Why Canada's on Top in Teen Pregnancy

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

Comments

[amhcw]

I grew up in NorthEastern Ohio, married a Canadian, and reared my children in Montreal. My observation was that they did not have the "pressures for sex" that I experienced in high school. I went to dances once or twice a week, danced close, and was escorted home by my boyfriend late at night. They had no dances other than their Grad Dance towards the end of their last year in high school, the eleventh grade. The prestige thing to do in my high school was to "go steady," my kids and their friends had to rustle up someone to go to their Grad Dance with. Now I had resisted my high school pressures but was totally glad that my children did not have to endure the agonies I did in order to do that resisting.

[CJWebber]

The pressures on teens to have sex are the same in Canada as in the U.S. Their cultures are too similar. The only real difference is religion; the amount of religion the the U.S. is overwhelming. You would then think that there would be less teen pregnancy there due to 'Christian Values' but it is the reverse. Gee, maybe 'Christian Values' aren't as good as just plain 'Values'.

[S1m0n]

The same suburb or Vancouver that this piece focusses on is also the place with the second highest life expectency in the world, (after somewhere in Japan). Again, the availability of conprehensive medical care plays a huge role in this.

[Tyler-Durden]

but education = socialism!!

lol, i'm kidding. seriously, excellent article, thank you

[grooveygrover]

knowledge is power

[1differentdrummer]

Conservatives aren't all that pragmatic, are they, except as to war? If it works, use it, is foreign to their thinking apparently.

[petphotos]

Excellent article and comments. I worked in emergency medicine in the 80's, in a couple different areas of the country. There was a big difference in the pregnancy rate in teenage and young adult women between New England and the mid-west.

[daveny]

"...during the Clinton years, abstinence-only programs started, promoting the virtues of chastity. And voila, teen births."

Not only that, but VOILA, resurgence of HIV, which is becoming a *huge* problem, especially in the gay community. The guys getting it (and spreading it) the fastest? The young ones who came of age in the late 90's and 00's... When the right was ascendant and killed comprehensive sex ed for a lot of the country.

This is simply a case of what works and what doesnt. Comprehensive sex ed starting when kids are entering puberty (around the 6th grade) and continuing through high school WORKS. It results in kids who don't have sex any earlier than their peers, but when they do, are more likely to be SAFE and SMART about it, and avoid either contracting STDs or becoming pregnant.

Personal experience has borne that out for me -- in NYC I'm always shocked at the number of young guys I meet who have HIV... or are well on their way to getting it, thanks to misinformation, ignorance, and recklessness. By and large, where do they come from? Conservative backgrounds, red states, poor communities. By contrast, I met a kid from my school district -- upstate NY, still has comprehensive sex ed -- who's 19, proudly describes himself as enjoying his "slut phase," but is so adamant about safe sex he wound up landing a guy in the hospital (kick to the groin) who tried to have unprotected sex with him!

[jajenkins]

This is what stupid hang-ups about the "problem" (sex) and then the solution (contraception, easy access to abortion) gets you.

And isn't it odd that easy access to abortion usually means that a society has fewer of them?

[JnrNorman]

Canadian health care the best rural care in the world. We should adopt all of it.
Teen Pregancies are wrong. Too many kids having kids here.

http://video.aol.com/video-detail/the-obama-deception/1757361927

[howeverfaraway]

In 1978, while visiting my grandmother in Ottawa, I (secretly) went to a Canadian clinic and had an IUD inserted. I was 17. Cost?- 15.00 Canadian. I went back to my little Southern town at the end of the summer, and avoided being the statistic so many of my classmates became. Easy access, good instruction during my visit to the clinic, and the promise of strict confidentiality made all the difference.

[MyThought]

Canadians, so far, don't have religious zealots trying to ban birth control pills, pharmacies refusing to issue them and everyone has access to health care.

Oh, and the GOP keep trying to say Canadians don't get to choose their doctors - this is an absolute lie. Canadians do pick their own doctors - the problem is a shortage of doctors.

[ceedub36]

Uh, the female guest on Bill Maher's show is KERRY WASHINGTON, not Carrie Washington. I would have figured that a Pop Culture critic would know that since she has such an extensive body of work in film. Wow.....That is kinda clueless!!!!

[FiveFortyOne]

Aww ... Don't be so harsh. The entire article needed some serious copy editing actually, that's not necessarily the responsibility of the author. The ideas were solid though.

[viewfromuphere]

actually, in Alberta (Canada's answer to Texas)...there were some pharmacists trying to say dispensing the morning after pill was "agaisnt their ethics...f­aith..what­ever"...I don't think it went anywhere. The overall attitude seemed to be a pharmacist didn't get to pick and choose what legal prescriptiions were handed to him/her...and if it truly felt strongly about it...well...get yourself another job buddy....

