Better education and access to contraception

Both initiatives are helping lower the rate of teen pregnancy in Hamilton

TEEN PREGNANCIES have plummeted in Hamilton over the past decade, mirroring a trend seen across Canada.

Between 2003 and 2015, the rate of teen pregnancies in Hamilton was cut in half, from 38.7 per 1,000 teen girls aged 15 to 19 down to 19.7.

Hamilton’s rate remains above the provincial average, which was 15.8 pregnancies per 1,000 girls 15 to 19 in 2015, the most recent year available. Ontario’s rate was also cut in half between 2003 and 2015.

“I don’t know what’s behind those societal changes but it is palpable,” said Dr. David Price, chair of McMaster University’s family medicine department and founding director of the Maternity Centre of Hamilton. “We’re not seeing the same sort of high volume,” Price said. “It used to be you could be on call overnight and deliver two or three teenagers 16 and under.”

Dr. Ninh Tran, Hamilton’s associate medical officer of health, said there are a number of factors contributing to the decline, including better education and increased use of contraception.

“Right now the trends are driven more by the North American cultural phenomenon of having more open discussion about sex and thinking about things like condoms and birth control pills,” said Tran.

“There’s much more awareness and knowledge about family planning,” Tran added, “whether that happens at the school level, informally through peers discussing things or reading things on the internet or having open and honest discussions with their parents.”

Price said the availability of multiple sources of birth control at family doctors’ offices has helped.

He also speculated that the introduction of the HPV vaccine for girls may have stimulated discussion in families about sexual activity.

“We’ve seen parents of children who are of fairly strong religious persuasion maybe recognizing that birth control is something that’s important for their daughter and encouraging them to seek medical advice,” said Price.

As with a number of social and economic factors in Hamilton, however, there are still significant differences in outcomes when the city is broken into smaller pieces. In postal codes beginning with L8H, L8K, L8L, L8M and L8N, which cover the lower city from Nash Road to about James Street and from the escarpment to the harbourfront, teen pregnancy rates are about twice as high as the Ontario average and 60 per cent higher than Hamilton’s average.

The numbers suggest teen pregnancy rates remain stubbornly high in parts of the city with lower incomes and poorer education outcomes.

“I think where we’re at now is highlighting OK, this is a societal trend, are there differences to this societal trend?” Price said. “Do we need to invest more energy and effort in certain populations?

“Because (in areas) where you’re almost at zero, there’s not much point in investing more resources,” he added. “If there are places that are one or two standard deviations above the mean, that’s where we’re going to get the most bang for our buck.”

“We’ve seen parents of children who are of fairly strong religious persuasion maybe recognizing that birth control is something that’s important for their daughter and encouraging them to seek medical advice.”

DR. DAVID PRICE

Chair, Family Medicine, McMaster University