A real crisis is occurring in America beyond politics, war, or religion – a crisis that affects the development of life skills, setting of goals, and financial stability of America's teenagers.
Each year, nearly 750,000 teenagers become pregnant, according to the Guttmacher Institute, the nation's largest nonprofit organization studying reproductive health.
Rather than learning math formulas and reading classical literature in high school, teenage mothers instead must grapple with buying baby formulas and reading bedtime stories. In fact, only half of all girls that become teenage mothers earn their high school diplomas by age 22.
To tackle this serious issue, preventing teenage pregnancy has truly become a multidisciplinary responsibility, involving health professionals, sex educators, parents, teachers, and even the government. Thanks to the efforts of these professionals and prevention programs, teen pregnancy rates have decreased overall since 1990, but still remain too high.
Parents, Educators, and Teen Pregnancy Prevention
Parents and school professionals have taken greater steps to involve themselves in teen pregnancy prevention. However, many parents find talking with their teenagers about sex embarrassing or uncomfortable. But research indicates that open conversations about sex might have positive effects on preventing teenage pregnancy.
According to the National Campaign to Prevent Teen Pregnancy (NCPTP), 46% of 1,008 teenagers polled in the “With One Voice 2010” survey say their parents are the ones who most influence their decisions about sex. According to these teenagers, having more open and honest conversations about sex with their parents would help delay sexual activity and avoid pregnancy.
Teenagers without open relationships with parents find it difficult to talk about pregnancy, abstinence, and other sex topics they encounter during adolescence. In fact, some teenagers find it so uncomfortable that they are less likely to buy birth control such as condoms, fearing that their parents would find out.
Because parents and teenagers find it difficult to discuss these sensitive topics, more parents are turning to the education system to provide teenagers with knowledge about sex and pregnancy prevention. Today, school counselors and teachers are often at the forefront of sexual education and pregnancy prevention.
In “The School Counselor in Sex Education,” published in The Personnel and Guidance Journal, several roles are identified for school counselors working with teachers and students in sex education. Author John J. Pietrofesa states school counselors must act as consultants when developing guidelines for sex education programs because of their knowledge of teenagers’ developmental stages.
Additionally, Pietrofesa indicates a need for counselors to work with teachers, so teachers become familiar with classroom techniques that facilitate discussion of sexual development. The idea is that with greater discussion and acknowledgment of development, students will make correct decisions about whether to engage in sexual activity or not.
One technique discussed was a “Values Certification Activity,” which asks students to “strongly agree, agree, disagree, or strongly disagree” with statements like:
- I talk freely to my parents about sex.
- Premarital sex is wrong.
- Love and sex are the same.
- Masturbation is wrong.
- My Parents taught me enough about sex.
After the activity, students participate in a classroom discussion indicating why they agreed or disagreed with the statements, increasing awareness of the differences of viewpoints. Facilitating open and honest discussion about sex education in the classroom prepares students for further discussions in pregnancy prevention programs.
Effective Pregnancy Prevention
Teenage pregnancy is often a moral and political quagmire, with differing views on whether to teach “abstinence-only” sex education or “abstinence-plus” education.
Abstinence-plus education focuses on teaching students to wait until they feel ready to have sex, while also providing students the necessary knowledge to correctly use contraceptives. Most studies and evaluations agree that abstinence-plus education is the most effective way of preventing teenage pregnancy.
According to the American College of Obstetricians and Gynecologists (ACOG), prevention programs overall typically focus on one or more of three objectives.
First, programs should educate and assist adolescents in increasing their abilities to abstain from or delay sexual intercourse. Typically, these programs provide information on abstinence for students who have not engaged in sexual activity in addition to information on contraceptives for students already engaging in sexual activity.
Pressure to engage in sexual activity is strong for many teenagers even if they don't feel ready to have sex. These programs focus not only on the emotional and physical risks of sexual intercourse, but also on refusal and negotiation techniques for those pressured to have sex.
For example, the “Postponing Sexual Involvement” program, a sex education program, seeks to provide information to students about sexuality, as well as information about dealing with peer pressure. During the program, instructors teach students about proper contraceptive use but focus on delaying sexual activity among teenagers.
