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TEENAGE PREGNANCY PREVENTION
TEENAGE PREGNANCY CARRIES HIGH
COSTS in terms of both the social and economic health
of mothers and their children. Teenage mothers are less
likely to receive prenatal care, and their children are
more likely to be born before term, to have low birth
weights, and to have developmental delays. Teenage mothers
are also less likely to complete their education than
moms over twenty years of age.
Teenage pregnancy and birth rates both dropped in the 1990s among all racial
and ethnic groups. Increased use of contraceptives and increased abstinence among
teens could explain the decrease (Moss*).
However, the U.S. still has the highest rate of teenage pregnancy among western
industrialized nations, 42.9 births
per 1,000 females aged 15-19. In 2002, there were 431,988 births to females under
twenty (Child Trends*). Four
out of ten girls become pregnant by the age of twenty. Eighty percent of these
teenage pregnancies are unintended, and 79 percent
of pregnant teens are unmarried. The birth rate remains high in low-income, minority
neighborhoods, where the birth rate still remains at 153 and 138 births per 1,000
for black and Hispanic teenage girls respectively (Annie E. Casey Foundation [AECF]*). Sixty percent of all teenage
mothers are in poverty at the time
of birth (Moss*).
Teenage pregnancy is linked to several risk factors. Being poor, living in a
single-parent household, child abuse, and risky behaviors such as drug abuse
and early or unprotected sex are all predictors of whether a teenager will become
pregnant (Kirby 1997*; Dillard*).
The three general strategies to reduce teenage pregnancy all try to increase the
factors that protect teens against these risky
behaviors. The first is an abstinence-only approach, which has not been shown
to be effective (Kirby 2001*; Manlove
et al.*). The second is comprehensive
health education or sexuality education that includes information on contraception;
this may delay sexual initiation and increase contraceptive use (Kirby 2001*).
Finally, youth development programs that include sex education along with other
activities (such as volunteering, mentoring, and job training) (Manlove et al.*) are associated with delayed
first sex
and lower teenage pregnancy rates (Kirby 2001*).
Overall, there are no simple approaches; a strategy to reduce teenage pregnancy
must
include sexuality education, strategies for teen pregnancy prevention, and changing
teenage behavior in relationships (Kirby 1997*).
Programs that seek to affect the teenage pregnancy rate should focus on increasing
teens’ assets, such as
knowledge about sex and sexuality and communication skills, that allow them to
approach sexuality responsibly.
Teenage Pregnancy Prevention Program Planning
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First, survey community
resources (number and location of walk-in health clinics,
access to contraceptives, after school youth programs,
etc.) (AECF*). Determine the history of
teenage pregnancy
prevention services in the community and who has been
involved in the issue. Document gaps in resources and
identify potential partners (Brindis and Davis*). |
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Carefully define specific short-
and long-term program goals. Some common short-term
goals include improving adult-youth communication,
improving knowledge of where to get birth control,
and increasing use of birth control and reproductive
health services (Advocates For Youth*).
Long-term goals include delaying sexual initiation,
decreasing
the frequency of sex, lowering the number of sexual
partners, and reducing teenage pregnancy and rates of sexually
transmitted diseases (Brindis and Davis*;
Grossman et al.*).
Avoid narrow goals such as changing attitudes or values
alone; these strategies are not effective
in reducing teenage pregnancy (U.S. General Accounting
Office *). |
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Involve all stakeholders in designing
the program. Often this is a difficult process, especially
if community norms preclude teen sexual activity (Grossman
et al.*).
Although schools and churches are the most difficult
actors to include, it is crucial to
get a range of ideas that include all cultures in a
community (Walker and Kotloff*;
Walker, Watson and Jucovy *;
AECF*;
Grossman et al.*).
