Social Policy & ServicesTaskforce on Teen

Pregnancy

Wendy HuangBlayne Lopes

Jessica NaddaffAshley Talbert

Problem Definition

“Social problems are labeled, constructed, and defined by individuals and groups, and these labels are accepted or rejected by society based more on the power and skill of the individual or group than on any objective manifestation of the condition being defined.” (Popple & Leighninger, 2011, p. 75.)

Problem Definition – The “Good” News

• The U.S. teenage birth rate reached an historic low in 2009, after an uptick in 2006 and 2007.

• The current teenage birthrate stands at 39.1 births per 1,000 women aged 15-19.

Number of Births & Birth Rate for Teenagers Aged 15-19

Problem Definition – The Bad News

• The U.S. teenage birth rate remains the highest among industrialized countries.

• Nearly two-thirds of births to women younger than age 18 and more than half of those among 18−19 year olds are unintended.

Teen Birth Rates in Industrialized Countries

Problem Definition – A Vicious Cycle

Children born to teen parents often have a unique set of needs which leave them at

increased risk for repeating early parenting, thus perpetuating the cycle of

poverty among future generations.

Problem Definition:Our Focus - Education

• In late 2009, President Barack Obama and the Democratic Congress approved a major change in federal sex-education funding.

• The change marks the first time in nearly 30 years that the federal government will fund any school sex education other than so-called abstinence-only programs.

Colonial & 19th Century America

• Adolescent pregnancy was not considered a problem because of biology and social norms

• Like today, men were condoned for having sex while women were not

• For women with unwanted pregnancies, abortions were an option

20th Century • In the early 1900’s, a

culture of dating and premarital intercourse emerged

• Teen Pregnancy was not a problem because young couples would have shotgun weddings

The 70’s and 80’s

• Teen Pregnancy “epidemic”

• Family Planning and Population Research Act of 1970 -Title X

• Title IX- Education Amendment of 1972

• Adolescent Family Life Demonstration Projects-Title XX

1990’s

• During the 90’s more infants are being born to single mothers

• During the Clinton Administration the Work Opportunity Reconciliation Act of 1996 is enacted effecting welfare of teen moms

• In 2006, Bush Jr. advocates for abstinence in teens and toward young people up at age 29

Plan B• Plan B is an emergency

oral contraceptive

• Not every state requires it to be available at all pharmacies due to a Conscious Clause

• Massachusetts State Law requires that it be made available within 24 hours

Daycare

• Currently most schools lack programs to help teen moms

• Salem High School has the Teen Parenting Program

• Teen Parents are available to meet with students at risk of becoming pregnant

Teen Pregnancy in the Media

Teen Mom’s as TV Stars

Benefits• The National Campaign

to Prevent Teen and Unplanned Pregnancy applauds MTV's efforts. "I think any effort that puts this issue in front of millions of teenagers week in and week out is a net win”.

Worries• While the four teen

moms may struggle on the show they are also on magazine covers each week • Worries that teen

pregnancy looks glamorous, girls may want their fifteen minutes of fame

‘Juno’ Effect

• "The Juno Effect": By talking about pregnant girls and by portraying them through the media as ordinary, we’ll get more teens having babies.

• "In the context of parents still not comfortable talking with their children about sex, with schools talking only about abstinence until marriage and with religion saying it's still a sin, the media have become very powerful sex educators." (Pesca, 2008)

Pregnancy Pact• The Gloucester Pregnancy

Pact was considered to be part of the ‘Juno’ Effect

• Girls in devastated inner cities are susceptible to messages from movies and pregnant stars such as Jamie Lynn Spears

• In 2010, Lifetime created the move “The Pregnancy Pact”

Do you think Hollywood makes teen pregnancy attractive to teens?

Systems

Must address the systems that allow racism to continue and

change the fundamental conditions that help to

maintain racially disparate outcomes.

What’s the Problem?

Consider the social world inhabited by a poor woman. What meaning

might having a child add to her life?

Race – General Trends

• The teen pregnancy rate increased for every racial/ethnic subgroup between 2005 and 2006.

