Britain Has the Answer to Defunding Planned Parenthood

(Bloomberg) -- Teen pregnancies are falling so fast in parts of the U.K. that conception rates for women over 40 may soon outpace those for girls who are less than half their age.

It’s a remarkable turnaround for young women in England and Wales, while those later in life are enjoying better health and improving technologies for couples unable to conceive naturally. Teen pregnancy rates are now the lowest since records began in 1969, while the conception rate for women over 40 has more than doubled since 1990, data for 2015 released this week by the U.K.’s Office for National Statistics show.

Researchers attribute the decline largely to improved education, widespread access to free contraception and increased social stigma.  In 2015, 21 out of every 1,000 girls age 15 to 17 became pregnant, down about 50 percent from 2007. At the same time, the number of abortions had by girls in that age group has also plunged by about half.

The success story in fighting teen pregnancy comes as the U.S. weighs defunding Planned Parenthood, a major health-care and abortion provider, reigniting the debate over family planning. The House GOP’s bill to replace the Affordable Care Act would cut all money to the group, which provides abortions but doesn’t directly use federal dollars for the services.

Such a move would be “a disaster,” said Kaye Wellings, professor of sexual and reproductive health research at the London School of Hygiene and Tropical Medicine.

“There’s an argument going on in the U.S. about whether you need education or contraception,” Wellings said. “It’s a silly argument: Education didn’t stop anyone getting pregnant. It provides the motivation not to get pregnant. Contraception provides the means by which you can avoid pregnancy. You need both.”

The Guttmacher Institute, a sexual- and reproductive-health policy organization in Washington and New York, estimates that without publicly funded family-planning services, U.S. teen pregnancy rates would be 73 percent higher than they are now.

The White House has said it would support funding Planned Parenthood if it stopped offering abortions.

Britain has used a comprehensive strategy to tackling teen pregnancy. In 1999, the Labour government made a big push and spent hundreds of millions of pounds expanding contraceptive services and improving sex education. The British tabloids had a field day, with headlines like “Nanny State Uproar as Labour Declares War on Teenage Sex.”

For years, the strategy didn’t appear to be working. Teen pregnancy rates hovered in the low 40s until 2008. Then, suddenly, the rate started to sink each year—decreasing by as much as 12 percent. By 2015, when the first babies born under the new government program turned 16, the rate had fallen to 21 conceptions out of every 1,000 girls.

A review published in The Lancet by Wellings and other academics last year found the strategy “likely contributed to” the decline. Another major factor: In 2012, the government required children to remain in school or in vocational training until age 17, Wellings said. Others say children are behaving better generally. In 2014, 38 percent of 11- to 15-year-olds said they drank alcohol, down from 54 percent in 2007.

David Paton, an economics professor at the Nottingham University Business School who studies teenage pregnancy, said it would be “nonsense” to credit the government for the drop in teen pregnancies.

“It’s hard to prove a negative, to disprove there was no effect from the strategy,” he said. But he said he was skeptical that spending in the late 1990s could be connected to a decline in pregnancies that only took hold almost a decade later. And austerity cuts in the program haven't slowed the decline, he said.

Whatever the cause, it’s clear British women are waiting to start a family. The average British woman first gives birth at 30. The conception rate for women 40 and over rose to 15.1 in every 1,000 in 2015 from 6.6 in 1990, the ONS said. And last year, government data showed that more women over 40 had babies than those under 20 for the first time since 1947.

“All the milestones in life are moving back,” Wellings said. “People are leaving school later. They’re getting jobs later. They’re leaving home later. They’re settling down with partners later, and having children with their partners later. They’re retiring later.”

A study by the Family Planning Association, a U.K. charity, found that every £1 ($1.25) in cuts to sexual and reproductive health services paid for by the National Health Service led to £86 in costs later for social services.

Two countries have severely restricted contraceptive funding: modern-day Iran and Romania under dictator Nicolae Ceaucescu, said Amy Tsui, a senior scholar at the Bill & Melinda Gates Institute for Population and Reproductive Health. 

“In Romania, by restricting contraception and abortion access, maternal deaths increased substantially to being the highest in Europe,” she said. “This is not a club of nations that I would like to see the U.S. join.”

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To contact the editor responsible for this story: Lisa Fleisher at lfleisher2@bloomberg.net, Timothy Coulter