http://www.washingtonpost.com/wp-dyn/content/article/2010/01/25/AR2010012503957_2.

html

Rise in teenage pregnancy rate spurs new debate on arresting it

The pregnancy rate among teenage girls in the United States has jumped for the first time in more than a decade, raising alarm that the long campaign to reduce motherhood among adolescents is faltering, according to a report released Tuesday. The pregnancy rate among 15-to-19-year-olds increased 3 percent between 2005 and 2006 -- the first jump since 1990, according to an analysis of the most recent data collected by the federal government and the nation's leading reproductive-health think tank.

Teen pregnancy has long been one of the most pressing social issues and has triggered intense political debate over sex education, particularly whether the federal government should fund programs that encourage abstinence until marriage or focus on birth control. "The decline in teen pregnancy has stopped -- and in fact has turned around," said Lawrence Finer, director of domestic research for the Guttmacher Institute, the nonprofit, nonpartisan research group in New York that conducted the analysis. "These data are certainly cause for concern." The abortion rate also inched up for the first time in more than a decade -- rising 1 percent -intensifying concern across the ideological spectrum. "One of the nation's shining success stories of the past two decades is in danger of unraveling," said Sarah Brown of the National Campaign to Prevent Teen and Unplanned Pregnancy. "Clearly, the nation's collective efforts to convince teens to postpone childbearing must be more creative and more intense, and they must begin today." The cause of the increase is the subject of debate. Several experts blamed the increase in teen pregnancies on sex-education programs that focus on encouraging abstinence. Others said the reversal could be due to a variety of factors, including an increase in poverty, an influx of Hispanics and complacency about AIDS, prompting lax use of birth control such as condoms. "It could be a lot of things coming together," said Rebecca Maynard, a professor of economics and social policy at the University of Pennsylvania. "It could be we just bottomed out, and whenever you are at the bottom, it tends to wiggle around. This may or may not be a sustained rise."

The report comes as Congress might consider restoring federal funding to sexeducation programs that focus on abstinence. The Obama administration eliminated more than $150 million in funds for such groups, but the Senate's health-care reform legislation would reinstate $50 million. The new findings immediately set off a debate over funding. Critics argued that the disturbing new data were just the latest in a long series of indications that the focus on abstinence programs was a dismal failure. "Now we know that after 10 years and over $1.5 billion in abstinence-only funding, the U.S. is lurching backwards on teen sexual health," said James Wagoner of Advocates for Youth, a Washington advocacy group. Supporters of abstinence programs, however, said the findings provided powerful evidence of the need to continue to encourage delayed sexual activity, not only to avoid pregnancy but also to reduce the risk for AIDS and other sexually transmitted diseases.

"Research unmistakably indicates that delaying sexual initiation rates and reducing the total number of lifetime partners is more valuable in protecting the sexual health of young people than simply passing out condoms," said Valerie Huber of the National Abstinence Education Association, who blamed the increase on several factors. "Contributors include an over-sexualized culture, lack of involved and positive role models, and the dominant message that teen sex is expected and without consequences," Huber said. The Obama administration is launching a $110 million pregnancy prevention initiative focused on programs with proven effectiveness but has left open the possibility of funding some innovative approaches that include encouraging abstinence. The rate at which U.S. teenagers were having sex rose steadily through the 1970s and 1980s, fueling a sharp rise in teen pregnancies and births. That trend reversed around 1991 because of AIDS, changing social mores about sex and other factors, including greater use of contraceptives, which pushed the U.S. teen pregnancy rate to historic lows. The U.S. rates still remained higher than those in other industrialized countries. The decline in teen sexual activity had leveled off starting about nine years ago, and the teen birth rate began to increase in 2005. It wasn't known before if the increase was due to more pregnancies or fewer abortions and miscarriages. For the first time, the new analysis uses those factors in calculating the teen pregnancy rate. The analysis examined data on teenage sex and births collected by the federal Centers for Disease Control and Prevention's National Center for Health Statistics and data on abortions collected by the CDC and Guttmacher -- the two best sources of such data. The abortion rate among teenagers rose 1 percent in 2006 from the previous year -- to 19.3 abortions per 1,000 women in that age group, the analysis found. Taking that and miscarriages into account, the analysis showed that the pregnancy rate among U.S. women younger than 20 in 2006 was 71.5 per 1,000 women, a 3 percent increase from the rate of 69.5 in 2005. That translated into 743,000 pregnancies among teenagers, or about 7 percent of women in this age group. "When birth rates go up and down, it could be the result of kids getting fewer abortions," said John Santelli, a professor of population and family health at Columbia University. "This shows that it's a true rise in pregnancies."

