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Sun August 19, 2012

Teen Pregnancy Declines, But U.S. Still Lags Behind

Originally published on Sun August 19, 2012 3:20 pm

Roxana Castro sits in an orange chair in the waiting room at Mary's Center in Washington, D.C. She's 17, and expecting a baby boy next month. The pregnancy was a surprise, she says, mostly for her parents, but also for the baby's father.

Even with her mother's help, Castro admits she's nervous. The father of the baby says he'll be there, but she knows this is a big responsibility, and says she's not ready to start a family just yet.

"A baby is so fragile," she says. "I don't know how to take care of it or anything."

The U.S. teen pregnancy rate is the highest in the developed world. In 2008, nearly 7 percent of girls between ages of 15 and 19 became pregnant. But there's good news: The numbers have been going down for a few decades, hitting a 42-percent drop by 2008. The decline occurred across all races — though blacks and Latinos continued to have higher numbers.

The dramatic decline is a huge success for those who have worked to prevent teen pregnancy, but there's still much work ahead.

Prenatal Care – And Preventive Action

Last year, Mary's Center worked with nearly 200 prenatal-care patients under 19 years old.

Bernadete Aldrich is one of the first people who talks with the girls who walk through the doors. She sees three or four pregnant teens every week.

"A lot of them come, unfortunately, in the end of pregnancy, so they would not have prenatal care," she says. They come because they're afraid. "They are afraid of parents, or society or school. They hide as much as they can. They need a lot of information."

Mary's Center offers counseling and other services to pregnant teens, but what they're most proud of here is their after-school program.

Franchesca Medina, 17, has been coming to the after-school program for a few years.

"We do homework, workshops, we have fun — we watch movies," she says.

And they talk about sex. Franchesca isn't shy about how she prevents pregnancy.

"Condoms," she says. "And also, I'm wearing the patch."

U.S. Lags

"Teens have really done a terrific job," says Sarah Brown, the CEO of the National Campaign to Prevent Teen and Unplanned Pregnancy. "They are having less sex, and those who are having sex are using better forms of contraception."

Brown calls the ongoing decline in teen pregnancies a profound change – and last year's change absolutely surprising.

"The teen birth rate last year went down 9 percent," she says. "That is the single-largest one-year decline that's ever been noted since we started counting, I don't know, in the Truman administration."

Even so, the teen birth rate in America is still higher than every other developed country – three times higher.

"I think the primary explanation is not that they have ... fewer teens having sex, but U.S. teens are not as good ... at using good contraception," Brown says.

Someday, though, Brown says the U.S. can achieve the same figures as those other countries.

"I see no reason why we can't get there, but we'll have to focus on these things we've been talking about — sexual activity, contraceptive views, relationships, cost of contraception and how that affects choices," she says. "And all these things have been dealt with, to greater or lesser success, in some of these countries that have lower rates."

Preventing The Slide Into Poverty

There's a connection between teen motherhood and poverty that's often the subject of debate. The conventional wisdom is that a teenage girl has a baby young, maybe out of wedlock, and that is the start of a fall into poverty. New studies, however, say it is actually a lack of economic opportunity that leads teens to pregnancy. Brown says it's both.

"Teen pregnancy often is a continuation of a pattern in a family or in a neighborhood where a lot of young women have had babies at a young age," she says. "But I think the answer is that by postponing pregnancy and childbearing till an older age, these young women have a chance to escape poverty — but it's not assured."

That's one reason learning about contraception is only part of Mary's Center's strategy to prevent unplanned pregnancies.

"We just keep them busy," says Lydia Casmier-Derfler, who helps coordinate the teen program.

"We keep them busy with college prep, we keep them busy with tutoring, learning about financial management, so on and so forth, and so instead of being in the streets," she says, "they're here at Mary's Center instead."

Mary's Center is happy with its results. Last year, more than 100 teens participated in the after-school program, and not one became pregnant. Places like Mary's Center have helped to lower Washington, D.C.'s teen pregnancy rate. Still, the decline of teen pregnancy rates in the city over the past three decades is only half of what's been seen nationwide.

A Cultural Shift

One state that has long struggled with high rates of teen pregnancy is Mississippi. It used to be that sex education was not required in Mississippi school districts, and abstinence was the state's official policy.

Last summer, the state legislature voted to give school districts the choice of adopting a new policy called Abstinence Plus. A group called Mississippi First is trying to get school districts with the highest birth rates to adopt it.

"Many people don't realize that almost every single county in Mississippi has a teen birth rate that is higher than the national average," says Rachel Canter, the group's executive director. Some counties have a rate of about 111 teen births out of every 1,000 girls, she says.

The response has been encouraging; 35 school districts said they wanted to sign onto the Mississippi First program.

"One of the things that I think really helped people was seeing how bad the data really was," Canter says. "Also, there was a poll that came out that showed that 92 percent of public school parents in Mississippi support sex-ed in public schools, and I think that really changed the perception that a lot of people in politics had about whether or not parents were really supportive of this idea."

Altogether, the data and the response represent a cultural shift for the state, Canter says.

