Speaking of which, a note to Christina: it has NEVER been that God didn’t want you to have sex. Rather, it has always been that small, vocal groups of individuals wanting power over others have said that there version of God didn’t want you to have sex. Control a person’s sex life and you control them.

On the other hand, if the specified cohort is female U.S. residents between the ages of 16 and 19 who have a steady boyfriend and do not use birth control, I suspect the failure rate is quite high, but still nowhere close to 26%, much less 86%.

I would guess that the 26-86% range refers to the number of teenage girls who have unprotected intercourse and not to the number of preganacies.

I was a spirit-filled, Bible believing, church attending Christian teenager and my fervent belief that God didn’t want me to have sex was the ONLY thing that prevented me from having actual intercourse with my boyfriend (though we did everything else but - an excellent way for girls to learn the pleasures of extended foreplay and for guys to learn to give really good oral, in my experience). However, there was at least one couple in my church youth group who didn’t develop our repertoire of ‘workarounds’, got pregnant and felt they had to marry at 18.

The point being that not having sex is REALLY HARD - because those rampant teenage hormones just make it feel so damn good (evolution rocks!). Without an exceptionally strong personal belief system and/or punitive social sanctions (’fallen women’, forced adoptions etc) I doubt that abstinence will ever be an effective method of preventing unplanned pregnancies.

This isn’t even true in theory, according to the good folks at teen advisor.

Yeah.

Ann Fessler wrote a wonderful book called “The Girls Who Went Away”, and I’m finding that the thinking in this day and age, for all the open mindedness of some of it, is nearly the same as it was back then. There is still a social doublt standard which supports the males sowing their wild oats, and when abstinences fails it is still the girl who is looked down upon for “allowing it to happen”.

A previous commenter mentioned the male contraceptive injections; I can’t wait for those to come out on the market. It will be nice to share the responsibility and have pregnancy become a mutual decision. I’ve always used the pill and a condom, and one more method can’t hurt as far as I’m concerned.

Abstinence ed is primarily aimed at preventing sex, not preventing pregnancy. Otherwise, abstinence education would include detailed instruction about sexual activities that won’t get you pregnant.

While we’re at it, let’s look at other ways of behaviorally influencing people to reduce the likelihood of pregnancy.

Let’s encourage high school girls to only have sex with men over 30. Hell, 40. These men are very likely to be careful to not knock her up.

How about encouraging same-sex experimentation in teens? Maybe we can figure out how to modify sexual orientation temporarily! This would be something the religious right should get behind, because they could then use the technology to make gays straight later in life!

This was pointed out at the Volokh Conspiracy (which may not be to everyone’s taste as a blog, but it does seem to be correct in noting that people should be careful to check that they’re not using the periodic abstinence figure).

For those who don’t know, the “regular sex, no contraceptive use at all” figure involves about 85% of heterosexual couples with the woman in the right age group having a pregnancy within a year.

“Typical use” contraceptive failure has a fairly standard definition. Firstly, you believe any person who says they are using a given method. So the woman who takes the pill when her alarm goes off every day, the woman who takes it when she remembers in the morning, the woman is only remembering it two days in three, and the woman who got the script and didn’t get it filled? As long as they tell researchers they use the pill for contraception (and, I think, that they don’t want to get pregnant: not all couples using contraception are actually committed to avoiding pregnancy), they’re counted in the pill stats.

Then you follow these couples (I think they’re usually supposed to be long term relationships that have regular sex) for a full year from the time of beginning to use that method of contraception (failure tends to drop when people are practised users for various reason, so it’s the first year for comparison purposes). The percentage that gets pregnant is the typical use failure rate. Normally they rely on reported pregnancies, that is, they do not have the participants take pregnancy tests regularly, it has to have got to the point where the woman has noticed it. So failure rates are actually an underestimate, since 25% or so of pregnancies will miscarry unnoticed.

“Perfect use” is similar except you discard any couple who reports mis-using the method. (I do not know how that’s enforced.)

So abstinence would be tricky, because couples using it aren’t supposed to be having regular sex. But the closest comparison would be to get long term couples who claim to be beginning abstinence, believe them, and find out how many have had a pregnancy by the end of a year. For perfect use I guess you would have to drop everyone who reported sex.

