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I've heard many times that putting a child on birth control, or allowing them access to birth control without parental knowledge, will lead to the teenager having premarital sex.

Here are a few examples of articles that at least strongly imply if not outright state that access to birth control will lead to pre-marital sexual activity.

Is this belief true? Does independent access to birth control lead to sexual activity, and if so can someone give a rough estimate of how significant an effect access to birth control has on the likelihood of teenagers to have pre-marital sex?

I'm interested specifically in the United States perspective for the sake of this question.

March Ho
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dsollen
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    This line of reasoning always makes the somewhat ridiculous implied assumption that teenagers *won't* think about sex or want to have sex or try to have sex if they're not told about birth control... – Shadur Sep 03 '15 at 05:15
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    related: http://skeptics.stackexchange.com/questions/8041/does-abstinence-only-sex-education-reduce-the-frequency-of-teenage-sex-or-the-ra (Basic gist of Larian's answer is that the availability of contraceptives seems to have no effect on when teens have sex, but does correlate to STDs and pregnancies.) – JasonR Sep 03 '15 at 11:26
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    @user19555: Yes, that is related. Good find! But that isn't the conclusion. The answer talks about abstinence-only sex ed., not contraception. – Oddthinking Sep 03 '15 at 13:28
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    @Shadur - you may want to google "Peltzman effect". The concept isn't as obviously ridiculous as you think, from research standpoint (and I can assure you that it does work exactly as proposed, even if not for all people. Most of the people in my social circle refrained from sexual activity specifically due to concerns of unprotected sex and lack of availability of protection). – user5341 Sep 04 '15 at 17:54
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    @user5341 I'm sure keeping the kids ignorant and scared worked out just fine for your social circle. – Shadur Sep 04 '15 at 17:57
  • @Shadur - clearly some of us are more capable of rational decision making. – user5341 Sep 04 '15 at 17:59
  • @Shadur Honestly I would expect that teens will be more likely to have sexual intercourse with contraceptive. After all, I see little reason that the presence of contraceptives would prevent anyone from having intercourse, so if even a small number of teens who previously refrained due to risk of pregnancy now have sex it would mean an increase. I suspect that this difference works out to be extremely minor in comparison to those having intercourse as well, but that's for studies to say. Remember this question is simply about facts, not policy or rather birth control should be available – dsollen Sep 04 '15 at 18:59
  • I used to work with a bunch of people from a **very** conservative area: If you didn't have a car it was effectively impossible to obtain any birth control. **Every** marriage over a period of several years was either arranged or due to pregnancy. – Loren Pechtel Sep 05 '15 at 03:17

1 Answers1

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Studies by Kohler et al in 2008, Blake et al. in 2003 and Kirby et.al.'s global study in 2007 have shown that efforts to improve teenagers’ access to contraception do not increase rates of sexual activity, and in turn also produces some positive outcomes.

  1. Per Lawrence B. Finer in 2013, "the high rate of sexual coercion among young adolescents is certainly cause for concern, it should not be used as a brush with which to tar sexual activity among those older teens who are capable of both deciding to initiate sex and, based on our findings, able to initiate contraceptive use when doing so. Fears that early exposure to contraceptive methods would encourage sex among young adolescents should be assuaged by recent evidence that vaccination against human papillomavirus did not increase sexual activity among 11- and 12-year-old girls."

Teaching young adolescents about contraceptive methods and prescribing or offering methods before they are likely to become sexually active is prudent: Knowledge of and access to contraception at an earlier age would help those adolescents who initiate sex early, and would likely increase contraceptive use among older teens as well. No study of sex education programs to date has found evidence that providing young people with sexual and reproductive health information and education results in increased sexual risk-taking.

  1. Per Victor C. Strasburger in 2010, "eight peer-reviewed, controlled clinical trials have revealed that giving teenagers freer access to condoms does not increase their sexual activity or encourage virginal teenagers to begin having sex, but it does increase the use of condoms among those who are already sexually active."

  2. Per Committee on Adolescence in 2007, "providing information to adolescents about contraception does not result in increased rates of sexual activity, earlier age of first intercourse, or a greater number of partners. In fact, if adolescents perceive obstacles to obtaining contraception and condoms, they are more likely to experience negative outcomes related to sexual activity."

  3. According to a review of research studies conducted in 1993 by WHO, 10 studies found that school sex education leads to an increase in the adoption of safer sexual practices by sexually active young people (UNAIDS, 1997). Six studies showed that adolescents delayed starting sexual activity or decreased their overall sexual activity. Two studies reported that access to counselling and contraception had no effect on the timing and level of sexual activity. It was also found that sex education was most effective if it was given before adolescents became sexually active.

  4. "Teenage girls and women who were provided contraception at no cost and educated about reversible contraception and the benefits of LARC methods had rates of pregnancy, birth, and abortion that were much lower than the national rates for sexually experienced teens" per Gina M. Secura et.al. in 2014.

In summary, we found that in a cohort of teenage girls and women for whom barriers to contraception (lack of knowledge, limited access, and cost) are removed and the use of the most effective contraceptive methods is encouraged, a large percentage opted to use LARC methods.

  1. There is no evidence of a relationship between increased access to emergency contraception and sexual risk-taking. Improved availability of emergency contraception does not lead to sexual promiscuity or increased risk of sexually transmitted infections. Adolescents are no more likely than adults to engage in sexual risk behaviors when they have increased access to emergency contraception.

