News

Time to go Dutch?

The government aims to halve the pregnancy rate amongst girls under 16 by the year 2000. At present nearly 10 girls in every thousand aged 13 to 15 get pregnant each year. Within eight years the Department of Health (DoH) expects this to be reduced to nearer five. The trouble is that nobody really knows how to achieve this in a way that is acceptable to the party of Family Values. Two truths stand in the way of the DoH’s good intentions: poverty and sexual repression.

Girls under 16 living in deprived areas are more likely to get pregnant and less likely to have abortions, according to a recent study from Tayside, reported in the British Medical Journal.¹ The same is true for young women between 16 and 20, and seems unrelated to the availability of NHS abortion services. Deprived areas were geographically closer than the more affluent areas to the hospitals where abortion services existed, but this did not seem to favour girls and women from poorer localities. There is little reason to believe that the situation in Tayside is uniquely bad and that the picture is different elsewhere. All this is despite contraceptive services being available from GPs (who have a financial interest in providing them), a network of family planning clinics (albeit cut during the 1980s) and some voluntary sector clinics aimed at young people. The author of the study is scrupulously scientific and avoids comments about the reasons for these class differences.

The answer is to go dutch, and not with caps but in attitude. A recent review of the Dutch family planning services, published in the Health Service Journal,² reported that the teenage pregnancy rate in the Netherlands is one fifth that of Britain, despite family planning services that are extensive but, on UK criteria, of poor quality. Specialist training for family planning, choice of woman doctor and trained family planning nurses are few and far between.

The important difference between the two countries seems not to lie with services but in societal attitudes. In the Netherlands widespread media coverage of all aspects of sexuality in a unsensational way seems to be the basis of a relaxed and open attitude towards sexual behaviour, so that adults can discuss sex with young people sensibly and act as good role models. British culture is much less open, and sexuality is not yet treated as entirely normal behaviour. Many young people find their way around the emotional barriers created by the parental generation and obtain the information they need, but not all.