Sept. 3, 2008 -- The revelation Monday that the 17-year-old unmarried daughter of Alaska Gov. Sarah Palin is pregnant has reignited debate over whether sex education programs focusing primarily on abstinence are effective in keeping teen pregnancy rates down.
The campaigns of both Republican John McCain, who on Friday named Palin as his running mate, and Democrat Barack Obama have emphasized that the matter should not be exploited for political ends. But even so, the announcement has the potential to make waves as both McCain and Palin have expressed a commitment to abstinence-only sex education programs.
Specifically, Palin has a record of opposing any school-based sexual education program other than those that adopt an abstinence-only approach. During her 2006 Alaska gubernatorial campaign, Palin responded to a question on sex education programs with the answer, "The explicit sex-ed programs will not find my support."
Palin also opposes the termination of a pregnancy in all cases except when the mother's life is in danger.
Sexual health experts overwhelmingly agree that such programs represent an ineffective strategy in reducing teen birthrates, favoring instead what is known as comprehensive sexuality education. Such programs incorporate advice on using contraceptives and safe sex practices to reduce the risk of unwanted pregnancy and sexually transmitted disease.
"Bristol Palin's pregnancy is another illustration of the need for comprehensive sexuality education," said Stephen Conley, executive director of the American Association of Sexuality Educators, Counselors and Therapists.
"It's a reminder of how, even in strong families where youth are taught to refrain from sex until marriage, teens can make poor decisions," he said. "Teens need the reinforcement of school programs that give them the information and skills they need to take responsibility for their sexual health."
Eli Coleman, professor and director of the Program in Human Sexuality at the University of Minnesota Medical School, agrees.
"This is just another case of the countless teens that become pregnant in this country," he said, adding that the United States has one of the highest teen pregnancy rates in the world.
"Armed with one of the most effective educational systems in the world, the nation's policymakers have chosen to invest in a sexuality education approach that preaches abstinence until marriage," he said. "As a consequence, America's youth have been denied knowledge about how to protect themselves and their partners when they do become sexually active."
On the other side of the debate are groups such as Abstinence Clearinghouse, which maintain that abstinence-only programs work to reduce risky sex behaviors in teens.
Leslee J. Unruh, founder and president of the Abstinence Clearinghouse, says that linking Bristol Palin's situation to the debate on the validity of these approaches is "a cheap shot."
"Abstinence works. It works every single time," she said. "I think it is very unfair to blame the abstinence community and abstinence legislation. ... Blaming sex education for the failures of people who make a mistake is not fair."
Sex Education a Topic of Fierce Debate
The debate over what role the educational system should play in sex education has raged since sex ed programs built around abstinence were first put into practice in 1996. Today, federally funded programs are required to teach that abstinence is the only certain way to avoid unintended pregnancy and sexually transmitted infections, and that a monogamous marriage is the expected standard of sexual activity.
Schools that receive funds are also barred from providing more comprehensive information on contraception or safer sex practices to prevent STDs -- even if nonfederal funds are used for that purpose.
"Since 1996, over $1.5 billion in U.S. tax dollars have been spent on abstinence-only until marriage programs and without having any impact," Conley said. "Governors are paying attention to this huge waste of public money. That's why 25 states, including Alaska -- prior to Gov. Palin's term -- have withdrawn from federal funding under the Title V abstinence-only program."
Wasilla High School, one of the schools that Bristol Palin attended, is one of the country's many schools that promotes an abstinence-based sexual education curriculum. A message left with the school was not returned. But on Tuesday, the Boston Herald reported that Principal Dwight Probasco said the school's sex ed program pushes abstinence, and that the school is barred from distributing contraception.
But Unruh says that the programs cannot necessarily be blamed in the care of Bristol Palin.
"To say that this young woman was given information on abstinence, we can't know that," she said. "If she was, it should have worked. But people make mistakes."
Those on both sides of the issue claim to have research on their side. Proponents of comprehensive sex education for teens point to a study known as the Mathematica study, which suggests that abstinence-only methods are ineffective. Unruh calls the study flawed, noting that the research was performed using a population of teens already at high risk for sexual activity and pregnancy.
Still, other studies also suggest that comprehensive sex education -- which proponents note encourages both abstinence and safe sex if sex occurs -- is more effective than its more abstinence-heavy counterpart.
"There is strong evidence that implementing comprehensive programs can achieve some of the goals of both those who strongly believe young people should abstain from sex and and those who believe young people should use contraception if they do have sex," said Doug Kirby, a research scientist who specializes in studying the effects of sex education on teens.
"On the other hand, we must also recognize that comprehensive sex education programs are not a cure-all," he said. "They reduce sexual risk-taking by about one-third. This is much better than nothing."
Kirby adds that while the Mathematica study and two other studies suggest that abstinence-only programs have little if any effect on sexual behavior, he notes that other research shows very weak evidence that one or two of the abstinence programs used today may delay teens' initiation of sex.
Still, some research suggests that adolescents who take pledges to remain abstinent until marriage do work. On Tuesday, research released by the Journal of Adolescent Health suggested that those age 12 to 17 who make such pledges delay having sexual intercourse longer than other adolescents who are similar to them but who do not take such a pledge.
"Our data suggest that it is a good idea for teens who are inclined to delay sex to make a pledge, because they're more likely to delay sex if they do so," said lead study author Steven Martino, a behavioral scientist at RAND in Pittsburgh, in a press release issued Tuesday.
Isolated Incident, or Example?
Still, sexual health experts maintain that comprehensive sex education is more effective than abstinence-only programs. And they point to Bristol Palin's situation as evidence.
"It is impossible to ignore such a public example of how abstinence education -- even strong parental values -- are not enough to help young people negotiate their own sexual feelings and desires," said Pepper Schwartz, professor of sociology at the University of Washington in Seattle.
"Hopefully, teens will get the message that having sex at a young age at all -- and certainly without protection -- is unwise," said Judy Kuriansky, a clinical psychologist at Columbia University Teachers College. "Hopefully it will make parents wake up to see that their kids are not listening to them ... and as a result they will fall into the same predicament as Bristol Palin, who likely didn't use protection because that would have been really against her mother's approval."
But Unruh says it should be parents -- not educators -- who should talk to children and teens about sex.
"The fact is that it is a private matter," she said. "We think 'family first,' and we think that parents are the primary sex educators of children. But children will make their own decisions."
"We don't know the whole story. ... In this case, nobody has heard her story."
Michelle Schlief contributed to this report.