Teen Birth Rate, 1991 -2014 10 Lessons Learned and Battle ...txcampaign.org/wp-content/uploads/2016/04/Lessons...in-the-Trench… · 10 Lessons Learned and Battle Scars Shared Sarah

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20 Years Focused on Preventing Teen Pregnancy (and Unplanned

Pregnancy, too)10 Lessons Learned and

Battle Scars Shared

Sarah Brown, Former CEO The National Campaign to Prevent Teen and

Unplanned PregnancyApril 11, 2016

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U.S. and Texas Trends

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1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Birthsper1,000

Teen BirthRate, 1991-2014

UnitedStates Texas

Sou rces:1 9 9 0 -2 0 1 2 B i rth Data - Ven tu ra,S.J. , Hami l ton,B .E., &Matthews,T.J. (20 1 4).National and StateP attern so fTeen B i rth s in th eUn ited States,1 9 4 0 -2 0 1 3 .National V ital Stati sticsRepo rts, 6 3 (4 ).Retrieved fromh ttp ://www.cd c.go v/n ch s/data/n vsr/n vsr6 3 /NVSR6 3 _0 4 .pd f;2 0 1 3 B i rthd ata - Martin , J.A., Hami l ton ,B .E., Osterman ,M .J.K ., Curtin,S.C.&Matthews,T.J. (2 0 1 5 ).B i rth s:Fin al Data fo r2 01 3.National V i tal Stati sticsRepo rts, 64 (1). Retrieved fromh ttp ://www.cd c.go v/n ch s/data/n vsr/ n vsr6 4 /n vsr6 4 _0 1 .pd f;2 0 14 B i rth d ata - Martin ,J.A.,Hami l ton ,B .E., Osterman ,M .J.K., Curtin,S.C., &Matthews,T.J. (2 0 1 5 ).B i rth s:Fin al Data fo r2 01 4.National V i tal Stati sticsRepo rts, 64 (1 2), 1 -6 4.Retrieved fromh ttp ://www.cd c.go v/n ch s/data/n vsr/n vsr6 4 /n vsr6 4 _1 2 .pd f.

Teen Births and Pregnancies in Texas

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Teen Births inTexas,Girls15-19

Teen births (2014) 35,063

Teen birthrate(2014) 37.87births/1,000girls

Changeinteenbirthratefrom2013 -8%

Changeinteen birthratefrompeakyear1991 -52%

Teen PregnancyinTexas,Girls15-19

Teen pregnancies (2010) 66,760

Teen pregnancyrate (2010) 73pregnancies/1,000girls

Changeinteenpregnancyrate from2008 -14%

Changeinteenpregnancyrate frompeakyear 1988 -38%

Lesson #1We often forget to explain WHY we care

So….why DO we care about TP?

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Why care? It is hard on the teen mothers…• Only 40% of mothers who have children

before 18 graduate from high school • Less than 2% of mothers who have children

before age 18 have a college degree by age 30• 61% of community college students who have

children after enrolling don’t finish their education, which is 65% higher than the rate for those who don’t have children

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Why Care? …and their children

Compared to children born to older moms (20-21), children born to teen moms are more likely to:–drop out of high school–become teen parents themselves–use Medicaid and SCHIP– experience abuse/neglect– enter the foster care system– end up in prison (sons)–be raised in single-parent families– live in poverty 6

Putting it all together

A child born to a teen mother who is unmarried and has not finished high

school is NINE times more likely to be poor than a baby born to a woman who

is NOT a teen, HAS finished high school, and is MARRIED.

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Lesson #2

Because we have not consistently explained the role of TP and UP in

limited education, poverty, and risky family structures, pregnancy planning and prevention have become defined as controversial reproductive health issues – thus getting us all drawn into what I

call the…8

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Vortex of ICK….

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Lesson #3

We are too reluctant to talk about money$$$$$$$$$$$$$$$

even though…

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Lesson #4All of us in MCH/FP and related areas

need to get straight on when our interests/interventions should begin.