• Birth rates for teenagers fell in 2009 for all racial and ethnic groups.

• Non-Hispanic black youth, Hispanic/Latino youth, American Indian/Alaska Native youth, and socioeconomically disadvantaged youth of any race or ethnicity experience the highest rates of teen pregnancy and childbirth.

Birth Rates by Race/Ethnicity

Hispanic Teens

• Latinas have the highest teen pregnancy rate and teen birth rate of any major ethnic/racial minority in the country.

• Despite a considerably higher birth rate than any other group, Latinas have similar rates of sexual activity.

• Access is the problem.

African American Teens

• 50% of black teen girls get pregnant at least once before age 20—nearly twice the national average.

• Despite an increase between 2005 and 2006, the pregnancy rates among black teen girls have declined dramatically over the past fifteen years.

• Similar issues regarding lack of Access &

Opportunity to Latina teens.

Socioeconomic Status

• A very high proportion of teen births occurs in low-income families.

• Disparities in rates across different racial/ethnic groups reduce significantly when socio-economic status is considered.

• Federal interest in the teen pregnancy “problem” largely a result of the fact that babies born to poor families are more likely to end up needing taxpayer-supported benefits.

Sexism

• Messaging in a lot of the sex education and abstinence only education is punitive rather than supportive.

• Abstinence only education ties a woman’s morality and personal worth to her sexual purity.

• Women, especially poor women, have limited capacity for economic independence due to the policies currently in place.

Heterosexism

Comprehensive sexuality education unlikely to include any positive reference to same-sex relationships. In fact, sexual orientation is among the three most likely

topics to be excluded from a sexuality education course.

LGBTQ

• Young lesbian women are more likely to experience pregnancy than their heterosexual counterparts.

• LGBTQ youth may have twice the risk of experiencing an unintended pregnancy as their non-LGBTQ peers.

Abelism

Disabled youth are at an increased risk for abuse and are often ignored when it

comes to sexuality education because of the perception that they are unlikely to

engage in sexual activity.

Age – General Trends

• Birth rates overall and by race and ethnicity are consistently higher for ages 18-19 than for ages 15-17.

• Although the downward trend for both age groups has been similar, long-term declines were smaller for older teenagers.

Ageism

• Young women are generally disempowered in the arena of their reproductive health.

• Often assumed that a woman’s age will determine how well she is able to mother her children.

• Stigma of being a young mother – young motherhood is not the problem in itself.

• Need to speak a language that respects all youth.

Geographic Trends

• Research shows that neighborhood-level variables, like higher median household income, and better access to family planning services, are predictors of higher contraceptive use among adolescent women.

• State-specific teenage birth rates are highest across the southern United States.

Other Marginalized & Oppressed Groups

• Youth in Foster Care - 2.5 times more likely to have been pregnant by the age of 19 as compared to young people not in foster care.

• Homeless and Runaway Youth - Less likely to receive any sexuality education because of their lack of engagement in the usual delivery systems.

Implications

• Punitive public policies.

• Marriage is promoted as a cure to systemic poverty.

• Policymakers assume it's possible to compel women to modify their behavior without addressing the structural factors that push low-income women into single motherhood in the first place.

Abstinence-ONLY• Abstinence-only education is

a valued based pedagogy because it contains family and religious values

• Teaches sexual activity outside of marriage has harmful physiological and psychological effects

• Prohibition on discussing contraceptive or safe sex practices

Abstinence Advocates

• Sex before marriage is inappropriate and immoral

• Abstinence is only 100% effective method to prevent pregnancy and STIs

• Information about sex, contraception and HIV can encourage early sexual activity

• Traditional values and religious faith , consistent with abstinence message, have positive effects

Only 6 states allow same-sex marriage

What message does this send to youth who identify as LGBTQ? Is this message inclusive?

