Until the recent introduction of the human relationships course in Queensland high schools, education about sexuality was limited to a description of the reproductive organs, isolated from decision making, self-esteem and personal rights, as well as from factual information about sexuality, reproduction and contraception, In no way were adolescents prepared for dealing with sexual development and the issues and choices they face.
A further stumbling block for adolescents is society's denial of their sexuality. Indeed, adolescents may deny their own sexuality, as evidenced by the widespread non-use of contraception. Yet they are sexually active.
Reliable data on adolescent sexuality is scarce. A survey of Newcastle adolescents in 1989 found that at 15 years of age 27% had experienced sexual intercourse, at 17 years, 41% and at 18 years, 62%. Youth have a real need for contraceptive access and information.
Australian surveys show that 85% of teenagers think that information on sex and contraception should be available before age 16, but that barely half received any sex education at school and only about half could discuss sex with their parents.
The Human Relationships Education Program is being introduced into Queensland schools over a five-year period. It addresses five areas: communication; relationships; self-esteem; values; sexuality. The program content varies between schools, and no school is compelled to cover issues such as contraception or pregnancy options.
The Family Planning Association was set up in 1972 to provide information and access to contraception. Teenagers currently form a sizeable part of its clientele, but are most likely to be from middle-class, metropolitan homes. Many teenagers are unaware of the service and of its relevance to themselves, so the widespread non-use of contraception persists.
The majority of teenage pregnancies result from the non-use of contraception. A 1979 survey found that 63% of males and 47% of females aged 18 to 25 years had, at some stage, ``taken the risk''. The information presented to Children by Choice in Queensland suggests that the situation is the same today.
Contraception requires planning, and an acknowledgment of the intention to have sex. However, forward planning is oftendisapproved of. Teenage girls may be unwilling to accept themselves as sexually active, thinking ``good girls don't have sex''. Women of all ages seem to feel comfortable with the excuse that sex was not expected. Furthermore, an intention to use contraception, especially condoms, may not be followed through at the time of intercourse.
Sometimes, young women's non-use of contraception is due to a belief that it is not possible to fall pregnant because they do not love their partner, or because they are too young, or because they have not been having sex long enough.
Another class of reasons for the non-use of contraception is the dislike of the various methods. Young people sometimes say that various forms of contraception are unsafe or that ``condoms take the feeling away''.
Contraceptive services are still not aimed at young people's needs. Confidentiality is a big issue, as are the questions of parental consent and the age of eligibility. Access to confidential information and assistance is particularly limited for young people in rural areas and small towns.
Australian Bureau of Statistics figures show that in 1990 there were 3266 births in Queensland to women aged under 20. This represents 7.2% of total births in Queensland. Australia-wide, there were 15,107 teenage births in the same year, 5.75% of the total.
A comparison of adolescent and adult women visiting Children by Choice shows that teenagers do not fit the same pattern as adults in a number of ways:
1. Teenage women are more likely to be dealing with their first pregnancy.
2. Teenagers usually present further into their pregnancy.
3. Teenagers are less likely to attend the service on their own. They are likely to be accompanied by a parent or a partner.
4. Teenagers are more likely to be single, and less likely to have ever been married.
5. Teenagers are more likely to be students (usually high school) or unemployed.
On presentation to the counselling service, many young women are still coping with their initial reactions to discovering the pregnancy: usually shock, denial and fear.
Sensitive, non-judgmental counselling can help deal with these first reactions and provide an opportunity for the woman to discuss her feelings about the pregnancy and her circumstances, making possible careful consideration of all the options.
It is especially difficult for young women to consider realistically the impact of their choice on all aspects of their future. Some young women, unable to make a decision about an unplanned pregnancy, will become mothers by default rather than by choice.
For adolescent women, counselling may include dealing with their parents. The initial reaction of teenage girls' parents often includes anger, but this usually subsides and most parents are extremely cooperative and concerned for their daughters. However, there are cases where counselling may involve conciliation of the young woman and her parents, at times including protection from their initial anger.
Currently the percentage of young women choosing adoption as a solution to an unplanned pregnancy is very small. Only 68 newborns were relinquished for adoption in Queensland in the 1991-92 financial year, and eight of these were special needs adoptions. This is an extremely small number considering the birthrate in Queensland is around 44,000 per year. The vast majority of young women facing an unplanned pregnancy choose parenting or abortion.
Abortions in Queensland are performed legally under section 282 of the Criminal Code. Most of the cost is covered by Medicare. When considering abortion in unplanned pregnancy counselling, the woman will be given an opportunity to discuss her feelings about abortion and any moral, ethical or practical concerns she has. She will be offered support for her decision and will be able to obtain information about abortion clinics, the procedure and instructions for pre- and post-operative care.
Accurate statistics on abortions in Australia are hard to obtain because there is no central reporting of abortions except in South Australia. National estimates, however, are usually around 80,000 per annum.
As society becomes gradually more accepting of single parenthood, marriage as a solution to unplanned pregnancy is becoming less frequent. Nevertheless, in 1990, Australia-wide, 21.5% of all married women giving birth for the first time within a marriage had been in the current marriage for less than one year, and 10.7% had been married for less than 7 months prior to giving birth. For teenage women the figures are significantly higher: 71% had been in the current marriage for less than one year and 48.7% had been in the marriage for less than 7 months at the timeof giving birth.
Single teenage parents have many special needs. They suffer the consequences of an interruption to education, with subsequent loss of career options, and financial difficulty. Also, early parenthood means an interruption to the normal processes of adolescence as a transition to adulthood. The existing socioeconomic disadvantage of women is also accentuated by teenage pregnancy.
Sex education and the prescription of contraception are clearly insufficient prevention for unplanned teenage pregnancy and will not solve the myriad of problems facing youth. This requires much wider social change. The reproductive rights of women, including adolescent women, must be recognised. There must be:
* An open attitude towards youth sexuality, which means sexuality as a part of life, and not just married life.
* Support for young women to develop their skills fully, not only as potential wives and mothers.
* Encouragement of self-esteem in young women, including the right to say ``no''.
* Information about the positive and negative consequences of sex incorporated into a total picture of sexuality and not dealt with separately.
* Freely available, safe and effective contraceptives.
* Active promotion of condoms, including education on how to use them.
* A positive attitude towards unmarried, pregnant teenagers, including practical support to enable them to continue with their education.
* An acceptance that the choice in teenage pregnancy ultimately belongs to the young woman herself.
* The continued availability of safe, legal and affordable abortion services, with sympathetic treatment of women.
[The authors are members of the Children By Choice Association, Brisbane.]