Combating Teen Pregnancy There’s Been Progress, but Much Work Remains to Be Done

May is National Teen Pregnancy Prevention Month, designed to increase public awareness and commitment to teen-pregnancy prevention. Its message? Teen pregnancy and early childbearing carry tremendous emotional, physical, and financial ramifications for parents, children, and the community.

Every year, one in three students does not graduate from high school in the U.S. It’s a crisis that is even more severe among minority students. Yet, as we seek to solve this growing problem, there is an important piece to the puzzle missing. As federal, state, and local officials, along with community and business leaders, philanthropists, and others, develop strategies that will help reduce these troublesome dropout rates, they are neglecting to look at the role too-early pregnancy and parenthood play in the problem. For example, only about 50{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of teen moms receive a high-school diploma by age 22.

Preventing teen pregnancy also plays an important role in the economic recovery of our region. High teen-birth rates impact workforce development, costing nearly $11 billion a year in the U.S. for taxpayers, and create higher health care and education costs.

Prevention is also a tool to address child poverty and its associated symptoms. Studies have shown that children of teen mothers tend to have low school achievement, more health issues, are incarcerated during adolescence, have their own children as teenagers, and face unemployment at a young age.

Research has shown that high rates of teen pregnancy and teen birth rates cannot be solved by one person, program, policy change, or organization. When addressing the sexual health of our children, every member of the community has a role in creating sustainable solutions to teen pregnancy. We need a comprehensive approach that will involve the combined efforts of schools, policy makers, medical providers, businesses, funders, faith and community organizations, and especially parents.

First, the good news. In April, a report by the National Center for Health Statistics reported the number of teen births in 2010 was the lowest since 1946. They credited “strong pregnancy-prevention messages” and noted contraceptive use “may have contributed.” Still, the U.S. lags behind other countries, such as the United Kingdom and Canada, whose birth rates are substantially lower. But, locally, we have our own story to tell.

Holyoke and Springfield consistently rank among the cities in Massachusetts as having the highest teen birth rates. In 2009, Holyoke had the highest teen birth rate in the state for the seventh year in a row (96.8 births per 1,000 girls ages 15-19), while Springfield ranked fourth (72.1). Both cities have large disparities in teen birth rates given their populations. In Holyoke, the white teen birth rate in 2009 was 26, and the Hispanic teen birth rate was 132 — five times the rate for white teens. In Springfield, meanwhile, the white teen birth rate was 18, and the Hispanic teen birth rate was 132 — more than seven times the rate for white teens. The black, non-Hispanic rate was 59 — more than three times the rate for whites.

The causes of high teen birth rates are many, involving multiple risk and protective factors such as access to sexual-health education, access to condoms and contraceptives for sexually active youth, and how an adolescent sees his or her future — either one filled with opportunity or the feeling that a bright future is out of their reach.

To help our children protect their dreams, the community must be set on the right path to transforming how we address adolescent sexual health and permanently reducing teen pregnancy and sexually transmitted diseases. With this understanding, the Youth Empowerment Adolescent Health (YEAH!) Network — which advocates for the implementation of policies, programs, and services to improve the sexual health of youth in Hampden County — partnered with the statewide Massachusetts Alliance on Teen Pregnancy to compete for a Centers for Disease Control and Prevention grant to support a community-wide initiative to prevent teen pregnancy. Called the Youth First Initiative, it brings together community teams to develop solutions to teen pregnancy using local data to drive decision making.

Also, mayor-appointed task forces, called the Springfield Adolescent Sexual Health Advisory and the Holyoke Adolescent Sexual Health and Teen Pregnancy Prevention Task Force, were recently created to address the high rates of teen births and sexually transmitted infections among youth in both Springfield and Holyoke.

In addition to a comprehensive sex-education curriculum that has been implemented in Springfield public schools, the school system has taken a preventive and responsible role in improving the health of their students, so that they can focus on their education. Leaders who understand that addressing teen pregnancy also is a strategy to reduce the dropout rate proposed a policy to make condoms available, not freely distributed, through the school nurse only to students who choose to be sexually active.

This practice would allow youths who are sexually active to see a health professional and receive education on abstinence, counseling, and instructions on the proper use of a condom, as long as a parent hasn’t opted their child out of the program. Hopefully, after speaking to the school nurse, the student may change their mind and choose not to be sexually active and not need a condom. However, if they still choose to be sexually active, they would now be able to protect themselves and others from sexually transmitted infections or pregnancy.

The new policy, which was approved by the Springfield School Committee in April, will go into effect in September for students age 12 and older in the middle and high schools. The policy is based on research of condom-availability policies in public schools throughout Massachusetts and the country. Dr. Laura Koenigs, a pediatrician in Baystate Adolescent Medicine at Baystate Children’s Hospital, co-authored a study that compared the rates of sexually transmitted infections among teens in Holyoke before and after their implementation of a condom-availability policy. The study found that, within three years of implementing a condom-availability policy, in Holyoke’s middle and high schools, the rate of gonorrhea and chlamydia decreased by 47{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} among boys 15-19 years old — a substantial drop that highlights the impact of policy on health outcomes.

Also, working with teens as director of the YEAH! Network, I like to tell them that, in order to protect their future goals, they must protect their health. They must empower themselves with the knowledge they need to make healthy choices in their lives, including learning about their sexual health and having access to quality sexual-health services. But the most important contraceptive is for teens to envision their future and be relentless in their efforts to protect their dreams.

We still have much work to do, but the new national birth rates for teens — among the lowest in history — serve as a reminder that the more education and tools children and youth have about their sexual health, the better they will be empowered to make healthy decisions and prevent early sexual activity that can lead to long-term consequences to their health and their future prosperity.

As we continue to strive as a community toward lower teen birth rates, I encourage parents to consider the following tips provided by the National Campaign on Teen and Unplanned Pregnancy to help prevent their children from becoming a statistic.

• Be clear about your own sexual values and attitudes;
• Talk with your children early and often about sex, and be specific;
• Supervise and monitor your children and adolescents;
• Know your children’s friends and their families;
• Discourage early, frequent, and steady dating;
• Take a strong stand against your daughter dating a boy significantly older than she is. And, don’t allow your son to develop an intense relationship with a girl much younger than he is;
• Help your teenagers have options for the future that are more attractive than early pregnancy and parenthood;
• Let your kids know that you value education highly; and
• Know what your kids are watching, reading, and listening to.

These tips for helping your children avoid teen pregnancy work best when they occur as part of strong, close relationships with your children that are built from an early age. v

Dr. Sarah Perez McAdoo, who formerly saw patients as a member of the department of General Obstetrics and Gynecology at Baystate Medical Center, now devotes her full-time efforts to community health, especially in the area of teen-pregnancy prevention, as director of the YEAH! Network.