Comprehensive Education Advocates

• Respects the diversity of values and beliefs represented in the community and is complimentary to the sexuality education child receives from caregiver or family

• Encourage abstinence but inform participants about STI and HIV prevention

• Utilize demographic, epidemiological and social science research to identify populations at risk of early pregnancy and/or sexually transmitted infections

• Utilize health behavior to guide the selection of risk and protective factors and selection of intervention activities

Changing Values

• American society has been developing more permissive attitudes toward sexuality since the 1960s and 1970s

• Overwhelming pressure for both young males and females to be sexually active

• Decreased fear of AIDS/HIV leading to less use of condoms or contraceptives

• Unmarried parenthood less stigmatized than in the past among both teens and adults

• Changing values surrounding the institution of marriage

87% of American public support strengthening a culture of

personal responsibility regarding sex, getting pregnant, and bringing children into the

world.

Latino/Hispanic Values

• The taboo against teen pregnancy is not strong in many Hispanic communities

• Families and children are a blessing in many Latino cultures

• Hispanic girls who become pregnant are less likely to have an abortion

• Large number of Roman Catholics among the nation's Hispanics

• Two-thirds of Latino teens are the children of immigrants

Civil Rights Dilemma

• The discrimination that “teen moms” face at school is a major reason many of them drop out of school

• Pregnant teens are sometimes excluded from attending regular classes because they are seen as a distraction.

• In many instances, parenting teens are not provided with the necessary support services, such as day care and adequate transportation, which they need to stay in school.

For example:

• At a suburban school district, an administrator who felt that a pregnant teen would present an “inappropriate image” of the school refused to allow the 17-year-old mother to participate in her graduation ceremony.

• A junior high school administrator tore down the poster of a pregnant girl who was running for school office claiming that she was “advertising” pregnancy.

• In schools throughout California, girls are being strong-armed into attending separate programs for pregnant minors. Girls whom remain at their high school face unlawful discrimination.

National Campaign to Prevent Teen and Unplanned Pregnancy

Mission is to improve the lives and future prospects of children and families and, in

particular, to help ensure that children are born into stable, two-parent families who are committed

to and ready for the task of raising the children.

Change the way the public views the problemEncourage careful, consistent use of family planning

Encourage responsible, healthy relationshipsSupport evidence-based polices

Educate policymakersWorks directly with young people

The Virginia Teen Pregnancy Prevention Partnership for Youth in Foster Care

Ensure that older adolescents who transition out of foster care will have the opportunity to develop skills and knowledge that will encourage and promote healthy sexual behaviors.

• Educating foster parents, foster case managers, Independent Living Program staff, social workers, youth advocates, group home directors and human service providers on the following:• adolescent reproductive health and behavioral risk reduction • skills for implementing Power Through Choices (PTC), a

comprehensive curriculum designed specifically for youth in foster care and group home settings.

• teen sexual communication • issues faced by young males in out-of-home care to help them

avoid early parenting and delinquency in child support.

The Candies Foundation

“Pause before you play…”

Birds and Bees Text Line

BrdsNBz was the first service of its kind in the US

The BrdsNBz Text Message Warm Line - that's Birds and Bees - provides accurate, nonjudgmental answers to teens' questions about sex and relationships in North Carolina.

Teens can text their question to BrdsNBz, and a trained staff member will provide a medically accurate, non-judgemental, confidential and free answer within 24 hours.

Programs Making A CHANGE

• Street Smart is an HIV and STD prevention program for runaway and homeless youth in non-school settings.

• Enabl (Education now and babies later) provides state matching funds to local and community organizations that target at risk youth, including foster youth.

Latino/a Based Programs

• Plain Talk/Hablando –community based initiative focusing on increasing conversation between parents/community adults (walkers and talkers) and teens.

• That Latina/o Pregnancy Prevention Workshop• Created to address the knowledge and

research gap surrounding disparity in teen pregnancy rates with Latino populations

What are YOUTH doing?Civil Liberties & Public Policy program (CLPP):• Educate, train and support new activists and leadership to secure

reproductive freedom, justice and sexual rights for everyone.

Teens to Legislators: Safeguard Policies and Services that Protect Youth• In North Carolina more than 250 youth met with legislators to discuss teen

pregnancy prevention, access to care, and adolescent well-being during 2011 Adolescent Health Advocacy Day.