Recognize that while there will rarely be a consensus,
it is possible to agree on a common good, such as lower
pregnancy rates (Brindis and Davis*). |
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Plan a role for parents. While some
programs are specifically aimed at improving parent-child
communication, research shows that even improving parent-child “connectedness” is
effective in reducing teenage risky sexual behavior
(Kirby 2001*). |
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Plan from the outset to involve
men and boys. Both are often overlooked in teenage pregnancy
prevention programs (Sonenstein et al.*). |
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Design outreach efforts to recruit
teens via radio spots and flyers placed in malls and
other places where teens gather. Make sure to find
boys through sports teams, the YMCA, etc. (Sonenstein
et al.*). |
Health/Sexuality Education Programs
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Teen education programs
should last for more than two or three sessions (Advocates
For Youth*). Effective programs often run for more
than 14 hours total, or use small group settings for
instruction and discussion. Provide basic, accurate
information, and don’t talk down to teenagers
(Kirby 1997*). |
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Involve parents and work on improving
parent-child communication (Manlove et al.*). Talking
about sex doesn’t encourage kids to have sex;
in fact, teens often rely on their parents to address
the issue (AECF*; Grossman et al.*). |
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Use specific strategies for teenage boys. For example: |
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Train men to teach
teenage boys, and choose trainers who will be role
models—e.g., athletic team coaches (Sonenstein
et al.*). |
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Avoid locating classes
based at clinics or other sources of health care
because boys rarely visit doctors. |
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Don’t reinforce
negative views of males, such as men using girls
for sex or failing to pay child support. |
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Focus on preventing
STDs rather than pregnancy, because STDs are perceived
as a more immediate and tangible threat. |
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Redefine ideas of
manhood to include responsibility for sexual behavior
(Advocates For Youth*). |
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Tailored strategies are needed for
teenagers in different age groups. Written materials
and behavioral strategies should be geared to specific
levels of literacy, physical and emotional development
(Brindis and Davis*). All teens should learn behavioral
skills such as decision-making, refusing to have sex,
and how to bring up contraception in a relationship
(Brindis and Davis 1998*;
Manlove et al.*). |
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For children in elementary and middle
school, programs should stress unambiguously that they
are too young for sexual activity and that abstinence
is the norm (Brindis and Davis*). |
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For adolescents in high school,
peers are the most important influence of whether to
have sex; if they perceive that other teens their age
are sexually active, they are more likely to be as
well (Dillard*). Although peer education programs
are a popular way to address other adolescent issues,
peer sexual education programs have not been rigorously
evaluated (Brindis and Davis*; Manlove et al.*).
Programs should instead address peer influence through
teaching behavioral skills and changing perceptions
(Manlove et al.*). Virginity pledges are a popular
strategy to utilize peer influence to responsible ends;
indeed, students taking pledges delayed their first
sexual experience by about eighteen months. However,
when they finally did have sex they were one third
less likely to use contraceptives (Alford*). |
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Programs for teen mothers should
differ from those for teens without children (Brindis
and Davis*; Manlove et al.*; Kirby
2001*). |
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Clinics can be a valuable partner
in educating teens. Clinics that use one-on-one counseling,
provide accurate information about abstinence and contraception,
and provide contraception, have been shown to increase
contraceptive use without increasing sexual activity
(Kirby 2001*). Be sure the clinic can provide or refer
to mental health and other health services (Advocates
For Youth*). Clinics should provide one-on-one
counseling to teens as well (Kirby*). |
Maintaining Progress
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Follow up on teenagers
who visit clinics for health and contraception services.
Continue outreach; a sustained effort is necessary
to maintain results, because every year brings a new
cohort of adolescents (Kirby 2001*). |
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Develop performance measures based
on your goals and previously mapped community resources.
For example, are community clinics open longer hours?
Are teens delaying when they first have sex, and using
contraception when they do? (AECF*). |
TEENAGE PREGNANCY PREVENTION RESOURCES:
PUBLICATION FINDER
TEENAGE PREGNANCY PREVENTION RESOURCES:
WEB SITE FINDER
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National Campaign to Prevent Teen
Pregnancy
The Campaign is a nonpartisan organization committed
to reducing the national teenage pregnancy rate by one
third between 1996 and 2005. Its web site has a store
of useful materials for practitioners and parents,
particularly research on teen sexual behavior and
its connection to other issues and attitudes. |
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Resource Center for Adolescent Pregnancy Prevention
ReCAPP is a resource site created by Education, Training,
and Research Associates, a nonprofit organization.
It contains teaching
materials and theoretical
materials on teenage pregnancy prevention. |
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Child Trends
Child Trends is a nonpartisan, nonprofit research organization
that tests strategies for improving the well-being
of children. It has research briefs on adolescent sexual
behavior, fatherhood, and marriage. |
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