We've had these high teen birth rates for a very long time, but it was the type of issue that people didn't want to touch with a 10-foot pole, because they thought that everyone else wouldn't want to talk about it."

Not anymore, she says.

"I'm in my 30s; people in my generation have a different orientation to a lot of these issues," she says. "So many of our peers had babies as teens, we don't want it to happen to our children."

Copyright 2012 National Public Radio. To see more, visit http://www.npr.org/.

Transcript

CHERYL CORLEY, HOST:

It's WEEKENDS on ALL THINGS CONSIDERED from NPR News. Guy Raz is away. I'm Cheryl Corley.

The U.S. teen pregnancy rate is the highest in the developed world. In 2008, nearly 7 percent of girls between the ages of 15 to 19 became pregnant. But here's the good news: The numbers have been on the decline for a few decades, hitting a 42 percent drop by 2008. The decline occurred among all races, although black and Latinos continue to have higher numbers. Our cover story today: Progress in the effort to prevent teen pregnancy and the steps ahead.

In a moment, we'll talk about why there's been such a dramatic decline. First, NPR's Lauren Silverman takes us to Mary's Center, a clinic in Washington, D.C., dedicated to preventing teen pregnancy.

UNIDENTIFIED MAN: Now serving A020...

LAUREN SILVERMAN, BYLINE: Roxana Castro is sitting in an orange chair in the waiting room at Mary's Center. She's 17, and next month, she's expecting a baby boy.

ROXANA CASTRO: (Foreign language spoken)

SILVERMAN: She says it was a surprise, mostly for my parents, but also for the father. When Roxana moved here from El Salvador two years ago, she was expecting to finish high school.

CASTRO: (Foreign language spoken)

SILVERMAN: I got stuck in the 11th grade, she says. I only had a year left. Roxana won't be the first in her family to have a baby as a teenager.

CASTRO: (Foreign language spoken)

SILVERMAN: She says my mom was 17 when she had me, the same age. Even with her mom's help, Roxana admits she's nervous. The father of the baby says he'll be there, but she knows this is a big responsibility, and says she's not ready to start a family just yet.

CASTRO: (Foreign language spoken)

SILVERMAN: She says a baby is so fragile. I don't know how to take care of it or anything. Last year, Mary's Center was working with nearly 200 prenatal care patients under 19 years old.

BERNADETE ALDRICH: I am the leader of the Department of Social Services.

SILVERMAN: Bernadete Aldrich is one of the first people who talks with the girls who walk through these doors. She sees three or four pregnant teens every week.

ALDRICH: A lot of them come, unfortunately, in the end of pregnancy, so they would not have prenatal care, because they're afraid. They're afraid of parents or society or school. They hide as much as they can. They need a lot of information.

SILVERMAN: Mary's Center offers counseling and other services to pregnant teens, but what they're most proud of is their after-school program.

FRANCHESCA MEDINA: My name is Franchesa Medina, and I'm 17.

SILVERMAN: Franchesca has been coming to the after-school program for a few years.

MEDINA: We do homework, workshops. We have fun - we watch movies.

SILVERMAN: And they talk about sex. Franchesca isn't shy about what she does to prevent getting pregnant.

MEDINA: Condoms. And also, I'm wearing the patch.

SILVERMAN: Learning about contraception is only part of Mary's Center's strategy to prevent unplanned pregnancies.

LYDIA CASMIER-DERFLER: We just keep them busy.

SILVERMAN: Lydia Casmier-Derfler helps coordinate the teen program.

CASMIER-DERFLER: We keep them busy with college prep, we keep them busy with tutoring, learning about financial management, so on and so forth. And so instead of being in the streets and following their friends wherever their friends may go, they're here at Mary's Center instead.

SILVERMAN: And they're happy with the results. Last year, over 100 teens participated in the after-school program, and not one became pregnant. Places like Mary's Center have helped to lower Washington, D.C.'s teen pregnancy rate. Still, the city's decline over the past three decades is only half of what we've seen nationwide.

CORLEY: That's NPR's Lauren Silverman. Sarah Brown, the CEO of the National Campaign to Prevent Teen and Unplanned Pregnancy, calls the ongoing decline in teen pregnancies a profound change - and last year absolutely surprising.

SARAH BROWN: The teen birth rate last year went down 9 percent. That is the single largest one-year decline that's ever been noted since we started counting, I don't know, in the Truman administration.

CORLEY: Brown says it's impossible to know what's behind that number, but she's sure of one thing.

BROWN: Teens have really done a terrific job. They are having less sex, and those who are having sex are using better forms of contraception.

CORLEY: So we have a situation where teen births in America is way down, but the rate is still higher than every other developed country.

BROWN: That's right. Our sort of major trading partners. And I think the primary explanation is not that they have many fewer teens having sex, but U.S. teens are not as good, when they're having sex, at using good contraception.

CORLEY: So, what specifically do you, your organization, tell young people as you try to educate them about avoiding pregnancy?

BROWN: Well, we try to communicate to teens as well as their parents and others, too, that getting pregnant and having children is one of the most important things that anybody does at any age in their lifetime. As a general matter, like most Americans, we recommend that teens postpone having sex.