Teens gather at Massachusetts State House:• On February 4th youth and service providers from across the

Commonwealth rallied at the State House to tell the story of how youth programs have changed their lives.

• Youth speaker Natalie Nyambura shared her own experience with the teen pregnancy prevention program at the United Teen Equality and Lowell Community Health Center.

Federal and State Policies and Programs

President’s Teen Pregnancy Initiative

• Signed December 2009, Funding in March 2010• 75M for Tier 1 for replication of comprehensive

evidence-based programs• 25 M for Tier 2 for research and demonstration

projects toward promising programs• Public and private entities• Age appropriate & medically accurate• Newly created Office of Adolescent Health within the

Department of Health and Human Services (DHHS )

Public Health ActTitle X: Family Planning

• Since 1970, only federal grant program for providing individuals with comprehensive family planning and related preventive services

• provide access to contraceptive services, supplies and information• priority to low-income persons• Funding not to be used for abortion• 2008, 88 grantees served five million through network of 4,500

community-based clinics, including State and local health departments, tribal organizations, hospitals, university health centers, independent clinics, community health centers, faith-based organizations, and other public and private nonprofit agencies

• $317,491 million FY10 facing total elimination from federal budget

Public Health ActTitle XX: Adolescent Family Life

• Created in 1981, run by the Office of Adolescent Pregnancy Programs (OAPP) within Office of Population Affairs (OPA)

• Three main parts: Prevention, Demonstration and Research• $16,658,000 in fiscal year 2010, compared to 31million in 2003• Preventive programs directed toward age 9-18• FY 2010, was not appropriated funds for prevention projects• 2001, the program supported 73 abstinence education projects and 37

care projects• 2010-2011, supported 27 care demonstration largely for pregnant and

parenting teens.• Research on the causes and consequences of adolescent premarital

sexual relations, adolescent pregnancy and parenting.• Research grant for FY 2008 for summarizing & reviewing past AFL

research and proposing future topics

Social Security ActTitle V: Abstinence Education

• Part of 1996 Welfare Reform, from 1998-2002, $50 million a year in mandatory funds added to the Maternal and Child Health (MCH) Block Grant• ACYF Administration on Children, Youth

and Families (part of HHS) • Requires states to match with $3 for

every $4 received from the federal government • 8-point (A-H) definition of Abstinence

education

Special Projects of Regional and National Significance (SPRANS)Community-Based Abstinence Education Program (CBAE)

• Started FY 2001• Public and private, community agencies or schools,

local demand• Funds does not go through the state • Currently $113 million to 80 CBAE grantees• 2003, 28 new grants totaling more than $15• Target young people ages 12 to 18.

Personal Responsibility Education Program (PREP)

• Part of health care reform (Patient Protection & Affordable Care Act) in 2010, added this section to Title V, for 2010-2014, Section 513: Personal Responsibility Education

• 75million/year total for this Section, 55million for state grants • 10 million of the 75 million for new programs• 5% of that remainder for Indian or tribal organization • Target those at most high-risk or vulnerable for pregnancies

or otherwise have special circumstances, including youth in foster care, homeless youth, youth with HIV/AIDS, pregnant youth who are under 21 years of age, mothers who are under 21 years of age, and youth residing in areas with high birth rates for youth.

• Age appropriate, medically accurate & complete.

State Policies• 43 states, the District of

Columbia, the Federated States of Micronesia, and Puerto Rico applied for PREP

• 30 states and Puerto Rico applied for the Title V abstinence-only program

• 35 states and the District of Columbia require that public schools teach some form of sex or STI/HIV education

• Between 2007 and 2009, 6 states new requirements that sex education be both medically accurate and age appropriate (Colorado, Hawaii, Iowa, North Carolina, Oregon and Washington)

• Foster care round table with support of the National Campaign ( 8 states: Arizona, Colorado, Illinois, Maryland, Massachusetts, Michigan, Oklahoma, and Virginia

State Education Policies

New Mexico• How to engage

Hispanic individuals and families

• Does not mandate sex education or regulate its content if taught

• More CBAE than 42 other states, no Title V in FY09 nor in FY10

• Applied for PREP in FY10,

Nevada• State requires sex

education, but largely has abstinence funding.