[Skepticat]

In Canada Universal Health care is regulated at the provincial level with common basic standards to be met to obtain federal funding. Doctor shortages are not that widespread but depend on where you are. In Western Quebec near the Ontario border for example there is at the moment. In South central Ontario where I live it isn't a problem. In all provinces & territories Canadians pick their doctor - and doctors not bean counters determine treatment. If eligible ( citizen or landed immigrant ) you can not be excluded or charged more because of pre-existing conditions.

[jajenkins]

It's not a shortage exactly - though anyone can use more doctors.

My province, Saskatchewan, is absolutely massive. But there are only one million people in it and most of it is rural.

There are a lot of rural hospitals and a programme for home-care (both my roommates make house-calls all day) but no matter where you stick your clinic or hospital it will still be an hour's drive away from some patients.

In the far North it takes 45 minutes+ for an ambulance or helicopter to get to your farm-house.

[Willow712]

I got divorced when my daughters were 4 and 6. My youngest daughter had a baby when she was 17. She is now 34. She will freely admit that when young people come from broken homes, where there is dysfunction going on, split loyalties, parents changing their lives around and dragging the kids with them (approx. 50% of the population in this country), young people want to grow up, have something of their own, and they want their own life to cfhange, so they are careless about birth control, because they have no expectations of living their adult life well. . She agrees that if parents are married, the young person goes to Church, is in sports, gets fairly good grades, they will not have a baby because they have goals of college , etc. All of my daughter's friends had a baby young, because they had no college goals, knew they'd grow up, live and die in small towns, working at Walmart, having no goals for their future. Young people aren't stupid. They know about birth control. My daughter says that someone with goals of going to college and having a career will not get pregnant in high school. Over half the parents in families are divorcing, people are moving around the country, young girls will believe whatever young boys tell them if they are feeling unwanted or unloved at home. They think a baby will tie them together with someone who professes to love them.

[llisa]

I agree (except for the church part) that high expectations and good role models encourage kids to have goals of college and careers.

Access to real information and respect in the teens as young adults capable of making choices are also beneficial.

[degenerate1991]

Absolutely correct. It is sad that girls would get the impression that having a child would get her closer to her teenage boyfriend, since that is a sorely mistaken impression. There is nothing a young guy could want less, short of HIV perhaps, than a child. I hope your divorce wasn't too rough (my parents' divorce has been a violent, hate filled affair which has dominated all my life that I can remember).

[hollace]

One comment here mentions poverty, but if everyone is headed in that direction,that would mean you have no control over your body,your reproductive health or future.
I am always amazed at the fear Americans seem to feel about discussing Womens health, and how it is tied in to politics. Hope more money is spent on education as your kids will have a better chance for a good future.

[woodsywizz]

Education - access to healthcare - honesty - naaaaah. Must be the parkas.

[nervousexpat]

yeah, 'cause it's -40F all year round in Canada.... everyone knows that! GAWD

[SD Indy]

That would explain a lot. It's too damn cold to go anywhere toooooo get laid.

[TimDanMick]

This is a failure of US parenting.
The average US adult is a hypocrite when it comes to the raising of children. As someone born in Europe my parents were honest with me and I was honest with my children. In the US parents feed their kids on constant BS, from religion to sexual behavior.
I knew my children were normal and would therefore experiment with drugs, alcohol and sex and advised concerning the moral pitfalls. We argued about all of these matters and they knew that if they had problems they could come to me, I might shout, but we would sort things out.
Try being honest with your children.
Here's a test. What if they ask you if there is really a Santa Claus? If you lie, you fail them and they know it.

[jajenkins]

You are quite right. And they are far more likely to experiment with drugs, alcohol and sex when it is prohibited.

Europeans, for example, have no stupid hang-ups about drinking in front of their kids. It is social drinking, so it is civilized and no one gets drunk. This sets a healthy example.

[llisa]

We were always honest with our kids. No Santa and no religious lies.

Straight information when they asked, and an excellent university that treated the students as adults and provided info and free birth control.

They grew up with the information and support necessary to make their own choices. I really do wish that more Americans would treat their children with respect and stop raising them on lies and impossible ideals.

My sister (who was pregnant with her first child on her wedding day) and her husband had their daughters take chastity vows and wear chastity rings. How hypocritical is that!? Though it may have worked too well, (they are grown and neither has ever had a boyfriend) it often causes children to experiment with sex with only the vaguest ideas of the consequences.

[SD Indy]

"We were always honest with our kids. No Santa and no religious lies."

-------

A-freakin'-MEN!

[carrieanna]

Excellent point. I think we get so obsessed with arguing what should be taught in schools that we forget that parents are still the most important role model. US parents have so many hang-ups about sex that they seem to have a hard time discussing it with their kids.

My friend's daughter is now 13 and has fostered an open dialogue about sex and puberty with her for a while. When I hung out with them over New Years we didn't have any issues talking about it in front of her. I'm a faux aunt, but I still want to be a positive role model to the girl, as well. It takes a village....