The rate increase was highest for blacks. Among blacks, the rate increased from 122.7 per 1,000 in 2005 to 126.3. For Hispanics the rate rose from 124.9 per 1,000 women to 126.6. Among whites, the rate increased from 43.3 per 1,000 women to 44.0.

http://community.michiana.org/famconn/teenpreg.html

TEENAGE PREGNANCY

Each year in the U.S. almost one million teenagers become pregnant--at enormous costs to
themselves, their children, and society. While the facts are clear, the issues of teenage pregnancy are complicated by our conflicting attitudes and behaviors. Talk of sex fills the airwaves; younger and younger girls are portrayed as sex objects; and sex is used to sell everything from clothing to news. Yet we are shocked at the rising numbers of teens who are sexually active. If we are truly concerned about the welfare of babies, children and adolescents, we must move beyond the moral panic and denial that so often distort the discussion. Designing effective solutions will require the thoughtful separation of fact, assumption and wishful thinking and an honest acknowledgment that much is still not fully understood about the causes of teenage pregnancy.

CONTRIBUTING FACTORS Cause or Effect? The burdens of early childbearing on disadvantaged teens are undeniable. Trying to untangle the factors which contribute to teenage pregnancy from its effects, however, leads to a "which came first, the chicken or the egg?" dilemma. Educational failure, poverty, unemployment and low self-esteem are understood to be negative outcomes of early childbearing. These circumstances also contribute to the likelihood of teen pregnancy. For example, recent studies suggest that most adolescent mothers have already dropped out of school before they become pregnant. On the other hand, adolescents still enrolled in school when they give birth are as likely to graduate as their peers. It is not clear how well the adolescents with the most problems would have fared in the future even without early parenthood. Trends in nonmarital childbearing. It may surprise some to learn that the teen birth rate was 50% higher in 1957 than it is now. Today's widespread concern over teenage pregnancy may have less to do with actual numbers and more to do with the growing percentage of teen mothers who are unmarried. Teens who have babies outside of marriage fit within a broader nationwide trend--unmarried women of all ages are having babies in increasing numbers. Births to single teens actually account for a smaller percentage of all nonmarital births than twenty years ago. Economic forces. In the 1950s when men with little education could find well-paid jobs, young people married if a pregnancy occurred. The loss of those jobs makes marriage less attractive today--an effect that can be seen on teens of all races. In 1955, for example, only 6% of white teenage childbearing occurred outside of marriage; today it is 42%. Economics may also be responsible for the lower percentage of poor adolescents who terminate their pregnancies, since Medicaid policies in most states do not pay for abortions, but do pay for services related to childbirth.

Motivation. The Alan Guttmacher Institute states that "while sexual activity among teenagers of all income levels is now common, having a baby is not. Adolescent childbearing is heavily concentrated among poor and low-income teenagers, most of whom are unmarried." While lowincome youths may not intend to have a baby, they may not be sufficiently motivated to avoid pregnancy. Without a prize beckoning from the future--a good job, financial independence and marriage--young people from low income backgrounds may have little incentive to delay childbearing. Mixed Messages. The American popular culture glorifies sex and ignores responsibility. Beginning in early childhood, young people are bombarded with sexual messages. At the same time, puritanical attitudes restrict the availability of resources and frank discussions about sex. Other Western nations with similar levels of adolescent sexual activity have much lower rates of adolescent pregnancy than the U.S. In countries with straightforward attitudes about sex, teens get more consistent messages, clearer information and greater access to contraception and abortion. Risk Factors. Although it is not inevitable, some life circumstances place girls at higher risk of becoming teen mothers. These include poverty, poor school performance, growing up in a single parent household, having a mother who was an adolescent mother, or having a sister who has become pregnant. Sexual Abuse and Coercion. A high percentage of girls who have sex before age 15 have been victims of incest or other sexual abuse. Further, half of the fathers of babies born to women aged 15-17 are 20 years of age or older; in one fifth of the cases, they are at least six years older. In the past this behavior would have carried severe social sanctions. Today, few men are prosecuted for having sexual relations with a minor, even though it is still against the law. _____________________________________________________________________________ ____ STRATEGIES FOR SUCCESS All teenagers need encouragement to postpone sexual involvement and information on pregnancy prevention if they become sexually active. But these components are not enough by themselves to make a significant impact on the reduction of pregnant and parenting teens. The issues of adolescent pregnancy are too complex for simple solutions. The Children's Defense Fund emphasizes that young people need both "the motivation and the capacity to avoid tooearly pregnancy and parenting." Further, young people are not a homogenous group, so solutions must be sensitive to individual and group differences. The most successful programs are ongoing and comprehensive. They combine several strategies which focus on helping kids succeed. Boys and girls who do well in school, participate in nonacademic activities, and plan for their future are less likely to become pregnant or bear a child during their teenage years. A wide range of interventions aimed at youth is also insufficient, however, if we do not address the larger overriding issues of poverty, racism and media messages that contribute to the complexity of the problem.

