E Jane Dickson: Teenage pregnancy is not contagious

It’s not that middle-class girls aren’t having sex. It’s just that middle-class parents are more likely to arrange a termination for their pregnant daughters
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The Independent Online

Ever since there have been boys and girls and bike sheds, there have been myths about pregnancy; it won't happen the first time; you won't get "caught" if you're standing up.

Now, in response to this week's proposals from the National Institute for Health and Clinical Excellence (Nice) to introduce midwives into schools, a new piece of folk wisdom is doing the rounds: pregnancy is contagious.

The NHS watchdog has identified teenage girls, along with domestic abuse victims, drug users and non-English speakers, as among the least likely to use antenatal services despite being the most in need. Fatal complications in pregnancy or childbirth are five times higher than average in deprived communities, and the provision of antenatal advice in schools with a particularly high incidence of teenage pregnancies is just one of several outreach initiatives framed to address this inequality.

The proposal, however, has been greeted with outrage by those who fear the knock-on effect. "Bringing antenatal classes on to the school premises runs the risk of normalising teenage pregnancy and of increasing the very problem it was intended to address," warned Norman Wells, director of the Family Education Trust.

I am unconvinced by the "knock-on knock- up" theory (subtext; if you destigmatise teenage pregnancy, they'll all want one). Partly because it is the ongoing stigma attached to very young mothers that prevents them from accessing antenatal care through the usual channels in the first place, but mainly because unlike the Family Education Trust, whose website also expresses vigorous concerns about "the teaching of homosexuality in schools", I do not believe that destigmatising an issue is the same as promoting it.

I can see there is a case, in an ideal world, for advancing improved access to antenatal care outside school hours: pregnant pupils need every hour of education they can fit in. But if, in these days of reducing social services, putting midwives into schools – a scheme backed by the College of Midwives – has been identified as the quickest, cheapest and most effective way of providing point-of-need care, I don't think the heavens will necessarily fall.

Sex and schoolchildren is a hugely emotive subject and teenage pregnancy is just its most visible manifestation. While Britain holds the unenviable pole position on teenage pregnancies throughout Western Europe, the rate has in fact been falling since 2002 – which suggests that the much-derided "what to do with a condom" classes are not entirely wasted. There are very many, very complex reasons why teenagers are either getting pregnant or fathering babies (and I wish the two were more often related), but one of the most obvious is that a lot of teenagers are having a lot of sex. Certainly many are having a lot more sex than their parents had at their age, and this, I think, is a major factor in society's unease about teenage sexuality.

As the mother of a 14-year-old daughter and a 12-year-old son, I understand this unease very well. When I and my friends were my daughter's age, we were still giggling over how to say "penis". (There were those who thought it rhymed with "menace" while one would-be sophisticate – OK, it was me – held out for "pay-nee", pronounced in the French fashion.) Today's teenagers giggle over things I hadn't heard of when I was a married woman.

They may or may not be more experienced than we were, but they're certainly a hell of a lot better informed. I might wish for a wider hearing of the abstinence option in the general discourse (that's where the dreaded "little chats with Mum" come in) and the pernicious misinformation of pornography is, I think, something to be strongly resisted. But I cannot for the life of me follow the argument of those who oppose sex and personal health education on the grounds that "it's only making things worse". It's like saying that since some horses have bolted, the doors should be blown off all stables.

I wish, too, that we could move on from the hoary and wholly unhelpful notion that "nice girls don't", that teenage sex is somehow the preserve of a promiscuous underclass of Vicky Pollards. This week's tabloid headlines suggesting in-school antenatal classes are being presented on a par with optional music and ballet lessons are nasty and plain wrong, but they do point up a fundamental class consciousness that too often clouds the debate. Because it is not the ballet-dancing girls whose lives are most likely to be changed by an unplanned pregnancy. It's not that middle-class girls aren't having sex. It's just that middle-class parents are more likely to arrange a termination for their pregnant daughters and said daughters will then move on smoothly, if not seamlessly (I don't believe abortion is an easy matter for most women) with their lives and aspirations. It is girls who, for whatever reasons, believe that a baby will make their lives better who make it through to the statistics.

This is the real root of Britain's teenage pregnancy problem. Which is not to say the branch does not require our urgent attention. There is no logical or sociological reason why pregnant teenagers should not have the same care as the most impeccably married woman. It's not a matter of setting good or bad examples; the fact is young women are ill and dying for lack of antenatal care and a plan has been suggested that just might work. Until we have the imagination or resources to come up with a better plan, a little less censure and a lot more sympathy would go a long way.