College Pregnancy Prevention Programs Need to Go Beyond Abstinence

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Commentary Sexual Health

College Pregnancy Prevention Programs Need to Go Beyond Abstinence

Martha Kempner

A new Arkansas bill mentions abstinence explicitly while avoiding any direct mention of contraception—suggesting that state lawmakers are kidding themselves about the behavior of college students.

Arkansas state Rep. Deborah Ferguson (D-West Memphis) undoubtedly has good intentions with her new bill to address unplanned pregnancy, which passed the state house in an 87-2 vote on Tuesday. According to the legislation, HB 1534, Arkansas has one of the highest teen pregnancy rates in the country. However, many of those pregnancies occur after young people have left high school—which is where most pregnancy prevention and sexual education efforts are focused. The bill notes that of 4,089 births to Arkansas teenagers in 2013, some 3,000 were to 18- and 19-year-olds.

Not all individuals this age attend college, of course. But in order to try and reach those who do, Ferguson’s bill would require the Arkansas Higher Education Coordinating Board to develop an action plan that would include educating community college and university attendees about pregnancy prevention at their initial orientation sessions, incorporating medically accurate information about unintended pregnancy into compatible coursework, and discussing abstinence with students. However, the bill mentions abstinence explicitly while avoiding any direct mention of contraception—suggesting that most Arkansas lawmakers are either kidding themselves about the behavior of college students or would rather send a moral message to young people than actually help them prevent unintended pregnancy.

To be fair, the language used in the bill does seem to hint at contraception. It suggests that the action plan should “integrate information that is recognized as medically accurate by the American Congress of Obstetricians and Gynecologists about the prevention of unplanned pregnancy into academic courses if and when appropriate.” ACOG supports providing young people with information about and easy access to all forms of contraception from condoms to intrauterine devices (IUDs). But no mention of these methods make it into the bill. Instead, the sentence about ACOG ends with “including without limitation abstinence education.”

Moreover, only abstinence came up in the debate about the bill. According to the Arkansas Times, after Ferguson explained the legislation, “one of the bill’s cosponsors, Rep. Robin Lundstrum (R-Springdale), rose to make sure Ferguson didn’t forget to emphasize a crucial point. ‘The bill also includes an abstinence component, correct?’ she asked.” Ferguson assured her colleagues that it did.

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It seems highly probable that Ferguson supports making contraception available to college students. It’s even possible that Lundstrum does too. As sponsors of the bill, however, they likely knew this would be controversial and hid behind ACOG recommendations and abstinence language in order to get the bill passed. I get that. Political expedience is important, and legislators have to live within their state’s reality. Unfortunately, what we’re left with is a bill that seems to suggest we gather all college freshmen together at orientation and tell them to keep their pants zipped for the next four years. The language is so vague the board—or institutions—could easily develop a program that includes no mention of contraception at all, despite what the sponsors may have been subtly intending.  

That’s just not going to work. Abstinence education is ineffective, even with younger students. A 2007 study of federally funded abstinence-only-until-marriage programs found that the students who attended them had similar numbers of sexual partners and a similar age of first sexual intercourse as their peers not in the programs. Similarly, a British review of 13 abstinence-only programs in the United States found that they had no effect on sexually transmitted infection or pregnancy rates. In fact, they didn’t significantly affect the number of students engaging in vaginal sex. And, on an individual level, researchers have found that 88 percent of teens who take a pledge to remain a virgin until they’re married do have heterosexual intercourse before their wedding day. More concerning, pledgers who have sex are less likely to use contraception when they do become sexually active than their peers who had not pledged.

It is one thing to debate abstinence programs when we’re talking about high school students. Some parents think 14-year-olds shouldn’t have sex, period. As they get older and kids get more mature, the question of whether or not they are old enough for sex becomes more complicated, and opinions become more divided. Regardless, in many ways, 18- and 19-year-olds are more adults than they are teenagers. They can drive. They can vote. They can serve in the military. And they are having sex. By age 19, seven out of ten young people have engaged in sexual intercourse. The National Survey for Family Growth found that 44.9 percent of never-married 18- and 19-year-old girls and 42.6 percent of their male peers had had sex in the three months before they were surveyed. Individuals this age are definitely sexually active, and as such they are definitely at risk for an unintended pregnancy.

I have done many college orientation workshops about sexuality, and I would have been embarrassed to stand up in front of those emerging adults and suggest that the best thing they could do is to stop having sex. It’s not realistic, and it’s not necessary.

Instead, I’ve helped them understand the importance of thinking critically about each sexual experience. We’ve talked about who it would be with (do you feel comfortable with this person, and how will you feel next time you sit down next to her in Econ?); where it would take place (maybe wait until a night when your roommate is out instead of doing it under the covers knowing she’s wide awake on the upper bunk); whether it was consensual (you can’t assume your partner is into it—you have to ask); and whether it was protected against STDs and pregnancy (condoms and another form of birth control together is the very best option). Because I have been lucky enough to be at institutions that made contraception accessible, each talk ended with a mention of the many places on campus where students could get free condoms as well as how to make an appointment with health services to get prescription contraception methods. Information and access were combined. 

This is what college students need, because this is what is missing from too many high school sexuality education programs. Ferguson’s bill recognizes the problem of unintended pregnancy but doesn’t (likely because it couldn’t) go far enough in suggesting a solution. For that matter, it is unclear how much authority the Higher Education Coordinating Board itself has in implementing these policies at an institutional level. I can only hope that lawmakers in other states, and perhaps future lawmakers in Arkansas, won’t be afraid to admit that older teens are having sex, that they are getting pregnant, and that they need real help. A better approach for legislators would be to make sure, through an actual mandated action, that all state schools are providing both information and access to contraception. This is the only way we can ensure young people are able to make the best decisions about their sexual and reproductive health, both during college and in the years after.