DR. WALLACE: This past summer my family spent three weeks in Holland visiting relatives. I'm 16 and have never been sexually active, but my two female cousins told me that they have sex with their boyfriends and so do their close friends, but they don't know any girls who have become pregnant.

Ironically, I know several girls who got pregnant and wound up giving birth to the babies. Is there any study available how American teens compare to teens in Europe? I would like to send it to my Dutch cousins. — Tyler, Seattle, Wash.

TYLER: According to a survey conducted by the Guttmacher Institute, the United States leads nearly all other developed nations of the world in rates of teenage pregnancy, abortion, and childbearing. The United States is the only developed country where teenage pregnancy has been increasing in recent years, with the U.S. rate for teens 15 to 19 years of age standing at 96 per 1,000 girls compared to 14 per 1,000 in Holland, 35 in Sweden, 43 in France, 44 in Canada and 45 in England. (These six countries were compared with each other.)

It is notable that the teenage abortion percentage alone in the United States is higher than the combined abortion percentages in the five previously mentioned countries. Those developed countries with the most liberal attitudes toward sex, the most easily accessible contraceptive services for teenagers and the most effective formal and informal programs for sex education have the lowest rates of teenage pregnancy, abortion and childbearing.

France, England and Sweden have a national policy encouraging sex education in the schools. Holland, Canada and the United States leave it up to the individual schools themselves.

The authors of this study concluded that, although the specific approaches used vary from country to country, increasing the legitimacy and availability of contraception and sex education (in its broadest sense) have been effective in reducing teenage pregnancy rates in other developed countries and that there is no reason to believe such an approach would not be successful in the United States.

They note that "American teenagers, at present, have inherited the worst of all possible worlds regarding their exposure to messages about sex. (The media) tell them that sex is romantic, exciting, titillating ... yet at the same time (they) get the message that good girls should say no. Almost nothing they see or hear about sex informs them about contraception or the importance of avoiding pregnancy."

Dr. Robert Wallace welcomes questions from readers. Although he is unable to reply to all of them individually, he will answer as many as possible in this column. E-mail him at rwallace@thegreatestgift.com. To find out more about Dr. Robert Wallace and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.