Should we consider giving the morning-after pill at school?

Picture: Cate Gillon
Picture: Cate Gillon
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Contraception and unwanted pregnancies are thorny topics back in the headlines. Ruth Holman and Peter Kearney present their perspectives

YES

By Ruth Holman, chairwoman of the Scottish sexual health lead clinicians group

Why is emergency contraception not available in schools? Why are condoms and contraception not accessible? Vaccination against a sexually transmitted infection – HPV – is given in schools, why can’t pregnancy and other sexually-transmitted infections be prevented?

The Scottish Government is prepared to make a stand on controversial subjects like gay marriage, why does it run scared of its critics on the subject of making emergency contraception available in schools? The Scottish Government should give consideration to the availability of certain interventions in schools, particularly in areas with higher teenage pregnancies, including the availability of emergency hormonal contraception (the morning-after pill).

The government needs to endorse and strengthen interventions in schools and close working with agencies which work with young people excluded from school. School nurses make a very positive input into the lives of young people as they are so well placed to be approachable, but the way they are used varies.

School nurses are under increasing time pressure due to the volume of child protection work they are involved in, as well as additional work for vaccination programmes. There are some examples of excellent school nursing involvement with sexual health, such as in Grampian and Ayrshire. School nurses do not have enough administrative support, so that a lot of their time is spent on paperwork. If they had more support, they would be able to free up time to provide care, advice, support and provision of contraception and other services to young people. A relatively small investment in more school nurses and administration would bring a very generous return.

The potential for the school nursing service to make an impact is restricted by lack of finance for posts and also timidity on the part of government and local authorities.

NO

By Peter Kearney, director of the Scottish Catholic Media Office

In every field of medicine today, “evidence-based” treatments are commonplace. Politicians with their hands on the public purse strings want value for money and, above all, they want results. With one exception ­– sexual health. There, funding for strategies, treatments and projects seems to be inversely proportional to their success.

This anomaly was highlighted in devastating detail in March 2002, in a paper published in the Journal of Health Economics titled the Economics of Family Planning and Underage Conceptions, by David Paton.

This suggested that “improving access to family planning can have an ambiguous impact on underage conception and abortion rates”. The reason for this ambiguity is that access to family planning may increase the likelihood of young people engaging in sexual activity in the first place.

Testing took place on data covering UK regions between 1984 and 1997. Over this period, Paton found no evidence that the provision of family planning reduced either conception or abortion rate for the under-16s.

The results of this research set the cat among the pigeons.

Questions were raised in parliament, and the government asserted that new international research contradicted the findings.

A year later, in an equally detailed paper, Mr Paton comprehensively demolished these claims, concluding the strongest evidence available in the sources cited by the government, together with evidence from other well-regarded studies, far from being contradictory, is perfectly consistent with the key finding that increased access to family planning does not reduce underage pregnancy rates.

Yet we now have the Scottish sexual health lead clinicians’ group proposing that the morning-after pill should be distributed to children in schools.

Such a move is the equivalent of parking an ambulance at the bottom of a cliff rather than putting a fence round the top.

There are multiple, serious problems with this reckless advice – there is no research into the long-term health effects of prescribing the morning-after pill to teenage girls. Prescription of the morning-after pill has, so far, had no effect on overall teenage pregnancy levels – quite the opposite.

Yet, we are urged by “experts” – whose strategies have all failed – to

continue pouring petrol on to a

bonfire.

SUPPORT FOR YOUNG MUMS-TO-BE

AROUND two girls aged under 16 become pregnant in the Lothians each week, although that figure has been falling in recent years.

According to the most recent NHS figures, 93 girls aged 13-15 became pregnant in 2010, down from 99 in 2009, and 111 a year earlier.

Critics have pointed to the failure of safe sex initiatives, but NHS Lothian has a range of schemes both to encourage safe sex among youngsters and to help out teenage mothers.

The Family Nurse Partnership provides intensive support for females under 20, giving them information on how best to care for their baby.

All young mums-to-be who are pupils in Edinburgh and Midlothian are also offered a place at a unit at Wester Hailes Education Centre.

A full-time teacher works at the unit to help with academic and pastoral problems. Baby massage and healthy eating are among sessions offered between regular classes.

The programme is funded by the City of Edinburgh’s Hospital and Outreach Teaching Service.