T O P I C R E V I E W
Member # 29754
posted 05-06-2011 04:35 PM
Let me start out by saying that I love the work you all do. As far as I'm concerned, you're the best sexuality information site on the web. I find the focus on informed decision-making and agency for young people to be especially impressive, as the majority of other sexuality information presented to young people (really, older people too) is burdened with implicit or even explicit behavioral directives. In a way, that makes this issue all the more striking to me. (Also, I'm going to be using the phrase "pregnancy risk"; while this has a somewhat negative connotation for how pregnancy is viewed, it seems to be the most appropriate phrase when discussing pregnancy in the context of efforts to not become pregnant.)
You get a lot of questions about pregnancy risks from a given event/behavior/situation someone has experienced/engaged in. In many of these cases, the Scarleteen experts have a tendency to vastly exaggerate the pregnancy risks. I'll illustrate this with an example (I'm not picking on September here; I've seen this plenty of times): http://www.scarleteen.com/forum/ultimatebb.php?/ubb/get_topic/f/27/t/025753.html September compares the pregnancy risk here with mostly-non-penetrative genital-genital contact to that from the withdrawal method, which I agree is probably the best comparison for which there are widely accepted data. The problem is that sie cites a risk between 4% and 25% for this single instance of unprotected genital-genital contact. First, including the typical use statistic in this instance makes no sense, as this is representative of perfect use - no ejaculation in the vagina (typical use for withdrawal is imperfect use i.e. it includes all of the times where, for couples using withdrawal as their sole method of birth control, the male partner fails to withdraw/withdraw completely before ejaculation). The bigger problem (the one I see happening with frequency) is that September is asserting the yearly pregnancy risk as representative of the risk associated with a single instance, which is a wild misrepresentation. I'd have to have access to the data on the number of times each couple engaged in potentially-pregnancy-causing activities before the woman became pregnant for any given method to calculate the precise pregnancy rate for a single instance of sexual activity, but if we assume that the couples polled for the statistics had pregnancy-potential sex twice a week on average for the year, the risk from a single instance of penis-in-vagina intercourse where withdrawal is used is closer to .04% than 4% (as 96 out of every 100 women would have had pregnancy-potential sex using withdrawal over 100 times in that year without becoming pregnant), not controlling for the point in the woman's fertility cycle at which the sexual activity took place. For the 4% risk for that single activity to be an accurate metric, 4 out of every 100 women would have to become pregnant after a single instance of penis-in-vagina intercourse where withdrawal was used. That doesn't happen; citing the yearly figure is inflating the risk by as much as a couple hundred times (again, it's impossible to be sure without actually counting the number of times couples have sex, which we don't do because controlling for factors like how far apart the sexual activities are spaced and when they occur in relation to fertility cycles would make it nearly impossible to derive generalizable, useful statistics). My numbers and the specification of the risk rates as yearly are taken from Planned Parenthood here: http://www.plannedparenthood.org/health-topics/birth-control/withdrawal-pull-out-method-4218.htm Obviously it's a good idea to encourage young women who have engaged in behaviors with the potential to cause pregnancy to get tested for pregnancy, such that they will have plenty of time to weigh their options if they do, indeed, become pregnant. Too, it's good to encourage young men and women who do not wish to reproduce at any given point in time (or ever) to take steps to reduce their chances of doing so. However, misrepresenting pregnancy risk is not an ethical strategy for achieving these ends. My guess is that this isn't an intentional misrepresentation, but it is widespread enough in the expert responses that I find it concerning. I think a better way to respond to these kinds of questions would be something like: "We don't know the pregnancy risk presented by a single instance of activity/behavior X; the yearly rate is [yearly rate]. Given that most couples who have potentially-pregnancy-causing sex do so more than once a year, you risk is going to be lower, probably a lot lower. That said, behavior/activity X does pose a pregnancy risk, and if you're not comfortable with that, you should obtain EC (if still within the effective period) or get tested for pregnancy (if outside the effective period for EC). You may also wish to take steps to further reduce your pregnancy risk in the future (and STI risks as well) - check out our contraceptive information." Pretty much the same information, but with a more accurate representation of the pregnancy risk.
Member # 36725
posted 05-06-2011 06:19 PM
Johann7: As always, Scarleteen strives to ensure that the services we offer are accurate and appropriate, and part of that is and ideally should be listening to our users about the information posted. However, we also ask that those critiques/ concerns/ complaints be submitted in certain ways. In the user agreements you signed upon becoming a user here, it states, quote: If you have a concern or complaint to lodge with our staff regarding any aspect of Scarleteen or its boards, it should be sent via e-mail or posted in the Staff Stuff area of the boards. I'm going to go ahead and leave a message in the staff area so that this post can be seen - but also so that it can be moved to a more appropriate area of the boards.