The program teaches adolescent girls techniques to resist sexual pressures with their boyfriends if they are not ready in addition to techniques to avoid high-risk situations involving drug use. The program was shown to be an effective way of delaying sexual intercourse in teenagers as well as promoting contraceptive use for those who have already had sex.
Some programs focus on improving adolescents use of and access to family planning services and tools such as condoms. ACOG has found students who have access to condoms, in addition to training on their use, were more likely to use them than students who did not receive information on correct contraceptive use.
These programs remain controversial because critics claim that increased access to contraceptives will increase the rate of teenagers who engage in sexual activity. However, in “Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy,” from the NCPTP, research into programs that provide and teach about condoms showed no increase sexual activity. In fact, programs that promoted both abstinence and condom use were shown to delay sexual intercourse, as well as increase condom use for students who were already sexually active.
The third pregnancy prevention approach focuses on showing teenagers what life options exist for them outside of young pregnancy.
These programs typically include service learning opportunities and life planning to broaden the skill sets and experiences of teenagers. These programs don't necessarily focus on high-risk behaviors like teen sex, but rather on the development of personal values and problem-solving skills.
In another program, the “Teen Outreach Program,” students perform a minimum of 20 hours of volunteer service in hospitals, nursing homes, tutoring programs, and more. Throughout the program, students participate in classroom discussions with a facilitator to discuss their volunteer service, and what they learned from their experiences.
In the program, students discuss topics such as understanding values, dealing with family and interpersonal stress, human growth and development, and physical and mental issues that arise in the transition to adulthood. Even though none of the subject matter explicitly spoke of teen sex, subsequent evaluation of the program showed those who completed it were less likely to experience a teen pregnancy.
The White House's Teen Pregnancy Prevention Initiative
In 2010, President Barack Obama made significant changes to budget appropriations for sex education and pregnancy prevention programs.
Under the president's Teen Pregnancy Prevention Initiative (TPPI), $75 million in funds were made available to replicate programs that were rigorously evaluated and shown to be effective. This is in stark contrast to former President George W. Bush's administration, which promoted a strict “abstinence-until-marriage” sex education policy.
Because no “abstinence-until-marriage” programs have proven effective in the long-term, President Obama eliminated more than $170 million in annual funding directed at these programs. Now, focus has shifted to promoting abstinence-until-ready in addition to providing students with birth control options.
Under this new policy, the U.S. Centers for Disease Control and Prevention (CDC) has partnered with the Office of Adolescent Health to develop program goals and implement these programs in high-risk communities.
First, the new initiative seeks to reduce the rates of teen births in targeted areas, specifically African American and Hispanic communities. Together, Hispanic and African American youth accounted for nearly 60% of teen births in 2009, necessitating greater focus on increasing access to evidence-based programs for these youth.
The new initiative also increases the link between teen pregnancy prevention programs and community-based clinical services such as community hospitals and organizations like Planned Parenthood. By increasing access to contraceptives such as birth control and life-planning services, the CDC predicts by 2015 that it can reduce teen birth rates in targeted areas by 10%.
Working With Teenagers
The teenage years are a tumultuous time of growth and development. Coupled with pressures for sexual activity, teenagers require guidance and effective information about pregnancy prevention.
Statistics from U.S. Centers for Disease Control and Prevention
- Between 1990 and 2005, the teen pregnancy rate decreased from 116.9 per 1,000 to 71.5 per 1,000.
- Still, 1 in 3 girls becomes pregnant in the U.S. before the age of 20.
- Teen pregnancy costs America taxpayers more than $9 billion each year in increased health care costs, increased incarceration rates of children born to teenage parents, and lost tax revenue from low income parents.
- More than two-thirds of public school districts have a sex education policy.
- 85% of those require the program to include abstinence education.
- Together, black and Hispanic youth comprised nearly 60% of U.S. teen births in 2009 although they represent only 35% of the total population of 15–19 year old females.
- In 2009, 46% of high school girls and 46% of boys reported ever having sex.
- In 2009, 61% of sexually active teenagers reported using a condom the last time they had sex. Twenty percent reported using birth control pills.
The "What If" Project
Statistics from the National Campaign to Prevent Teen Pregnancy
Between 1991-2002, teenage pregnancy declined by 30%. What if it hadn't?
- 12 million more children would have been born to teenage mothers.
- 460,000 additional children would be living in poverty.
- 700,000 more children living in single-mother homes.