story about plans to widen over-the-counter access to the contraceptive pill. A study by NHS South East concludes that the provision of the Pill by pharmacists, with no GP prescription necessary, should be widened from the five pharmacies currently offering the service. These pharmacies are in Southwark and Lambeth, two boroughs which apparently have the highest teenage conception rates in London and some of the highest in the whole of Europe. It seems that there has been a significant drop in emergency contraception in these areas since over-the-counter contraceptive pills have been made available.
This of course does not mean that women's behaviour with regard to casual sex has changed, simply that they are preparing better for it in advance, which as far as modern sex education goes seems to be the end and only goal. Even that does not seem to be happening as effectively as it could. In fact, the BBC reports, "While one pharmacy saw a significant drop in the use of emergency
contraception after the pilot was launched, the report also found that a
large proportion of women did not return for a subsequent pill supply -
having gone back to emergency contraception. Many said this was because
they did not have a regular partner."
This is enough of a shame when we are talking about adult or near-adult women, but becomes positively sinister when we read that the same NHS report suggests widening the over-the-counter service to include girls as young as 13 - which, of course, is already happening in the Isle of Wight and Manchester. Just how quick, convenient and "normal" can we make it for under-age girls to have sex? As one user of the South London service told the BBC, "It is a quick way to get contraception, and it is very private, unlike
a clinic where everyone will know what you are going there for." Talk as much as you like about guidelines for pharmacists and the questions they will be expected to ask before giving out the Pill, the fact is that this scheme intends to make it substantially easier to obtain the contraceptive pill and that is what will happen.
A Department of Health spokesperson has said, "Young people should think carefully before they have sex". And yet no-one thinks to point out to them that there are alternatives to "contraception and sexually transmitted infections". We could try that much-mocked word, ABSTINENCE, for a start. The comeback to that one, of course, is always, "But they're going to do it anyway so we have to make sure they do it safely". Well of course they're going to do it when we're making so much effort to show them it's normal and easy... in fact, it's the done thing and anyone who doesn't do it is, well, a bit odd.
There is no solid evidence that this approach works, anyway. The BBC reports that "Currently it is not known if the service has helped reduce teenage
pregnancies as conception data for the last three years is not
available" and quotes Dr Peter Saunders as saying, "There is no clear evidence from this study that it will reduce
unplanned pregnancy and abortion and there is a real risk that, by
encouraging more risk-taking behaviour, it could fuel the epidemic of
sexually transmitted disease. Without comprehensive research on real outcomes this
strategy could well be like pouring petrol on flames. We should instead
be focusing on evidence-based strategies aimed at bringing about real
behaviour change" (my emphases).
Isn't it time, at long last, to stop flogging a dead horse and try a new approach to sex education and reproductive health? As responsible adults who care about the health and welfare of our upcoming generations, I would suggest that it is our positive duty to do so. Instead of applying plasters to the wounds created by our current behaviours, we should - we must - suggest modifying those behaviours themselves. It can be done.