Sex study fuels debate on parental notification

By RUTH PADAWER, NorthJersey.com, January 19, 2005

Nearly one in five teenage girls who attend family planning clinics would quit using contraceptives -- increasing their risk of pregnancy or disease -- if their parents had to be notified first, according to a study published today.

The finding, published in the Journal of the American Medical Association, is likely to intensify an already heated debate about whether teens should have access to confidential sexual health services in a nation with the highest teen pregnancy rate in the industrialized world and millions of new sexually transmitted infections among adolescents each year.

Advocates of parental notification contend that it would deter teens from having sex. Opponents disagree, and they are sure to point to today's study, the first national look at teen attitudes on the issue. The study surveyed more than 1,500 female minors in 33 states.

The research began in 2003, just months after members of Congress introduced a bill that would have required clinics to notify parents before providing contraceptive drugs or devices to their daughters. Ninety-three House members signed on, including Republican Reps. Scott Garrett and Chris Smith of New Jersey.

The bill, which would have applied to any clinic receiving federal family-planning funds, died in committee, as previous ones had. But Rep. Todd Akin, R-Mo., has vowed to reintroduce it again this session, and both sides agree that the climate since November's election is more favorable for such a bill than it has been.

"I believe parents should be told what their children are up to," said John Tomicki, head of League of American Families, a traditional-values lobbyist in New Jersey. "Kids in that survey may say they'd still have sex, but if the law were in place, I think they would think twice."

Utah, Texas and one Illinois county prohibit state funding for clinics that do not require written parental consent before giving minors contraception. Three other states considered similar legislation last year, though none passed it. New Jersey has no such prohibitions.

Researchers of the JAMA study found that two in five teens did not tell their parents they were going to family-planning clinics. If the law required parental notification, only 30 percent said they still would go to a clinic for prescription birth control -- including the pill, the patch or contraceptive shots. By contrast, among teens whose parents knew of their clinic visits, 79 percent said they would continue to seek clinic care.

If the bill were enacted, 46 percent of the girls said they would use condoms instead, a less-effective form of birth control. Some said they would ask a private doctor for a prescription, though previous studies have found that 17 percent to 37 percent of private physicians won't provide reproductive health services to minors without parental consent. Eighteen percent said they would use no contraception at all or would use only withdrawal, a highly unreliable method.

Only 1 percent said they would stop having sex.

"Requiring teens to tell their parents that they're using birth control is just encouraging teens to have unsafe sex," said Rachel Jones, lead author of the study and senior research associate at the Alan Guttmacher Institute, which supports adolescent access to contraceptives and comprehensive sex education.

A previous study found that after one Illinois county began requiring parental notification a few years ago for minors seeking contraception, the birth rate among teens ages 18 and younger in the county increased, even as it decreased in nearby counties with similar racial and economic profiles.

In a separate study that the Guttmacher Institute unveiled Tuesday, researchers found that a teen's contraceptive use is more influenced by her attitude toward contraception than her views on teen pregnancy.

In interviews with 4,877 adolescent females nationwide, the study found that teens with the strongest anti-pregnancy attitudes (measured by phrases such as "one of the worst things that could happen to you") were no more diligent in contraceptive use than those who viewed pregnancy positively.

The results call into question efforts to reduce teen pregnancy, which often focus on convincing teens of pregnancy's negative consequences. The authors said a better predictor of contraceptive use is a teen's attitude toward contraception: The more positive her views of birth control, the more likely she is to use it. They conclude that programs that promote positive views of contraception are apt to be more effective than those that point out the negative results of teen pregnancy.

Peter Bearman, a co-author of the study and a sociologist at Columbia, noted that teenagers' views are increasingly shaped by programs that talk about abstinence until marriage and only discuss the downside of contraception -- an approach supported by millions of dollars in federal funds.

Bearman made a splash in 2001 when he reported that students who took a "virginity pledge" delayed their first sexual encounter 18 months, compared with non-pledgers. But he also found that when they did eventually have sex, they were far less likely to use contraception. On Tuesday, he reiterated that pledgers' rates of pregnancy and sexually transmitted disease were no lower than those of teens who didn't take a virginity pledge.

E-mail: padawer@northjersey.com