Thus, sexual education programs encourage teenagers to practice immoral sexual behavior that they have learned from these programs. Since the Norplant for Consenting Teenagers program requires sexual education and counseling, it is subject to this objection.

Underlying the morality objection is the assumption that sexual education programs introduce students to various sexual behaviors and this encourages students to become sexually active. There is no evidence for this assumption. In fact, there is evidence that sexual education programs encourage students to abstain from sex. A study in Atlanta revealed that students enrolled in a sex education program are significantly more likely to postpone sexual intercourse through to the end of ninth grade than non-program students.  Likewise, a study of over a thousand students showed that males who participated in a sexual education program are less likely to have sexual intercourse than non-participating students. If parents want their children to abstain from sexual activity, they should be promoting sex education instead of protesting it.

Ideally it would best if parents would teach their children the health and moral issues involved with sexual behavior. The problem with letting parents have total responsibility of their child’s sexual education is that parents are not doing it. Only 18% of males and 32% of females in the United States first learn about sex from their parents. Further, research suggests that there is a great difference between what information parents think they have conveyed about sex-related topics and what the teenagers think they heard from their parents. Sexual education programs teaching about what type of birth control to use offer reliable sources for teenagers to learn about sexual issues and these programs act as safety nets to guarantee that teenagers have access to important sex-related information so that they can act more responsibly.

Presently forty-three states cover Norplant under Medicaid. The irony of the situation is that by the time the state is willing to pay for a Norplant system for a teenager, she has already given birth. Due to the costs of that child the mother has now become eligible for Medicaid benefits, which coincidentally include subsidized Norplant. Once the state subsidizes a good form of birth control for the teenager, the damage has already been done. The teenager and her child are dependent on social services. Instead of this ad hoc policy, why doesn’t the state supply teenagers with contraceptives before they become pregnant and consequently incur great social costs?

For the first three years the system is 99.7% effective at preventing pregnancy, while the rate drops to 99.3% by the fifth year of use. Currently Norplant systems cost about $365 per system plus a doctor’s fee.  The most common side effect of Norplant is irregular menstrual bleeding. One woman in eleven will discontinue Norplant during the first year because of this effect. On average, these women have the implants removed after about seven months of use. Irregular menstrual bleeding caused by Norplant tends to lessen within nine to twelve months of use. Weight gain, headaches, and nervousness are also reported side effects. Because Norplant is a progestin, it has most all the side effects related to their use, i.e., it has the same effects associated with Depo-Provera.
Since Norplant systems are implants that release small doses of progestin, unlike Depo-Provera, the implants must be removed when the doses expire. The Norplant removal procedure is more difficult than the implants’ insertion. Removing Norplant systems generally takes about thirty minutes. Of the women having the Norplant implants removed, 19% of the procedures will take over an hour and 24% of the women polled reported the pain as ‘significant’. Pain usually occurs when the insertion border is too deep. Improvements in the implantation and removal techniques have reduced this problem. For example, the Emory Method of Norplant removal has diminished the removal time to under ten minutes. Likewise if Norplant was developed as a one or two rod system, instead of six sticks, the removal procedure would be easier and less painful.

The future of many children of teenagers looks bleak from before they are even born. Thirty three percent of all pregnant teenagers receive inadequate prenatal care, since they either start late in the pregnancy or have too few medical visits. Because of teenage lifestyles, later prenatal care, and poor nutrition, both mothers and children are more likely to have health complications. While affluent pregnant teens are less likely to have these symptoms, they still display several of the symptoms.

Once the children of teenagers are born, the home environment for these future children is not optimal. Two-thirds of all teenage births are to unmarried women. These mothers will probably not receive a high school diploma — only about half graduate from high school by the age of thirty. Eighty-four percent of fathers of children born to teenage mothers live apart from their children and only one-third report visiting their child at least once a week one year after the child’s birth. Sixty-one percent of teenage mothers living apart from the child’s father report that the father offers inadequate support for the child. Finally, when children live in poverty with a single teenage mother, they are at greater risk for lower academic and intellectual accomplishment, problems with self control, and social behavior problems than children of older mothers.   These problems are primarily due to the effects of a single parent household, a larger family size, and lower maternal education. Teenage parents often struggle to complete a high school education and thus face poor career opportunities. Consequently they are disproportionately poor and usually are dependent on public support. The vast number of teenage pregnancies translates into large social costs. Public funds pay for at least half of all teenage births. Births, however, are not the sole cost to the state. Within five years, 77% of all teenage mothers will go on welfare. Furthermore, 43% of all welfare recipients started their families as unmarried teenagers. In 1989, the government spent over twenty-one billion dollars for social, welfare, and health services for families begun by teenagers. Furthermore, babies born to teenagers in that year will cost the government at least six billion dollars over the next twenty years. Even more disturbing is that teenage motherhood and teenage fatherhood both tend to perpetuate themselves from one generation to the next, i.e., children of teenage parents tend to become teenage pareants. Thus, the teenage pregnancy rate that is occurring in the United States is creating spiraling costs for government spending.