• Parents must sign consent for children to participate in sex education during school

MA• Evidence-based teen

pregnancy prevention services to at-risk youth

• Targets Brockton, Chelsea, Chicopee, Everett, Fall River, Fitchburg, Holyoke, Lawrence, Lowell, Lynn, New Bedford, Springfield and Worcester

Federally Approved Evidence-based Programs• List of 28 Federally approved abstinence-plus programs• Largely middle school and high school, 1 target at

elementary school aged• Example: Making Proud Choices!

Middle school and community- basedGoals and dreams of adolescent Consequences of sex : Knowledge about STDs/STIs and condom use Negotiation-refusal and condom use skillsRole plays, video clips

State Abstinence-only Programs

• Florida (Project SOS) vs. Massachusetts (Healthy Futures)• Urban and rural• Abstinence as a possible choice• Stage presentation: skits, music, local celebrities• Afterschool clubs or classroom based• Virginity phrasing• Jemmott study: 33% of abstinence, 42% of

comprehensive, 47% of healthy lifestyle, 57% of safe sex, • Sex until “ready”, not disparage condoms,

State Comprehensive Programs

• Replicate Federally approved programs

• ReCapp and ETR Associates

• PACHA (Program Archive on Sexuality, Health & Adolescence)-Sociometric Corporation's collection of promising teen pregnancy and HIV/STI prevention programs.

Resource Related Dilemmas

Recently a proposed cut H.R. 217 has been brought to congress which would eliminate the federal funding

for Planned Parenthood.

• Will have a major effects on poor and women of color.• 92% of clients have an income below 250 percent of the

federal poverty level.

• Title X services received by single women ages fifteen through nineteen prevent an estimated 385,800 unplanned pregnancies, 154,700 births, and 183,300 pregnancy terminations

Resource Related Dilemmas• Cultural Competence - Lack of population-specific

appropriateness among youth-serving professionals. It is difficult to be inclusive of all youth including maintaining linguistic and cultural relevance.

• “Effective Technologies” - There are little to no evidence based programs for foster care, immigrant, runaway, homeless, disabled, adjudicated, or LGBTQ youth.

• Access - Teens do not have full and equal access to the supports and resources they need.

Recommendation• Advocates for Youth, European Tour since

1998• Right of adolescent to have knowledge

about their bodies • Respect in relationships to partners, friends,

family • Responsibility to avoid HIV infection and

other STI• Mass media public education

campaigns

Love without Fear (Renata Zolcinska, CRIPS, Paris)

Recommendations Based on Demographic Data• Need programs for runaway and homeless youth in non-

school settings.• Expand beyond schools and the usual community sites and go

to where the most marginalized young people might be found and engage them in our systems of care.

• Advocate for a more positive and realistic approach to adolescent sexual health..

• Focus on priority populations.• Understand the social and economic realities that shape the

worldview of mothers whose attitudes about childbearing and child-rearing are, in many respects, profoundly different from our own.

Actions You Can Take

http://www.amplifyyourvoice.org/end_abonly

Send a message to your representatives to Co-Sponsor the Repealing Ineffective and Incomplete Abstinence-Only Program Funding Act of 2011.

This act was introduced on March 15, 2011.

There is a feature on this page that automatically finds your representatives and creates a message template that you can edit.

Recommendations

“From solving youthproblems to problem solving youth”

-Teen pregnancy and sexual education curriculum directly affect youth. Instead of being their voice let them use their own voice!

-Educates and empowers youth to make informed choices.

-Raises their awareness about the systems that narrow the possibilities for so many youth.

A Call To Social Workers

“The fact is that social workers most will work with a pregnant or parenting adolescent at some point in their

careers”-Benson

Be informed of policies and empirically based best practices.