Six years ago, when the government revealed a programme aimed at halving the teenage pregnancy rate, even the British Pregnancy Advisory Service was sceptical, describing the plans as "about as useful as the Millennium Dome". But an independent study headed by Professor Kaye Wellings, of the London School of Hygiene and Tropical Medicine, has found that the strategy, which combines a national information campaign with coordinated local action to improve services and education, is starting to work.
Progress is slower than the government hoped, but the evidence is clear. In most of the high birth-rate areas, where the teenage pregnancy strategy has focused energy and money, rates of unprotected sex are stable and the teenage birth rate is going down. In more affluent areas, where the strategy has not been widely implemented, the number of young people not using contraception on a regular basis (and the rate of sexually transmitted infection) is actually rising.
Perhaps the most important finding is that sex education works. Girls who have more than 10 sex education sessions are less likely to get pregnant, while boys are more likely to use condoms. Sadly, only a third of the young people questioned had had more than 10 lessons.
Fifteen-year-old girls in England are twice as likely to be sexually active as those in France and Holland, and if they do get pregnant they are more likely to have the baby. Only four out of 10 teenage pregnancies end in abortion in this country, compared with six out of 10 on the continent. In most European countries sex education is compulsory and comprehensive. In Britain it is neither. It is no wonder that those at the sharp end sometimes feel as though they are trying to hold back a flood with their hands.
No doubt some will say they shouldn't bother to try. High teenage pregnancy rates in the UK are nothing new. In the 1960s we were already at the top of the league with Denmark. Teenagers in both countries contributed 50 births per 1,000. Then the pill became widely available, abortion was legalised and young women woke up to the fact that there could be more to life than marriage and motherhood. All over Europe the numbers of teenage mothers plummeted. By the end of the 70s the UK rate had dropped to 30 per 1,000, while Denmark had halved its rate.
But in the UK something very strange then happened. In 1979 Margaret Thatcher was elected and the downward trend stopped. Dead. The levels have since wobbled a bit, rising and falling with each "pill scare", but until now they have barely moved. Rates across Europe, however, continued to decline until they levelled off at less than one third of ours.
What these other countries seem to have grasped is that sex education is more about women's rights than morality; that having a baby at 15 is like trying to climb a mountain with weights on your legs - some may arrive at the top and be strengthened by it, but most will fall by the wayside. While we have been, as Wellings puts it, "stubbornly stuck on risk reduction and the mechanics of sex", European sex education has been dealing with relationships and teaching young people to take care of themselves and each other. Ours is the only country in her study where researchers found "high levels of regret" about early sexual experience. Ours is also the only country where provision of sex education is still mired in "controversy and political resistance" and where young people are subjected to "conflicting and confusing media representations of sexuality".
It has been instructive, as a member of the Independent Advisory Group on Teenage Pregnancy and also as a journalist, to watch national media coverage over the past four years. It is impossible to find a consistent line.
When, for example, the Independent advisory group suggested that sex education should be part of the national curriculum, the advice was interpreted, in disapproving headlines across the whole range of the media, as a controversial call for sex lessons for five-year-olds.
Yet when, two years previously, a wholly inaccurate story appeared saying that the government was launching an abstinence campaign, it was given an equally rough ride. Bizarrely, even newspapers that normally favour a high moral tone poured scorn on the idea. The Express headlined the story: "You can't tell a girl that it's OK to be a virgin". In the face of these confusing messages, researchers found, fear of pregnancy is losing the power that it once had. Fewer young women feel that a teenage pregnancy "is the worst thing that could happen".
Where the government's Teenage Pregnancy Unit has been able to get on with the job of implementing change, unimpeded by political interference and a hostile press, it is making headway. It has not been helped by the fact that no minister has yet found the courage to do the obvious thing: pour money into training for comprehensive and compulsory sex education. If we want our young people to learn how to protect themselves, it is we adults who have to grow up.