Sexual risk-taking involves any sexual activity that places one at risk for unintended pregnancy and/or sexually transmitted infections (STIs). Examples include unprotected sex, inconsistent use of contraception, use of contraception without appropriate protection against STIs, or multiple sexual partners. In 2008, the Bixby Center for Global Reproductive Health at the University of California San Francisco conducted a review of 16 studies on the impact of providing emergency contraception (EC) to adult and adolescent women. The review found no evidence that access to EC increased sexual risk taking. It found that women did not abandon their regular method of contraception when they had access to EC, did not use EC repeatedly just because it was available, did not engage in increased sexual activity and did not have increased incidences of STIs.

  1. American teenagers change both their sexual behavior and birth control choices in response to changes in the price of pregnancy, measured by labor market conditions, AIDS incidence, welfare benefits and abortion restrictions per Levine et.al. in 2000 which was again confirmed by research in Emily Gray Collins and Brad Hershbein in 2011.

The three- to ten-fold increase in the price of the Pill reduced the use of oral contraception by 1 to 1.8 percentage points, on average, or 2 to 4 percent, among college women. We also find evidence that the reduction in the use of the Pill was significantly stronger for women without health insurance, women with credit card debt, and older women. We find some evidence of substitution towards non-prescription birth control methods and emergency contraception among those same women, as well as a reduction in the number of sexual partners, particularly among frequent sex participants. We find minimal evidence of changes in STI infection or accidental pregnancy.

Per NCB in 2010, research carried out in England has found that areas of the country which have achieved the greatest reductions in teenage conception rates in recent years have provided both good quality school sex and relationships education as well as accessible sexual health services for young people.

Recent research also in the UK has shown clear links between teenage pregnancy and non-consensual sexual activity. Evidence presented at the Royal College of Nursing (RCN) highlights that many young people wish to access convenient and friendly school or community based drop-in clinics. Ideally these drop-in clinics should offer a range of services including contraception, STI testing and relationship advice and signposting to offer full support to young people

Research suggest that informative education around sexual health and relationships, coupled with improved access to contraception including condoms and implants, are the key to addressing these health issues.

Per John S. Santelli et.al. in 2007, "The decline in US adolescent pregnancy rates appears to be following the patterns observed in other developed countries, where improved contraceptive use has been the primary determinant of declining rates." Per Heather D. Boonstra, "Pregnancy rates have fallen either because teens are having less sex in the first place or because more teens who are sexually active are using contraceptives and using them more effectively. Researchers have analyzed the role of both over the last several decades, and they have concluded that the declines can primarily although not exclusively be attributed to improvements in teens’ contraceptive use."

pericles316
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    While you do answer the question, whether access to contraception resources affects the rate of sexual activity, I feel like half of this is addressing an entirely different issue, whether the access to contraception affects pregnancy rates. – Sean Duggan Sep 03 '15 at 12:49
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    The only section that deals at all the the question only talks about emergency contraception, not contraception in general. (The artcile is mainly about "does EC [morning after pill] decrease use of condoms") AKA this answer does not even attempt to answer the asked question. – Jonathon Sep 03 '15 at 13:04
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    While I appreciate all this information, I'm not certain it answers the question entirely. You provide details on sexual risk-taking, but this question is not focused exclusively on risky sex. I'm interested in any sexual behavior, including safe and protected sexual activity. Many arguing against contraceptive seem to have an implied belief that any sexual activity in teens, no matter how safely done, is a bad thing. While I don't necessarily agree with that sentiment I'm asking with it in mind. Does *any* sexual activity increase with birth control availability, and by how much. – dsollen Sep 03 '15 at 13:57
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    Sorry, but this does NOT answer the question. Almost everything is about effect on teen pregnancy, which is NOT what was asked. Item number 2 states that availability of contraception reduces "sexual risk taking" - i.e. *unprotected* sex, which shouldn't come as a surprise to anybody. – DJClayworth Sep 03 '15 at 13:58
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    This answer clearly provides important context, since the *effects* of unprotected teen sex are a very important reason why parents are concerned about it. However, it is a partial answer. I believe that the claim in the question has also more of a religious/moral slant (e.g. the claim is about teenagers having more sex overall, not having more *unsafe* sex, which seems quite debunked by this answer). – Sklivvz Sep 03 '15 at 18:19
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    That said, @DJClayworth some of the claims linked say that teen pregnancies *are increased* by available contraceptives, so this objectively partially answers the question. – Sklivvz Sep 03 '15 at 18:22
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    @Dsollen-Added points 1, 2, 3 and 4 with references for your question "does any sexual activity increase with birth control availability?" – pericles316 Sep 04 '15 at 04:47
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    Academic evidence is clear that involving parents in decision-making is crucial per a UK study-http://www.nursingtimes.net/nursing-practice/specialisms/sexual-health/does-access-to-contraception-raise-teenage-pregnancy-rates/5000013.article and there is some relationship between level of knowledge and levels of sexual activity, contraceptive practices and ability to access professional help per a Royal College of Nursing presentation here-https://www.rcn.org.uk/__data/assets/pdf_file/0007/357775/RS_Y_and_H_presentation_101101_-_Whitfield_Jomeen.pdf – pericles316 Sep 04 '15 at 06:49
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    @SeanDuggan, Jonathon Wisnoski, DJClayworth-added new points 1, 2, 3 and 4 kindly have a look to attest whether these new points address the question. – pericles316 Sep 04 '15 at 07:20