Teen Pregnancy: The Question of Prevention

The issue of teenage pregnancy has been in the news lately due to a 3% increase in teenage mothers giving birth in 2006 after a steady 14 year decline, according to an article in U.S. News & World Report (Kotz, 28). This increase has occurred only after the Bush Administration has pumped money into "abstinence-only" sex education, and refused funding for school districts that teach a sex-ed program that includes contraception. Research shows that lowering teen pregnancy rates is achieved by a more comprehensive sex-ed curriculum, which includes abstinence, contraception, self-esteem building and good decision making skills. More funding is needed in low income minority communities to implement these programs, because teenage pregnancy is significantly more prevalent than in higher income white communities.

President Bush has created a $74 million fund for abstinence-only sex education, "available only to schools that exclusively promote abstinence - contraception can be mentioned only in terms of its fallibility," as stated in an article published in New Statesman (O'Keeffe, 26). 35 states have now adopted these programs. Some states, however, have actually refused funding because they would not comply with Bush's directives. An article in Humanist notes that New Jersey, California, Connecticut, and Maine have refused to replace their comprehensive sex education programs for an abstinence-only one (Bruggink, 4). According to the American College of Obstetricians and Gynecologists, "In 2002, only 62% of sexually experienced teens had received instruction about contraception before they first had sex, compared with 72% in 1995" (Costello, 5). They go on to point out that, teens who attend abstinence-only sex-ed classes are no more likely to abstain from sex than those who never attended sex-ed class at all (6). This information can be disturbing for parents of teenagers who attend schools that promote abstinence-only, and the taxpayers involuntarily contributing to a program that no one is really sure if it works.

Humanist goes on to point out more unsettling information while citing a study released by California Congressman Henry Waxman in 2004:

...over 80 percent of abstinence-only curricula supported by the department of Health & Human Services (HHS) contained false, misleading, or distorted information about abortion, contraception, and gender roles, and routinely presented religious beliefs as scientific fact (Bruggink, 5).

It's almost is if they are using guilt and scare tactics to try to persuade teens to abstain from sex, and its all approved by the Federal Government.

Abstinence-only groups are misguidedly preaching against condom use as well. Dr. Trevor Stammers, a senior tutor at St. George's Hospital, London, who has written extensively on sexual health, claims in New Statesman that:

...sexual health campaigns have deliberately downplayed the fallibility of condoms on the basis that any doubts about their effectiveness would trigger a rise in HIV. "But HIV is the tip of the iceberg in terms of sexually transmitted diseases," he says, "Aids is fatal... and condoms offer no protection" (O'Keeffe, 27).

According to Humanist:

Despite repeated and conclusive evidence showing that condoms available in the United States don't have holes (if they do, the entire batch is discarded), and that the real reason for error is improper use, not product defect,

However, Uganda has adopted a program called the "ABC approach" to reducing HIV: "Abstain (from sex), Be faithful (one partner), and Condom use (every time)." As a result, HIV rates have dropped from 21 percent in 1991 to 10 percent in 1998 according to New Statesman (O'Keeffe, 27). So who are we to believe: the opinion of one doctor or the results of a program in place for years in an entire country?

As with almost everything, finding a middle ground is the key to lowering teen pregnancy rates. A comprehensive program that teaches abstinence, contraception, and basic life skills is most successful in reducing teen pregnancy rates. The American College of Obstetricians and Gynecologists outlines the characteristics of a successful sex education program:

1. Focus clearly on reducing one or more sexual behaviors that lead to unintended pregnancy

2. Maintain age-appropriate and culturally relevant behavioral goals, teaching methods, and materials that coincide with the sexual experience level of the participants

3. Utilize theoretical approaches that have demonstrated effectiveness at reducing other health-related risky behaviors, such as social learning theory, social inoculation theory and cognitive behavioral theory*

4. Allow sufficient time for presentation of information and completion of activities

5. Involve the participants to personalize the information being presented

6. Provide basic and scientifically accurate information about the risks of engaging in sexual intercourse without protection, and about ways to avoid participating in unprotected sexual intercourse

7. Address social pressures to engage in sexual activity

8. Model communication, negotiation, and refusal skills

9. Select teachers or peer leaders who are committed to the program and provide training to help them facilitate the program

10. Give and continually reinforce a clear message about abstaining from sexual activity and/or using birth control. (This appears to be one of the most important components of effective sexuality education programs.)

