Failures in sex education drive abortions rise

The advertisements touting 'painless abortions' are dotted across the internet, making it easy for mainland teenage girls to find an underground clinic near where they live.

They usually arrive dressed in their school uniforms so after the operation, they can return directly to class. Once, at a clinic in Nanning in Guangxi , a nine-year-old girl showed up for an abortion accompanied by a 13-year-boy, who told doctors he was the father.

'Doctors laughed when they heard the boy say he was responsible,' says Chen Yiyun, a professor specialising in women's studies at the Chinese Academy of Social Sciences. 'The fact is he's unable to assume any responsibility - he had even stolen the money for the abortion from his father.'

Chen has been collecting data on the sexual behaviour of young people on the mainland, and her studies indicate the number of abortions teenage girls are having has risen sharply in several cities since the mid-1990s. At one major gynaecological hospital in Beijing, they now account for up to half of all abortions. And the age continues to drop.

There are no national statistics on juvenile abortions, Chen says, and any official figures would not give the full picture anyway. Many girls have the procedure at small or underground clinics, where they are afforded anonymity - they do not have register their name or age. But sometimes the procedure fails, and so girls turn to regular facilities, such as the Red House Hospital in Shanghai.

Dr Zhu Zhenying, who works in the hospital's family planning department, says he too has witnessed a rise in the number teenage girls having abortions against a decade ago. 'They come in groups, in their school uniforms, and keep the abortion secret from their parents.'

But aside from the psychological effects of an unwanted pregnancy at a young age, the girls face health risks, Zhu says. Their bodies are still developing and abortions can lead to reproductive complications later on, compared with adult women who have the procedure. 'Medical literature also shows that the earlier a girl starts to have sex, the higher the chance of getting cervical cancer.'

Chen links the growing trend of juvenile abortions to the mainland's policies on sex education in schools, which she criticises as ineffective. Mainland schools began teaching students about sex in the 1990s, but the age at which students begin and the amount of information they are given varies across the nation, often even within a single city. The government's approach to such a crucial issue, one 'linked to the health of future mothers', needs to be overhauled, she says.

Sex education as well as classroom discussion about how to handle romantic relationships should be introduced systematically at the primary-school stage, Chen argued. 'Unfortunately, the Ministry of Education hasn't issued a guideline for these courses and hasn't established programmes to train the related teachers.' In addition, some parents are resistant to exposing their children to ideas about sex at an early age, a stance easy to appreciate given their own very different upbringing.

Amid the paralysis of response, Professor Peng Xiaohui, a sexologist at Central China Normal University in Wuhan , Hubei province , points to Sweden's approach as a model worth following.

Sex education in the Nordic country is carried out within families, schools and communities, as well as by a national network of 'juvenile clinics', which provide free consultation on sexual issues and drugs awareness. While a high proportion of pupils in middle school are having sex, rates of pregnancy, abortion and sexually transmitted diseases all remain low, Peng says.

By comparison, sex education and facilities like juvenile clinics are almost non-existent on the mainland.

Although family-planning and education authorities have issued directives to roll out sex education in secondary schools, details on how to reach the target have not been promulgated, Chen and Peng say.

'Sex education is required by national laws,' Peng says. 'Ironically, in practice, the decision about whether to introduce such courses is up to the heads of the schools or the local education departments. It depends on whether they are interested in it.'

Teachers say students often come to them in a confused state over love and sex, but responding is difficult. Zhao Min, who teaches Chinese at a middle school in Shanghai's Huangpu district, says part of the problem is teachers have little in their past that could help guide them. 'We are helpless and confused, too, when coping with students' problems in this area, because we didn't learn anything in university about sex education.'

Zhao recalls her school once offered a course called 'adolescent psychology' that touched on the topic. At times it was taught by physical-education teachers. But after one semester, the course was scrapped.

Zhao says many junior middle school students are in love, and with pornography so prevalent, young people need guidance early on. 'Often we see boys and girls playing happily together and boys will often touch girls' bodies. Girls won't feel uncomfortable; instead they think it's fun.'

Chen says the responsibility for guidance falls on both schools and families. But Peng suggests that relying on parents may be problematic, saying that 99 per cent of Chinese adults don't know anything about sex education.

In his sex education campaigns in middle schools, some parents raise objections, saying such information will simply lead their children to engage in more sex.

'My answer is that sex-related information is everywhere. It's impossible to quash teenagers' sexual impulses,' Peng says. 'What we need to do is give them understanding and instruct them on what to do.'

1988

The year medical abortions - via medication such as a pill - were legalised on the mainland as a family-planning tool