One in five American women give birth to a child before age 20, the highest rate of any developing nation. So, by all means, morning-after contraceptives should be available over-the-counter to women of all ages.
But that availability, which apparently will happen now that the Obama administration has decided to drop its insistence on an age limit, is just like the product in question — an emergency response, not a solid strategy.
Panicked teenagers rushing to the nearest pharmacy for the Plan B morning-after pill is better than those same teenagers giving birth to children without adequate financial or family support. But more proactive contraceptive measures are better than after-the-fact prescriptions. And for young teens — the group for which the administration had tried to restrict access — delaying sexual activity is the best idea of all.
The problem is, we really haven’t figured out how to convince young people not to have babies.
Scholars Phillip Levine and Melissa Kearney talked about this in an article posted on The Atlantic website in May:
“The evidence on targeted teen pregnancy prevention approaches is almost always disappointing. In previous work, we have shown that access to free family planning services for low income teens reduces the likelihood of giving birth, but not by very much. The most rigorous studies assessing the impact of access to Plan B emergency contraception points against there being an effect on pregnancy or abortion rates. Abstinence only programs also have no discernible impact on teen births. Sex education has been shown to have an impact on some outcomes like delayed initiation of sexual activity, but the evidence regarding its effectiveness in reducing teen childbearing is weak at best.”
The long-term strategy, they suggest (and I agree), is to convince girls early on that their future will be brighter if they postpone motherhood.
That’s really difficult, though. It involves improving schools and neighborhoods and tackling the problem of income inequality, which Levine and Kearney contend plays a role in teen pregnancies.
“We have found that girls from disadvantaged backgrounds who live in places with a larger gap between the poor and the middle class are considerably more likely to give birth as a teen than girls who have similar backgrounds, but face less inequality,” they wrote. “Income inequality is strongly linked to lower economic mobility — the ability to improve one’s station in life. And so our findings seem to suggest that girls who don’t see a chance to better their lives are more likely to have a child.”
At a time when too many college graduates struggle to find good jobs, convincing low-income middle- and-high-school girls that the future is theirs for the taking is a tough chore. But there is some evidence to show that good schools and intensive career counseling does reduce the incidence of teen pregnancies among girls from poor families.
Fixing schools and creating jobs in disadvantaged areas would do a lot of good in a lot of ways. Until then, at least we’ve got Plan B.
Barbara Shelly is a columnist for the Kansas City Star. Readers may write to her at: Kansas City Star, 1729 Grand Blvd., Kansas City, Mo. 64108-1413, or by email at firstname.lastname@example.org.