Teen Pregnancy Compared to Only a Few

Teen Pregnancy

Compared to only a few decades ago, American society has become more open and accepting of teenage pregnancy. Pregnant teens are no longer hidden away with relatives. More importantly, many school and community groups have adopted honest and aggressive strategies to address the growing incidences of teenage pregnancy.

This paper evaluates the effectiveness of four different styles of programs in preventing pregnancy in teenage girls. These programs include sex education in schools, one-on-one conversations between patient and health care worker in a clinical setting, service learning programs and finally, youth development programs. Emphasis is given on the effectiveness of these programs in preventing pregnancy in teenage African-American girls.

The first part of this paper is an overview of teen pregnancy statistics, both throughout the United States and with African-American teenagers in particular. The next part of the paper then identifies the factors behind the rising rates of pregnancy among black teenagers.

In the third and main part, this paper looks at the diverse programs and policies that are being implemented to help stop teenage pregnancy. The paper then evaluates whether or not these programs address the unique factors that contribute to teen pregnancy in African-American teens.

In the conclusion, this paper argues that pregnancy rates among black teens continue to rise, because these programs do not address the special factors behind pregnancies in this group. Thus, in order to effectively address teen pregnancy in black teenagers, more policies must be enacted to address factors like poverty and school drop-out rates.

Background

Overall, teenage pregnancies in the United States have declined since 1991. However, studies such as Singh and Darroch (2000) have shown that a full 40% of all young women become pregnant before they turn 20 years old. Furthermore, 25% of sexually active teenagers contact a sexually transmitted disease every year. Also, despite the steady decrease, the United States still has the highest pregnancy and birth rate among industrialized nations.

Numerous studies have looked into the causes for teenage pregnancy in the United States. In a longitudinal study, Harding (2003) found a strong link between neighborhood poverty and a teen's tendency to drop out of high school, engage in risky sexual behavior and have a teen pregnancy. Teen pregnancies were much more common in high-poverty neighborhoods than in their more affluent counterparts. Harding (2003) found that this causal link remained strong, even when different family backgrounds were taken in to account.

Other studies, however, believe that familial relations play a strong play a stronger role than neighborhood poverty. Moore and Chase-Lansdale (2001) found that African-American adolescents in poor neighborhoods have a greater probability of engaging in early sexual activity, compared to their peers in more affluent households. However, this study also found factors that create differences in sexual activity within the disadvantaged neighborhoods.

Moore and Chase-Lansdale (2001) found, for example, that African-American teenagers who enjoy strong bonds with their parents were more likely to abstain from early sexual behavior. This is particularly true for teen females and who have close relationships with their mothers.

Furthermore, Moore and Chase-Lansdale (2001) found that black teenage girls who experienced pregnancy were "significantly less likely" to be living in intact families. Rather, they often lived in single-parent households. Girls who did engage in risky sexual activity and experienced pregnancy also reported more "alienating mother-daughter relationships." Their mothers were often less communicative and as a result, the daughters felt more distant relationships.

Furthermore, Moore and Chase-Lansdale (2001) also posited that girls who lived with cohabiting adults were four times more likely to engage in early sexual behavior. However, this trend was countered among the girls who reported close relationships with their mothers.

The Moore and Chase-Lansdale (2001) findings contrast with the conclusions of the Harding (2003) study.

Harding (2003) concluded that the poverty in a young teenage girl's environment was the strongest predictor for engaging in early sexual activity and eventual pregnancy.

For Harding, these correlations hold true even when familial ties were taken into consideration. Since Harding conducted a longitudinal study comparing two sample groups, his findings are supported by solid research.

However, the conclusions of Harding's study are challenged when researchers focus on race. Moore and Chase-Lansdale (2001) found that within poor African-American communities, there were still significant differences in the rates of early sexual activity and teen pregnancy.

In these cases, the greatest predictor for pregnancy was the teenage girl's relationship with her mother. Those who enjoyed close-knit relationships with their mothers were far less likely to become pregnant, even when other factors were taken into consideration.

Thus, for disadvantaged young black women, the quality of the family unit assumes greater importance, especially if the teen lives in an impoverished neighborhood. Strong, close-knit families thus serve as a buffer, protecting many teens from the negative influences from their neighborhood. These close-knot relationships also come into play even for teens who engage in sexual activity. Moore and Chase-Lansdale (2001) additionally found that teenage girls who have close relationships with their mothers are more likely to practice safe sex by using contraception and having fewer sexual partners.

To be effective for all teens, pregnancy prevention programs thus need to address the special factors that give rise to pregnancy among African-American teenage girls. The next section discusses the main types of pregnancy and safe-sex programs currently being implemented and evaluates how these programs respond to the unique needs of the African-American community.

