Opt-out contraceptive programme proposed to curb teen pregnancy rates

New Zealand has the second-highest teen pregnancy rate in the developed world.
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New Zealand has the second-highest teen pregnancy rate in the developed world.

All teenage girls should be fitted with contraceptive implants or intrauterine devices (IUDs) before they become sexually active, researchers say.

The call for a free, universal long-acting reversible contraceptive programme in New Zealand has been made by academics from the University of Otago in an article published in the British Journal of Obstetrics and Gynaecology.

But Family Planning New Zealand say they will not be supporting the proposal as young women should be able to choose which contraceptive they use. 

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There are three types of long-acting reversible contraceptives currently available in New Zealand - the implant Jadelle, the copper IUD and Mirena.

Academics say giving adolescents full access to these contraceptives would help lower New Zealand's high teen pregnancy rates, and the costs they place on both the individual and society.

According to a report published by the Social Policy Evaluation and Research Unit in January, New Zealand has the second-highest teen pregnancy rate in the developed world after the United States.

However, New Zealand rates were found to be declining in all regions except Northland. In 2013, the proportion of all births that were teen births was 5.9 per cent - the lowest ever recorded.

Dr Helen Paterson from the Department of Women's and Children's Health said the rates of both teenage pregnancy and abortion had improved recently, possibly since Jadelle became funded by Pharmac five years ago.

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Long-acting reversible contraceptives had a failure rate of 0.5 per cent , compared to 9 per cent for the Pill, 18 per cent for condoms, and 22 per cent for the withdrawal method, she said.

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"The copper IUD lasts for 10 years, Mirena lasts for five and the implant lasts for five. You go once, and that's you covered for that length of time. They are highly effective."

Dr Neil Pickering from the Bioethics Centre said further research needed to be done to investigate when and how such a programme should be put in place, and what age group would be targeted.

But he envisioned it being an opt-out programme so adolescents would not have to go and seek care.

"We would see it happening as a normal part of a person's health care through school, just in the same way children are vaccinated."

There was no evidence to show that such a programme would encourage teens to become sexually active from a younger age, he said.

"Part of the proposal is that there should be a sex education package attached to this. It's not a matter of teens simply turning up, having a patch stuck on them and then being sent away."

Family Planning chief executive Jackie Edmond said she would prefer to see a range of contraceptives subsidised, and access to comprehensive sexuality education. 

Only around 7 per cent of women under 22 seen by Family Planning clinics used long-acting contraceptives, while 65 per cent used the Pill, she said.

"You want young women to have a lot of choice and conversation around what contraceptive they want to use."

Young men should be encouraged to use condoms regardless of what form of birth control a woman was already on, Edmond said.

"We worry that this again places all the onus on young women around managing fertility when actually this is a dual responsibility."

A Ministry of Social Development spokesman said the Government already provided non-recoverable grants to access contraception. 

Financial assistance towards the cost of obtaining or removing a long-acting reversible contraceptive had been available to beneficiaries and their daughters since 2012.

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 - Stuff

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