I've never met anybody who thinks it's just fine if a 13 or 14-year-old boy or girl is sexually active. But when they do become sexually active - and we hope that's as they get closer to adulthood and preferably in a stable relationship - that they are very, very careful about contraception. They really must avoid pregnancy and, of course, STDs as well.

CORLEY: So these are conversations that are had with both girls and boys?

BROWN: Absolutely. You know, the old phrase it takes two to tango. But it is the young women who become pregnant and bear the children and often are sort of left as single mothers, especially if they're teens. And the vast majority of contraceptive methods are used by women. Now, it is also true that men can be supporters. They can be good partners. But at the end of the day, the women seem to have the most at stake.

CORLEY: The conventional wisdom is that if a teenage girl has a baby, maybe out of wedlock, maybe not, but that's the start of a fall into poverty. There are new studies, though, that say it's actually a lack of economic opportunity that leads teens to pregnancy. So, which one is it?

BROWN: Well, I think it's actually both. Teen pregnancy often is a continuation of a pattern in a family or in a neighborhood where a lot of young women have had babies at a young age. But I think the answer is that by postponing pregnancy and childbearing till an older age, these young women have a chance to escape poverty - but it's not assured.

Simply postponing a pregnancy by a year may not change the outcomes, especially for the poorest and most disadvantaged young women. And I think in this economy, which we all see is so tough, thinking about the dollars and cents here is critical. You know, we used to encourage both young men and women to at least get a high school education. We now know that they really need even more than that. We should see anything that gets that derailed as a serious economic problem.

CORLEY: In recent years, teen parents are often in movies, they're on reality TV. TLC just launched this new teen mom show. Do these shows kind of glamorize teen pregnancy, or are they encouraging teens to wait to become pregnant?

BROWN: Well, the best way to answer that is to talk to teens who've watched these shows, and we've done that a lot. These shows are reality shows. They're not scripted, and the young people as well as adults who watch this, they come away and they almost all say, oh, my goodness. I never really got how gritty and hard and upsetting it was to be pregnant, to be a young parent.

CORLEY: Do you expect some day that the figures that we have in the United States will equal what we see in other industrialized or Western countries?

BROWN: I see no reason why we can't get there, but we'll have to focus on these things we've been talking about: sexual activity, contraceptive use, relationships, cost of contraception, how that affects choices. And all these things have been dealt with to greater or lesser success in some of these countries that have lower rates.

CORLEY: That's Sarah Brown, CEO of the National Campaign to Prevent Teen and Unplanned Pregnancy. One state which has long struggled with high rates of teen pregnancy is Mississippi. Rachel Canter is the executive director of Mississippi First, a group targeting the issue. Canter grew up in Mississippi.

RACHEL CANTER, EXECUTIVE DIRECTOR, MISSISSIPPI FIRST: When I was in seventh grade, actually, there was a girl who sat next to me in social studies who was pregnant, and I knew several girls in high school who got pregnant. Some of which didn't finish high school and had to go back and get a GED later.

CORLEY: It used to be sex education was not required in Mississippi school districts, and abstinence was the state's official policy. Last summer, the state legislature voted to give school districts the choice of adopting a new policy called abstinence-plus. Rachel Canter says Mississippi First is trying to get school districts with the highest birth rates to adopt it.

FIRST: Many people don't realize that almost every single county in Mississippi has a teen birth rate that is higher than the national average. So we're looking at some counties that have a teen birth rate of about 111 teen births out of every 1,000 girls. So we took five sexual health indicators, so three sexual health indicators about teen pregnancy and two about STDs. And we said if you hit three of these five indicators, you're going to be in the top priority counties. So there were about 17 of those counties, and within those 17 counties, 33 school districts.

CORLEY: So, Rachel, as Mississippi First went into these communities to talk about your program and to talk about the data, what kind of response did you get?

FIRST: We reached about 80 percent of the school districts that we wanted to reach. We even had school districts that were outside of our priority targets that contacted us. So all told, we had 35 school districts that said they wanted to sign on.

One of the things that I think really helped people was seeing how bad the data really was. And then also, there was a poll that came out that showed that 92 percent of public school parents in Mississippi support sex ed in public schools, and I think that really changed the perception that a lot of people in politics had about whether or not parents were really supportive of this idea.

CORLEY: When you talk about Mississippi, we think of it as, of course, as a Bible Belt region, and because of that, there might be resistance to sexual education. Is this a shift in attitude in the state?

FIRST: We've had these high teen birth rates for a very long time, but it was the type of issue that people didn't want to touch with a 10-foot pole, because they thought that everyone else wouldn't want to talk about it. And I think as we've persisted and the rates have just stayed so high, there has been a cultural shift.

I'm in my 30s and people in my generation have a different orientation to a lot of these issues. We've seen it in television. We've seen it on the Internet growing up. And now, we are the ones having children in public school. In our own generation, so many of our peers had babies as teens, we don't want it to happen to our children.

CORLEY: That's Rachel Canter, executive director of Mississippi First. And one last economic note: Despite the strides made in reducing teen pregnancy, it's still about an $11 billion cost to the country. Transcript provided by NPR, Copyright National Public Radio.

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