Getting Pregnancy Risks Right

Just as it’s counter-productive to hype up the risks of STIs it’s also counter-productive to hype up the risks of pregnancy.

Although we want young people to practice safer sex and avoid unplanned pregnancies it’s not good practice to say, or to suggest, that it’s very easy to get pregnant. Authors of this study suggest that the likelihood of pregnancy from one single act of intercourse ranges between 0% and 9% with an average of 3.1%

That’s a lot lower than a lot of young people think and it may be a lot lower than you thought too? But what is the problem of hyping up the risks of pregnancy? What seems to happen is that people have unprotected sex a few times, don’t get pregnant, believe they are infertile, and so continue having unprotected sex.

As the authors of this study conclude “A substantial proportion of young adults believe they are infertile. Improved provider counseling and sex education may be useful in helping them to better understand their actual probability of infertility, and this knowledge may lead to improved contraceptive use.”

So the more we hype pregnancy risks there is a paradoxical risk we discourage people from using contraception. However, hyping pregnancy risks also has other consequences too.

The most frequently asked question I get at BISH is from young people who are worried that they are pregnant – even though the sex they had could not really have started a pregnancy (eg dry humping or masturbation).

They think that there is a risk of pregnancy because some studies found that there were sperm in pre-ejaculatory fluid. This is something that we often talk about in sex education as a way of discouraging practising the withdrawal method or from using condoms incorrectly. This is also an effect from sex negative or abstinence models of sex education which says to young people that all sex is bad and that there are risks to all of it.

However, in this study it was found that only some people had sperm in their pre-ejaculatory fluid and even then it was pretty low.

“Although our pre-ejaculatory samples often contained sperm with equivalent concentration and motility to what would be regarded as fertile in ejaculatory samples, the actual number of sperm in the pre-ejaculates was very low. We are unable to say how this finding might translate into the chances of pregnancy if these samples of pre-ejaculate were deposited in the vagina except that the chances would not be zero. All but one of our pre-ejaculatory samples contained fewer than 23 million sperm, and values as low as this were seen in ejaculatory samples of less than 2.5% of men whose partners conceived in less than 1 year.”

It’s clear from this that there is a risk of pregnancy from penis in vagina sex without ‘full’ ejaculation but that it is much much lower. The risk of pregnancy from non penis in vagina sex from pre-cum is practically zero.

Why is it important to get this right? Well, for one, it’s important to be factual when we are teaching about RSE. I also don’t think it’s very ethical or effective to use fear appeals of pregnancy to prevent young people from having sex. The other reason it’s bad is because it affects young people’s mental health. In these many messages I get from young people they tell me that they can’t sleep, they can’t stop thinking about it, and in some cases they have had suicidal thoughts.

So let’s try to get this right when we’re teaching about contraception. It’s a good idea to use condoms and contraception if we don’t want to get or get someone pregnant. The risks for one time sex are low, but if we have regular penis in vagina sex over time then our overall risk of a pregnancy will be high.

Here are a couple of links from BISH where I write about this

Am I Pregnant?

Fertility Explained

‘Pre-Cum’

First published in the Facebook group I run for teachers

If you want a fun card game to teach about contraception buy my Safer Sex Aces game

For a really great safer sex lesson check out DO… RSE for Schools

© Justin Hancock, 2019