Early for sure…But what IS “early”?

When IS “the beginning”?

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Family and Child

Pregnancy/Birth Infancy

If, When, With Whom, Under

What Circumstances?

Risk factors under control?

Starting at the REAL beginning

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Lesson # 5

Our entire sector has been late to the

media party

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Lesson #6

Evidence matters but it is no match for ideology

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Lesson #7

We do NOT know what to do about men and teenaged boys.

Too little basic researchToo few men working in this area

Too many pinkprograms on blue paper

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Lesson #8We are too reluctant to talk straight…(at a minimum, “stakeholders” must be banned along with low-hanging fruit,

thinking outside the box, capacity building, and holistic )

We need to take a lesson from the Hospital for Special Surgery…

Be clear….

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My straight talk point“Aunt Sarah’s Tips”

• Babies need and deserve adult parents.

• Babies don’t cement relationships, they stress them.

• Babies don’t give unconditional love; they demand it from the adults around them.

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More Aunt Sarah….

• To boys and men: Making babies doesn’t make you a man. Being a devoted partner and father may.

• To girls and women: Sex won’t make him yours and a baby won’t make him stay.

• Sex has meaning, risks, and consequences. It’s not a casual activity. Take it seriously.

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And finally (I promise…)

• Getting pregnant – including getting someone pregnant – is one of the most important things any of us ever does, with generational effects.

• Pregnancy needs to be thought about and planned with as much care as we bring to all other key issues and choices.

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Lesson #9

Particularly with regard to preventing teen pregnancy, we

cannot side-step

contraceptionRemember the Sawhill Maxim…

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Some methods are more equal than others…

• Focus on highly effective, low-maintenance methods (HELM)

• For teens as well as older women• Several carefully designed studies have shown

the value of access to high-quality care (free, in many instances), including HELMs

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CHOICE Study in St Louis• Recruited 10,000 participants over four years• Removed cost barriers for all

methods• Offered LARCs as best choice,

but women could elect anymethod.

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CHOICE Results

Source:http:/ /www.choiceproject.wustl.edu/~/media/Files/ChoiceProject/Study-Findings-20120917.ashx.26

Women using LARCs or shots had lowest unintended pregnancy rates after 1, 2, and 3 years.

Lesson #10 (maybe a prediction?)

We are at risk of confusing

progress with victory

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The Case for Going On

• Things that go down can go up• US ranking• Progress not equal: – older teens– teen moms– minority teens

• Consequences arguably more serious • TP as a “gateway” issue…

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And HOW to go on….1. Integrate PPP into other larger sectors2. Focus on higher risk groups 3. HELM 4. Put what works to work5. ACA/OKQ/QA measures and more….6. Move into the 21st century (media, sex ed, and

more)7. Parents, parents, parents8. Teens, teens, teens 9. And finally…

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Tell the truth….

Especially for the most disadvantaged, simply postponing a birth for a few years may not make much of a difference in overall life trajectories if there is no simultaneous progress on other fronts (schools, employment, opportunity, and more). That is, reducing teen pregnancy is necessary but may not be sufficient for achieving better lifetime results.

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National Campaign resourcesthat may help

• StayTeen.org for teens 17 and under• Providers.Bedsider.org just for YOU• Bedsider.org for older teens and young

adults…

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Also: Bedsider WORKSRCT showed that women exposed to Bedsider

were significantly less likely to report aPregnancy scareUnprotected sex

AND: LESS LIKELY TO REPORT AN UNINTENDED PREGNANCY

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Source: Antonishak, J ., Kaye, K., Swiader, L. (2015). Impact of an Online Birth Control Support Network on Unintended Pregnancy. Social Marketing Quar terly, 1-14.

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Thank You!Reach me at:

[email protected]

Please visit:

TheNationalCampaign.orgStayTeen.orgBedsider.org

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