The Policy’s Fatal Flaw

While the Norplant for Consenting Teens policy may work, there is deep problem with the policy. The policy is a overly drastic solution to the problem. Teenagers need more information about reproduction and contraception. They currently do not know where to go for more information. Unfortunately the society is not open to discuss important reproductive and contraceptive topics with teenagers. As a result, one in three female teenagers will not use a form of contraception the first time they have intercourse and, one in five teenagers do not use any form of contraception.

Over half the teens polled incorrectly thought that they needed parental permission to buy over the counter contraceptive devices. Teenagers have cornered the market in contraception failure, e.g., their average failure rate for an oral contraceptive is 11% compared to the average for women over 20 is about 5%. Likewise, sexually active teenagers wait between thirteen to fourteen months after they started having intercourse to come to a family planning clinic. Sadly, in 1981 the most common reason for teenagers making their first clinic visit was their fear of being pregnant.

Sexual education offers hard-to-get information to teenagers. As a consequence, teenagers participating in sexual education programs are more likely to use a contraceptive when having intercourse and will use contraceptives more effectively. They will also abstain from sexual intercourse for longer periods of time. Since 80% of sexually active teenage males indicated that they believe they first had intercourse at too young an age, this phenomenon seems to be in the interests of teenagers.

Unfortunately the sexual education in the United States is inadequate. Over half of all teens do not take a sexual education course until after they have become sexually active. On average secondary schools only offer six and a half hours a year on all sexual education topics, and less than two of those hours covers contraception and STD prevention.

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Norplant should cost much less and Wyeth-Ayerst promised the US government that it will cost less in the future, see Hilts, P. (1993) ‘Contraceptive Maker to Cut Price for Clinics,’ The New York Times, Nov 11, B-13.
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Wyeth-Ayerst Laboratories (1991) and Upjohn Company (1993) for respective drugs.
Levine, C. (1979) for Depo-Provera and Sheldon, S. (1987) for Norplant.
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Both are costs from several HMOs in New York state. It appears to be the national average.
Wyeth-Ayerst promised the government that it would reduce the cost of Norplant by this date, see Hilts, P. (1993). The company has not fulfilled this promise.
Hilts, P. (1993).
Depo-Provera is more desirable for women who are considering having a child within the next two years or less. Since most all teen pregnancies are accidental, very few teenagers intend to have a child. While older teens, ages 17 to 19, may consider having children within the next two years more than fourteen year olds, the difference is minimal considering the number of accidental pregnancies. Ironically, when given the choice between free oral contraception or free Norplant implants, the older teenagers showed a preference for Norplant (see Polanczky, M., et. al. (1994)).
If Depo-Provera was to decrease its cost, there seems no reason to not include it as an option. Generally, Depo-Provera and Norplant offer no serious differences except in the ease of reversing the contraceptive effect.
National Research Council (1987).
The difference is taken from the varience from the cost of a Norplant unit in Sweden, $23, see Hilts, P. (1993).
This number is unrealistically high considering the number of multiple partners several female teenagers have reported (see Besharov, D. & K Gardiner, 1993). I have assumed this number to keep a very poor schenario.
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Kantrowitz, B. & P. Wingert (1993). ‘The NORPLANT Debate,’ Newsweek. Feb 15, 37-41. Also see,
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Hatcher, R. A. & J. Trussell (1994). Sadly, their condom use is consistently very low. This is not a feature associated with Norplant. Instead, we need to remove the focus on condoms as a contraceptive method and emphasize that condoms are for protection against STD’s and AIDS.
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Thornburgh v American College of Obstetricians and Gynecologists, 476 US 747, 772, (1986).
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8:20.
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This class of policies contains a number of policies that could contain other defining parameters. For example, parental permission may be required before a minor could consent to the implantation of a Norplant system.
That is, of course, if you do not think that pregnancy is a sexually transmitted disease.
One should note that this will increase the cost of the program.
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This assumption dehumanizes the women of the community and treats them like incubators.
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The cost of Norplant over five years is still less than A Dollar-A-Day for the same time, the failure rate is less, and the Norplant policy can effect teens before they give birth. For more on the Dollar-A-Day program see Dolgan J. & S. Goodman (1992) Dollar-A-Day: Teenage Pregnancy Prevention Program. Sponsored by Planned Parenthood of the Rocky Mountians. c/o Margo Daly.
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Appraising Long Term Contraception Distribution Policies for Minors

Abstract: Teenage pregnancy is costing the United States billions of dollars in social programs. These
costs are rising and so is the rate of teenage pregnancies. Unfortunately, teenage parents are driven into poverty and have a very little chance of escaping. Similarly, their children face poor care, higher health risks, and are more likely to be teenage parents. In light of this situation, some have proposed giving teenagers Norplant contraceptive implants.

This paper will investigate the economic, social, and moral issues involved with a public policy that distributes long term synthetic hormone contraceptive to teenagers. It will show that such a policy could save the United States billions of dollars, improve the contraceptive options for teenage women, and does not necessitate a coercive public policy that represses women’s rights. The problems facing implementing this public policy include radically restructuring our public schools and establishing a better governmental sexual education curriculum. This goal, however, will probably accomplish much of what the controversial policy was intended to do.