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How Shakespeare lowers teen birth rates in Europe

When an English teacher in the Netherlands wants to help students understand responsible sexual behavior, she turns not to a sex education curriculum but to Shakespeare.

"She uses 'Romeo and Juliet' to talk about sexual relationships and what love is," explains Barbara Huberman, director of sexuality education for Advocates for Youth in Washington. "She asks them, 'What do you think would have happened to Romeo and Juliet if she had gotten pregnant or if they had had contraception?' "

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That approach, novel by American standards, is part of a broad-based European approach to adolescent sexual behavior and responsibility outlined at a symposium on Capitol Hill yesterday, hosted by Advocates for Youth. It is one of many ideas Ms. Huberman and others hope Americans can use as they seek to reduce teen birth rates.

Fewer American teens are having sex, and among those who do, more are using contraceptives, according to a report released last week by the Annie E. Casey Foundation in Baltimore. Even so, about 40 percent of American women still become pregnant before the age of 20, adding up to a million pregnancies and nearly half a million births a year.

That gives the United States the highest teen birth rate of any developed country. In the United Kingdom, the rate is about half that of the US. "In the industrialized nations in Europe, there is a much more concerted effort to give young people consistent messages about sexuality," says Debra Delgado, a senior associate at the Annie E. Casey Foundation.

Clear sex-education curriculums in schools, Ms. Delgado adds, are reinforced by "social-marketing tactics" throughout the nation. These include billboards urging teens to protect themselves from pregnancy and sexually transmitted diseases. Young people also have access to free reproductive health services.

During a study tour in the Netherlands, Germany, and France last summer, Huberman and 40 other advocates observed that adolescents there are viewed as assets, not problems, and are expected to act responsibly. Sexuality education is not necessarily a "course" but is integrated throughout school subjects in all grade levels.

Europeans, she says, "also accept that older adolescents are going to be involved in intimate relationships. They prepare young people for using protection. The motto we heard over and over again was, 'I'll have safer sex or no sex.' "

European teens become sexually active a year or two later than American teens. "Our kids start at 15.8," Huberman says. "In the Netherlands it's 17.7."

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In France, an animated series of 20 five-minute segments called "The Joy of Life" features a grandmother teaching children about sex. "It covers everything from conception to what it means to be in an intimate sexual relationship," Huberman says. The segments run on national television and as movie trailers.

Advocacy groups in the US hope to reduce teen birth rates by an additional one-third by 2005. Yet those efforts face challenges.

William O'Hare, Kids Count coordinator with the Annie E. Casey Foundation, notes that the number of 15- to-19-year-old girls will increase by about a million by 2005. "We're swimming upstream demographically," he says. "This increase will disproportionately be among black and Hispanic teenagers, who have higher birth rates than whites. We'll need a one-third cut in the birth rate just to stay even in the number of teen births."

Delgado finds a "growing consensus" that it makes sense to promote a message to young people about the value of delaying sexual activity. Conversely, she says, it also makes sense to tell young people, "If you do have sex, you need to protect yourself."

Although solutions rest on the shoulders of teens, Delgado says, families and communities must be involved. They also need to recognize that "it's not one simplistic strategy that's going to reach all kids and work for all kids throughout their adolescence."

Mr. O'Hare points again to Europe as a model. "It's useful to recognize the sense of what's possible in these other countries," he says. "If they can do it, we can do it, if we put our public will toward that effort."

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