Programs and policies to prevent teenage pregnancy

There is a multitude of teenage pregnancy prevention programs currently being implemented in the United States. Many programs receive public and federal funding, while others are privately-financed. These programs can be grouped under four main types -- education programs, health care, service learning and youth development programs. Following is a discussion of these types of programs, followed by an evaluation of how these programs address the main predictors of pregnancy for African-American adolescent girls.

Education programs

The majority of these programs focus on educating teenagers regarding the safe sex and HIV prevention. Many of these programs emphasize abstinence as the safest method for preventing pregnancy and sexually transmitted disease. Many such programs are taught as part of the regular school curriculum. Other classes are conducted after class hours. Still other programs are conducted by experts and volunteers in juvenile detention centers and homeless shelters.

There is a wide diversity among the types of education programs. Advocates of abstinence-only education, for example, argue that contraception education have failed to stem the tide of pregnancy and sexually transmitted disease among high-school students. Napier (1999) argues that abstinence-only programs are the more effective solution. Programs such as the Washington, DC-based Best Friends, for example, match a teen girl with an adult mentor. Weekly one-on-one and group meetings will teach the girls self-respect and decision-making skills that will form the basis of a sexually-abstinent lifestyle. The Best Friends program also emphasizes avoiding drugs and alcohol, which are considered risk factors for early sexual activity.

Other cities have implemented similar programs, such Chicago's Project Reality. This program offers a "values-based" curriculum that espouses abstinence until marriage as the wise and moral choice. Similar to Best Friends, the Project Reality program offers participants weekly group lessons on substance abuse and human sexuality. In addition, however, Project Reality also addresses the "cultural influences" that promote teenage sexual activity. These influences include television programs and movies that portray teenage sexual activity as desirable, normal and generally free from consequences (Napier 1999).

Other programs focus more on the prevention aspect, instead of only abstinence. Many HIV education programs emphasize using condoms. Most public schools offered more comprehensive sex and HIV education that went beyond abstinence. Different age-appropriate programs have also been implemented in middle-schools and high-schools around the country. These school programs were successful in delaying teenage sexual activity and by extension, teen pregnancy.

Many studies have reported how these education programs have been successful in encouraging abstinence or safer sex. However, an evaluation of the content of these programs shows that both abstinence and safe-sex education do little to promote stronger family ties among disadvantaged families. It should be additionally noted that strong family ties between mother and daughter are the greatest predictor of delayed sexual activity for African-American teenage girls.

Thus, while abstinence- and safe-sex education help to address teenage pregnancy, the effectiveness of these programs are muted when race is taken into consideration.

First of all, it is unlikely that school districts in poor neighborhoods already have strained budgets and may not have the resources for extra programs like sex education. Also, many African-American teens in low-income neighborhoods are forced to drop out of school due to poverty. For these teens, school-based programs are useless. Furthermore, many teens who need to work to the augment family income will not have time for after-school or community education programs.

While the education programs have an invaluable function, particularly in HIV and AIDS prevention, they do not address the lack of strong family ties. After all, as seen in the Moore and Chase-Lansdale (2001) study, strong ties between mother and daughter and stable family relationships are a strong buffer against sexual activity, even in low-income and so-called "rougher" neighborhoods.

Overall, education programs by themselves are not effective enough to help prevent pregnancy among African-American teenage girls.

Health clinics and counselors

Community health activists have pointed to the role a clinician could play in helping teenage girls avoid pregnancy and sexually transmitted diseases. This is because clinic visits are confidential. In this setting, a health-care provider is in a unique position to provide both medical care, contraception needs and counseling to the patient. The one-on-one nature of this interaction has the further advantage of ensuring the session is tailored to the patient's unique individual needs (Boekeloo et al. 1999).

Because of its healthcare focus, many of these programs emphasize educating patients about sexual diseases. In one program, for example, a nurse spends 10 to 20 minutes discussing diseases like Chlamydia, complete with illustrated pamphlets. The nurse then teaches the patient how to put a condom on a banana. Role-playing exercises further help teenage girls develop skills to convince their partners to wear condoms (Boekeloo et al. 1999).

These health-care programs have several key advantages over other pregnancy prevention programs. First, the one-on-one nature of the program encourages greater openness for more reserved teens, who may be embarrassed about airing their concerns in group settings. Also, clinicians have more time to devote to the individual needs of their teen patients. Furthermore, though teenage girls are the main targets of many pregnancy-prevention programs, the healthcare programs also help prevent teen pregnancy by educating male adolescents as well.