For reference, my understanding of how contraceptive failure is measured comes from Trussell, James, Contraceptive failure in the United States, Contraception, 2004, 70(2):89-96

What I’m getting at is that the 26-86% figure is meaningless if we don’t know what it means.

Well, yes, in a sense. Its like having a garage some place that says, “26-86% of cars that come through our doors have to have their tires replaced.” This says nothing about “why”. If its a tire replacement place, this makes sense. If its a normal garage, which deals with all types of problems, you have to ask, “What is causing the problem with tires here?” On the other hand, if its a garage in a small town, there are only 500 cars in the entire town, and 26-86% of them are having to replace them “per year”…. Well, now you really have a *huge* problem, because its not just that a lot are needing tire replacements, its that something is happening to 100% of all the cars, which just “happens” to only result in 26-86% needed an immediate replacement.

But, only in the first instance does it mean that the problem is exaggerated. In the other two cases, it means you have a *much* bigger problem, which is simply not being reported, since not every car “happens” to need tires at the same time. This is an equivalent case to pregnancy and STD. Not everyone is going to report them, not everyone is going to be affected in a way that results in a report, but its pretty certain that the number of “failures” is much higher than the numbers *can* indicate. In that sense, its not just meaningful, its scary.

The accepted/most common definition for failure rate seems to be the expected number of pregnancies per year per 100 women using (or claiming to use, I guess, in the case of abstinence?) the method, but that strikes me as an awfully vague way to do it. How often are these women having sex? Daily? Weekly? Once a month? Twice per year? Unless an average frequency of intercourse is provided, the number is almost meaningless, yet this information is never provided or suggested.

The most likely candidate seems to be “Disease-Specific Sexual Abstinence User Rates: The Role of Science in Policy Making” by Clara S. Haignere, Health Educ Behav 2001;28;21. But that article doesn’t have any original research. Rather, it’s a commentary on “A Relative Risk�Based, Disease-Specific Definition of Sexual Abstinence Failure Rates” by Steven D. Pinkerton, Health Educ Behav 2001;28;10. But unfortunately, neither article seems to contain the 26-86% failure rate figure.

It looks to me as though Pinkerton isn’t measuring abstinence failure directly. (I imagine the direct data on that is lacking. For that matter, I bet it’s hard to measure how often condoms rip “in the field”.) Instead, he’s using rates of STD infection and unwanted pregnancy as a proxy (which, I guess, is good, since that’s what we’re ultimately interested in).

And that’s where math comes into play: if you have sex 100 times, and condom rips 10 times, that’s a 10% failure rate of the method, but that doesn’t equate to a 10% chance that your partner will get pregnant; or that 10% of your partners will catch your STD. For instance, you might have to engage in unprotected sex 70% of the time to have a 10% chance of being infected with chlamydia.

What I’m getting at is that the 26-86% figure is meaningless if we don’t know what it means. Is it referring to people who pledge abstinence but wind up having sex anyway? People who pledge abstinence but wind up catching an STD?

I think this topic raises the question about what we want from our children or the next generation of children. I want them to be healthy, wealthy and wise, to enjoy their childhood and grow at their own pace. I want them to know more than me in time, to appreciate more, understand things better and get more out of life than me. i say this from the position of someone who makes a conscious effort to get the most out of this one life that I can. Above all I want them to be safe.

That means that they should choose the time when they want to have sex and be able to choose when and if they have children of their own. They should avoid the emotional turmoil of having or even having to consider an abortion. They should remain free from disease and infections that might limit their lives or reproductive abilities.

As a parent my role in sex education for my children is to ensure that they have choices and information. Abstinence is a choice and they are welcome to opt for it but it is one of many. The pill and condoms are the most common contraceptives and these should be available. Two forms of contraceptive are more effective than one and mitigate the “I forgot” circumstance if they only forget one. There’s a new male contraceptive injection that will hopefully be available soon as well. Simply put, don’t leave your eggs in one basket. That is what abstinence only education does except it limits access to other preventative methods.