condoms it is 18 per cent, if you use the pill it is 9 per cent, and if you use a LARC it is 0.5 per cent.”

Dr Pickering says there is a good case for making it an opt-out programme which provides adolescents with the opportunity to have a LARC, rather than having to go and seek care.

“For a programme to be effective you need to get as many people involved as possible and an opt-out programme seems to be more effective. You still get the right to say no and in terms of justice it treats everybody the same.”

There is an alternative view:

. . . Family Planning chief executive Jackie Edmond says most young women aren’t having sex before they turn 16.

“We’re overkilling it putting implants in people who aren’t intending to or aren’t having sex,” she told NZ Newswire. . .

Family Planning is much more interested in ensuring there are good services and contraceptive options available to young women, Ms Edmond said. . .

The conversation around contraception also needs to extend to the role of young men.

“They need information around choices and access to services,” Ms Edmond said.

“It’s not just girls who are having to manage (fertility).” . . .

And it’s not just pregnancy that is the only unwanted consequence of sex.

LARC might be an effective contraceptive but it would not protect people from sexually transmitted diseases nor the emotional trauma that can follow early and casual relationships.

Then there’s the question of ethics in prescribing anything for all young women, most of whom don’t need it.

Health researchers might not be concerned about the moral dimension of this issue but would there not also be a danger of normalising early sexual experience?

Or have we come to a time when legal, moral, or not, that doesn’t matter?