Multilevel approach. While the sexual experiences of youth differ greatly, the fact remains that most will become sexually active during their adolescent years, and many will become pregnant or father a child. Consequently, the goals for programs addressing teenage pregnancy must be threefold: first, directed at delaying the initiation of sexual intercourse; second, directed at preventing pregnancy for youth who are sexually active; and third, directed at ensuring the wellbeing of young people who do become parents, including the avoidance of additional pregnancies. Sexuality education. While some have voiced concern that sex education increases sexual activity, studies show that this is not the case. In fact, effective sex education programs can decrease sexual activity and increase contraceptive use among those already sexually active. Successful programs have a number of similar components. They maintain a narrow focus on reducing specific sexual risk-taking behaviors; they provide accurate information about sexuality; they build interpersonal and communication skills to resist sexual pressures; they address both social and media influences on sexual behaviors; they reinforce individual values and group norms linked to responsible behavior and decision-making; and finally, they involve students in the learning process through small group discussions, role-playing, interviewing parents, and other activities. Many programs have also involved older teens as role models. Access to childbearing alternatives. Teenagers-both males and females-who are sexually active need easy access to contraceptives and confidential family planning services. Young women who are poor or low-income also need the same opportunities as their more advantaged peers to terminate a pregnancy if they decide that they are not capable of bearing and raising a child. Not for girls only. Too often, adolescent pregnancy is viewed as a problem having to do exclusively with teenage girls. Overlooked are the teenage boys and men who share equally in this responsibility. Their need for pregnancy prevention information and services is no less important. Clear, consistent messages. Young people need to hear strong and consistent messages about responsible sexual behavior. Certainly parents--through discussion and example--carry the primary responsibility for guiding their children, and they should be supported in doing so. But the larger community, and especially the media, must regularly reinforce parents with complementary rather than contradictory messages. Future prospects. Positive life options give teens hope for the future and the motivation to avoid early childbearing. Students need the skills and advanced training that will enhance their prospects for employment. They also need assurance that further education and/or meaningful employment will be available to them. Schools and businesses can play a crucial role in making this happen. Nonacademic opportunities for success. When children are isolated from their peers, lack positive adult role models or experience few successes, they are at-risk of slipping into problem behaviors. Communities must ensure that children have access not only to nurturing adults, but also to a broad spectrum of programs, activities, and service opportunities that can build selfconfidence, bolster self-esteem, and forge positive connections.

Family support and parenting programs. Current studies show that when fathers are involved in the physical care of their children before the age of three, they are less likely to sexually abuse their own or any other child in the future. To break the cycle of sexual abuse which often leads to teenage pregnancy, intensive family support programs, such as Healthy Families, are needed to teach fathers about parenting and help them connect with their children from birth. _____________________________________________________________________________ ___ TEENAGE PREGNANCY: THE FACTS Teenage sexual activity: 56% of young women and 73% of young men today have had intercourse by age 18, compared with 35% of young women and 55% of young men in the early 1970s. One in 5 youth do not have intercourse before the age of 20. (1) Most of the increase in teen women having intercourse in the 1980s was among white teens and those in higher-income families. (2) The fathers of babies born to teenage mothers are likely to be older than the women: Half of the fathers of babies born to women aged 15-17 are 20 years of age or older. About one in 5 of all teenage mothers had a partner six or more years older. (1) Some 74% of women who had intercourse before age 14 and 60% of those who had sex before age 15 report having had sex involuntarily. (3) Teenage pregnancy and birth: Each year, nearly one million teenagers in the U.S.-approximately 10 percent of all 15- to 19year-old females-become pregnant. About one third of these teens abort their pregnancies, 14% miscarry, and 52% bear children, 72% of them out of wedlock. (4) More than 9 in 10 teens who give birth keep their babies; few place their babies for adoption. (5) More than 40 percent of women in the U.S. become pregnant before they reach 20 years of age.
(5)

6 in 10 teen pregnancies occur among 18- to 19-year-olds. (1) U.S. teenagers have one of the highest pregnancy rates in the Western world-twice as high as rates found in England, France and Canada, three times as high as that in Sweden; and seven times as high as the Dutch rate. (5) One in every eight births in the U.S. is to a teenager; one in five among African Americans. (6 ) However, white teenagers (under age 20) account for about 68% of all adolescent births and 52% of births to unmarried mothers. Only 16% of adolescent mothers are unmarried black or Hispanic teens under 18. (7)

Cost: In 1992 the Federal government spent more than $34 billion on welfare for families begun by teenagers, up from $16.6 billion in 1985.6 In 1995, Indiana spent $7.4 million in Aid to Dependent Children for approximately 2,700 teen parents. (8) For every federal dollar spent on giving contraceptives to low-income women the government saves more than $4 in welfare payments, medical costs, etc. (6) Of all the women aged 15-44 who received welfare or AFDC in 1993, over half (55%) became mothers when they were teenagers. Only 5% were currently teenage mothers; of these, 83% were aged 18-19. (1) Unmarried childbearing: In early 1980s more than half of all births to adolescents occurred outside marriage, compared with only about one-third in 1970. (9) Only 34% of men 20 -29 years old were married in 1993, compared with 58% in 1973. (10) Contraception: Sexually active teenagers are more likely than any other age group to be nonusers of contraception--one in five currently use no method of contraception. (2) A sexually active teenager who doesn't use contraception has a 90% chance of pregnancy within one year. (1) Outcomes: The children of teenage mothers are at greater risk of lower intellectual and academic achievement, health complicatoins, social behavior problems and problems of self-control than are children of older mothers, primarily due to the effects of single parenthood, lower maternal education, and large family size. (9) Seven in 10 teen mothers complete high school or eventually earn a G.E.D., but they are less likely than women who delay childbearing to go on to college. (3)