*The social learning theory teaches that an adolescent's decision to use birth control is determined by an understanding of what must be done to avoid pregnancy, a belief that he or she will be able to use the method and that it will prevent pregnancy, and an anticipation of the benefit from accomplishing the behavior The social inoculation theory suggests that adolescents can develop a resistance to sexual pressures if provided with the skills and desire to do so. The cognitive behavior theory holds that you h must be taught decision-making and assertive communication skills to manage interpersonal encounters successfully (Costello, 6).

Long term commitment from parents and faculty, and of course funding, is crucial to a program like this to work.

Race and family income play a key role in whether or not a teenage girl becomes pregnant as well. The Center for American Progress stated that in July, 2008:

...the National Campaign to Prevent Teen Pregnancy hosted a congressional briefing on the racial and ethnic disparities in teen pregnancy rates. The research revealed that while 19 percent of white girls will become pregnant during their teen years, 53 percent of Latina and 51 percent of African American girls will do so. These facts demonstrate the significant need to develop culturally competent community and school based projects to educate teens on the consequences of teenage pregnancy,

The American College of Obstetricians and Gynecologists also states that family income has some impact on sexual behavior. Girls whose family income is below poverty level are more likely to become sexually active before the age of 20 than girls above the poverty level. Lower income girls are also less likely to use contraceptives, or use them properly, than their higher income counterparts (Costello, 4)

So what's the answer? Standardization of sex-ed curriculum nationwide to include abstinence, contraception, and skill building to raise girls self esteem in this emotionally tumultuous time, would be a good place to start. State by state, everyone's teaching something different. Those who take Bush's money can only teach abstinence, those who refuse can teach what they want. But where is the funding for the low income Latina or African American girl, who may not have a sex-ed class available at all, and is pressured into having sex by her boyfriend who says he "loves" her? Are we to say that manipulating teens with guilt and misleading information is morally and ethically right thing to do just because the state gets money for teaching it? Or should we continue the comprehensive sex-ed that has been used for years, that teaches abstinence along with contraception, and has contributed to the 14 year decline in teen pregnancy, before the increase in 2006? The old expression, "If it ain't broke, don't fix it," comes to mind. If a teenager is going to have sex, there is not much we can do to stop them, but we can teach them to be safe.

Works Cited

Bruggink, Heidi. "Miseducation: The Lowdown on Abstinence-Only Sex-Ed Programs."

Humanist 67.1 (Jan, 2007): 4-6. ContentSelect Research Navigator. EBSCO. Maag Library, Youngstown, OH. 7 Sep. 2008

Costello, Cindy, Ph.D. Strategies for Adolescent Pregnancy Prevention. Washington DC:

The American College of Obstetricians and Gynecologists, 2007.

Kotz, Deborah. "A Debate About Teaching Abstinence." U.S. News & World Report

142.23 (31 Dec. 2007): 28-28. ContentSelect Research Navigator. EBSCO. Maag Library, Youngstown, OH. 7 Sep. 2008

O'Keeffe, Alice. "Teenage sex: don't scoff at abstinence." New Statesman 132.4663 (10

Nov. 2003): 26-28. ContentSelect Research Navigator. EBSCO. Maag Library, Youngstown, OH. 7 Sep. 2008

Saada Saar, Maklia. "A Missing Piece of the Prevention Puzzle." Center for American

Progress. (2008): 7 Sep 2008. http://www.americanprogress.org/issues/2008/08/missing_piece.html.