Top

This year ten million teenagers will perform 126 million acts of sexual intercourse. In 1988, by the age of fifteen, 27% of unmarried young women had sexual intercourse and by the age of nineteen, 75% of women had intercourse at least once. Moreover, teenage sexual activity has been steadily increasing. For example, from 1982 to 1988 the rate for fifteen year old girls has increased from 19% to 27%. In 1993, 32% of ninth grade girls, ages 13 to 14, have had intercourse and about 7% of female high school seniors have had four or more sexual partners. America is not plagued by sex-crazed teenage women — their male counterparts are just as active.  In 1989, 33% of males by the age of fifteen, 50% by sixteen, and 86% by nineteen have had intercourse. Overall, the average age for intercourse is getting lower and the number of partners is increasing.
There is a large ethnic variance in the rates of sexual activity among teenagers. Prior to 1989, 81% Black males, 60% Hispanic males, and 57% White males, ages 15 to 19, had intercourse at least once. Female rates are: 61%, 49%, and 52% respectively. The rates have increased since the recording of this information. Planned Parenthood is the best place to learn about any birth control, and IUD Birth Control in particular. Offices are located in every major city.

Likewise, the average age for first intercourse varies over ethnic and social situations. The average age for first intercourse for a white male is 15.9 years old, while for a black male, it is 14.4 years old. A 1981 study showed that the average age for first intercourse for an urban black was 11.8 years old. The date of the study suggests that the average age has probably gone down.
It is important to note though that the bulk of the increase of teenage pregnancies in the United States is not due to urban conditions or the sexual behavior of ethnic minorities. While these groups have a higher than average pregnancy rate, their rates have leveled off and their small number does not greatly influence the national rate. Teenagers living at the poverty rate or up to 200% over the poverty rate are primarily responsible for the large increase in the national rate. This increase suggests that the principal explanation of the relatively high pregnancy rate in the United States is from factors that influence the entire country, and not specific groups.

This high rate of teenage sexual behavior involves great social costs. Each year, more than one million teenagers will become pregnant (1,014,620 were reported in 1987). By the age of eighteen, about one in four young women (23%) will become pregnant and by the age of twenty, the rate increases to over four in ten (44%). Sadly, 92% of all pregnancies among unmarried teenagers are unintended. Furthermore, one in five teenagers who experience pregnancy will become pregnant again within the next year. The rate of a second pregnancy occurring two years after a pregnancy increases to a little over three in ten. Teenagers are becoming unintendedly pregnant at a higher rate than any other group of women.
Top

Imagine that you are an administrator responsible for the education and development of the teenage population of a city. Currently 10% of all girls in the city, ages 15 to 17, give birth. Most of these teenage mothers do not continue to get their high school diploma and consequently will have difficulty gaining employment. Because of their poor employment options, most mothers most rely on welfare. Finally, in the inner city environment, the pregnant teens do not have the same pressures to go to college or
marry as teens in sub-urban environments. The teenage mothers seek support in matriarchies, consisting of relatives and friends who probably all were teen mothers. Thus teenage parenting continues its self – perpetuating cycle, with tremendous social costs. This is the situation the Lawrence Paquin School in Baltimore faced and what inspired many to support the school’s policy that supplies its students with Norplant birth control systems.

This paper will investigate the implications of a public policy that distributes long term synthetic hormone birth control methods to minors. For the program to be acceptable, it must fulfill three criteria. The program must be cost effective. Second, the policy must successfully deter teenage pregnancies. Third, any public program should be morally permissible. We should not embrace a policy that cuts costs if it entails violating individuals’ rights. A program that meets the above criteria will be proposed and examined. Then I shall discuss the common objections to such a project and evaluate the overall success of the proposed policy. I will first review both the social costs of teenage pregnancies, and information about the currently
available long term synthetic hormone contraception.

† I would like to thank …

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.