However, the success of these programs is once again tempered by factors like race and income. Recent budget cuts in social spending have forced many clinics in inner-cities and low-income neighborhoods to close. Since teens in low-income neighborhoods faced a higher risk of teen pregnancy (Harding 2003), the growing scarcity of community clinics is another factor that increases pregnancy among teenagers.

Additionally, clinics in low-income minority neighborhoods were few in number to begin with. The few clinics that did exist were hampered by poor funding. The strained resources only allowed for a skeletal staff and many were not able to give out free contraception.

Additionally, while these programs also provide invaluable services, their effectiveness is also quite limited. First of all, not every area has a clinic to begin with, and many clinics have previously closed. These health-care programs also require much investment on the part of the teen patient in terms of time and patience. Many would not feel comfortable going to such clinics, particularly when they have to work or when they would be recognized by other patients.

Finally, like education programs, health-care programs once again do not address the lack of strong ties between mothers and daughters.

Because of this limited, health-care based approached have only had limited successes in addressing pregnancy among African-American teenage girls.

Service Learning Programs

Service learning programs are another term to describe programs designed to involve teens in civic activities in their communities. Teens could participate in voluntary programs such as tutoring younger children, helping to maintain parks, assisting personnel in clinics and hospitals and working in nursing and retirement homes. Most of the teens participate in the voluntary programs, though others also receive class credit for their services (O'Donnell et al. 2000). Many schools make an extra effort to tie the community activity to current lessons.

Of all intervention programs, these service learning programs show the strongest evidence for reducing teen pregnancy rates while the teens are still enrolled in the program. An evaluation of the effectiveness of these programs in different locations around the country show that active service programs reduced rates of pregnancy or sexual activity among area teenagers (O'Donnell et al. 2000).

One of the earliest service programs was called Teen Outreach Program (TOP), which was instituted in several locations around the country. The TOP programs were conducted with the help of schools. TOP participants spent 46 hours doing various community services, ranging from tutoring to working in nursing homes.

A statistics showed that the program's participants showed lower pregnancy rates during the school year, compared to a control group. As an added benefit, TOP participants also reported lower rates of school failure (O'Donnell et al. 2000).

Researchers have suggested many reasons for the effectiveness of service learning programs. Some posit that the voluntary programs help focus the teenagers into thinking about the future. This is particularly true when the volunteer activities are tailored to students' interests. Thus, those who are interested in teaching are enrolled in tutorial programs. Students interested in carpentry and construction help in sprucing up public facilities or in building wheelchair ramps.

Corollary to this, others have posited that such activities may help keep children interested in school.

The increased focus on academics helps the teenagers to consider the consequences of risky sexual behavior. Others were inspired by the difference they can make in the lives of others. All these factors combine to encourage teens to avoid pregnancy and motivate them to stay in school.

Many of these programs have the added benefit of being privately-funded or using very little public resources. This factor makes these programs much easier to implement, especially in the low-income areas where teen pregnancy rates are the highest.

Another important factor behind the success of volunteer programs is the positive relationships many teens in these programs form with the program facilitators. Many teens have found caring mentors and close friends in their program facilitators. These teens reported that the close relationships have helped them develop self-esteem and made them feel more comfortable relating to their peers and to other adults (O'Donnell et al. 2000).

This last factor has significant implications for the success of such programs among African-American communities and in low-income neighborhoods. In these areas, the lack of a strong relationship with the mother or another parent contributes significantly to teen pregnancy.

Because many low-income and single parents have to work longer hours, many teens grow up feeling alienated and with little parental guidance.

Mentor-relationships could help address this alienation by giving young people a positive role model. Though the bond between mother and child would be difficult to replicate, a strong, positive relationship with a caring adult mentor would help to fill the void.

Youth development programs

Following the adage regarding an ounce of prevention, many programs specifically recruit youth beginning at age 13 and encourage them to participate throughout high school. These programs hold special activities and educational programs five days a week. Many operate during the "risky" hours in between school dismissal and dinner time, the time studies have shown to be the most likely period when risky or criminal behaviors occur.

Youth development programs do not target teen pregnancy per se. Rather, the focus is to curb a host of undesirable behavior ranging from drug use, petty theft and vandalism. The privately funded Children's Aid Society -- Carrera Program, for example, is a long-term intensive program that provides a host of services, from homework help, standardized exam preparation and sex education. Counselors are on hand to provide information on safe sex, reproductive health and other concerns. A "job club" helps participants maintain gainful after-school employment, plan a budget and individual bank accounts. Participants spend an average of 16 hours per month on the program. During summer months, the participants also have the option of enrolling in paid employment programs and participate in seminars and projects to hone their entrepreneurial skills (Philliber et al. 2000).