It's OK mum, I'm not pregnant

Why does contraception for teenagers cause such widespread alarm?

TEENAGE SEX is a dangerous issue and no one knows that better than Professor John Guillebaud. Even he, however, was taken aback by the ferocious row he triggered on Tuesday when, as professor of family planning and reproductive health at University College, London, he was reported to have suggested that 10-year-old schoolgirls could be fitted with a contraceptive device that would allow them to be as promiscuous as they chose without any fear of pregnancy.

The moral right reacted with predictable outrage. Life - the anti-abortion organisation - demanded his arrest, while the campaigner Victoria Gillick said that his proposal was tantamount to recommending that young girls be spayed.

Possibly more hurtful for the professor, who is also director of the Margaret Pyke clinic, and has a long and distinguished record of lecturing and writing on matters of sexual health, was the way his friends in the family planning movement also turned on him.

The Brook Advisory Centres for young people accused him of advocating eugenics, and the British Pregnancy Advisory Centre said it was "a dangerous road to go down".

How did this compassionate and thoughtful man find himself embroiled in such an unpleasant row? To understand this, and to draw out the true implications of what he said, it is necessary to go back to the origins of the story and trace its emergence on to the national scene.

Professor Guillebaud made his remarks at a conference held at the Royal Society of Medicine on Friday 22 January. The conference was entitled "Key Advances in the the Clinical Management of Contraception" and, as an expert, he had been invited to set out his vision of the future.

In his speech, he expressed enthusiasm for a new, Dutch-made device called Implanon, a tiny, 50mm rod of hormones that is inserted under the skin of the arm and lasts for three years. It is a refined, smaller version of an earlier device called Norplant and was granted a European licence last December.

Professor Guillebaud suggested that this could be the forerunner of an ideal, forgettable contraceptive that was reversible, had no side-effects and would finally deliver women from the tyranny of having to control their fertility with tricky, ineffective or risky methods such as the pill and the condom.

"What we are striving for is a form of contraception that you can turn on or off as you wish," he said.

Then he added: "In the future, and as a social policy, when you have an area with a huge rate of teenage pregnancies you could go into a school, obviously with the consent of the parents, and fit this device so that everybody would start out not being able to have a baby. It could be fitted into girls once they had had their periods but before they had had sex - for instance, at the time when they were having their rubella jabs."

His remarks were reported in The Observer the following Sunday, 24 January, under the headline "Contraceptive jabs [sic] forecast for children" but failed to elicit a reaction. They were then reported in General Practitioner, the magazine for family doctors, whence they were picked up by the Press Association, which put Professor Guillebaud's views to a range of anti- abortion and right-wing family organisations, which reacted with fury. The story subsequently ran yesterday in most national newspapers and on TV and radio.

In the furore, facts got lost. At the Royal Society of Medicine's conference, Professor Guillebaud had been setting out his vision of the future, not of the present. Nor had he advocated compulsion. Contraception should always be a matter of choice, he said.

Even as a future scenario, his vision is not uncontroversial. What he had tried to do was to look forward to the day, at least a decade hence, when the perfect, reversible contraceptive became available - what he dubbed his "magical brand X" - and to consider how society might react. He acknowledged that medical science was running ahead of social attitudes and that family planning groups were wary of intervening in such a way in the lives of such young people.

"But you can imagine that one day it would seem natural to take this kind of action," he added. Indeed, you can. To me, as the father of a 10-year-old daughter (and teenage sons), the idea of dealing with the mechanics of preventing pregnancy in an efficient and risk-free way has a strong appeal. It would leave parents and teachers free to focus on the emotional context of relationships - the importance of respect, the avoidance of hurt and the value of friendship and love - without being sidetracked by reminders to pack a condom with the taxi fare home.

The fear that easier contraception means easier, more plentiful and more promiscuous sex dominates debate on the moral right. But it is not borne out by the facts. Britain has one of the highest teenage pregnancy rates in the world and the age of first sexual intercourse is dropping. In the Netherlands, where frankness is preferred to ignorance on sexual matters, teenagers begin sexual relationships on average six months later than their British counterparts and their teenage pregnancy rate is lower.

If teenagers feel that there is someone to whom they can take their problems and seek advice, it's more likely they'll be open and confident about discussing sex.

The mechanics of contraception are only one part of sex, but they have a disturbing habit of distracting attention from the relationship that should lie at its heart.