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teen pregnancy

Texas’ teen pregnancy rate is the result of bad policy choices

From the Rivard Report:

In Texas each year, about 35,000 young women get pregnant before they turn 20. Traditionally, the two variables most commonly associated with high teen birth rates are education and poverty, but a new study, co-authored by Dr. Julie DeCesare, shows that there’s more at play.

“We controlled for poverty as a variable, and we found these 10 centers where their teen birth rates were much higher than would be predicted,” she said.

DeCesare, whose research appears in the June issue of the journal Obstetrics & Gynecology, said several of those clusters were in Texas. The Dallas and San Antonio areas, for example, had teen pregnancy rates 50% and 40% above the national average.

Research shows teens everywhere are having sex. Gwen Daverth, CEO of the Texas Campaign To Prevent Teen Pregnancy, said the high numbers in Texas reflect policy, not promiscuity.

“What we see is there are not supports in place,” Daverth said. “We’re not connecting high-risk youth with contraception services. And we’re not supporting youth in making decisions to be abstinent. We’re just saying that is an approach we want to take as a state – whereas other states have put in more progressive policies.”

Daverth said California invested in comprehensive sex education and access to contraception. There, the teenage birth rate dropped by 74% from 1991 to 2015. The teen birth rate in Texas also fell, but only by 56%.

In South Carolina, young women on Medicaid who have babies are offered the opportunity to get a long-acting form of birth control right after they give birth. They’re also trying that approach in parts of North Carolina. And Colorado subsidizes the cost of long-acting birth control. There, both abortions and teen birth rates are dropping faster than the national average.

Texas makes it hard for teenagers to get reproductive health care, Daverth says.

In Texas, if a 17-year-old mom wants prescription birth control, in most cases she needs her parents’ permission. “Only [Texas] and Utah have a law that if you’re already a parent, you are the legal medical guardian of your baby, but you cannot make your own medical decisions without the now-grandma involved,” Daverth said.

That’s part of the reason, she notes, Texas has the highest rate of repeat teen pregnancies in the country.

Emphasis mine. That’s pretty much our state in a nutshell. The problem is that any effort to deal with this necessarily begins the acknowledgment of the realities of the situation – you know, like that teens have sex and that teens who have sex without access to contraception and good information about reproductive health are much more likely to become parents than teens who do have those things – and we’re no good at that. Shame and denial is so much easier, and we live with the results of that.

Let’s talk about sex education

We’re not good at it.

Rep. Mary Gonzalez

A Democratic state lawmaker is looking to bolster high school sex education requirements in hopes that Texas can lower its teen birth rates.

Rep. Mary González, D-Clint, filed House Bill 1547 to require sex education classes to include “medically accurate, age-appropriate” human sexuality education. The bill would allow students to be excused from the course with the written request of a parent or guardian.

“It’s deeply troubling that Texas has one of the highest teen birth rates in the nation,” González said Tuesday. “Our young people deserve to have correct, accurate information.”

Teen birth rates in Texas are among the highest in the country. According to a 2014 report from U.S. Department of Health and Human Services, the teen birth rate among Texas women ages 15 to 19 was nearly 40 in 1,000 girls. The national birth rate in 2015 for teenagers of the same age was 22 births per 1,000 girls, according to the agency.

González filed the bill on the heels of the Texas Freedom Network’s most recent report that found that more than 80 percent of the state’s public school districts are not teaching sex education or exclusively teach abstinence-only birth control.

The study found that the number of school districts that do not teach sex education has increased to more than 25 percent in 2016 from 2.3 percent in 2008.

The group also found that another 58 percent of school districts took an abstinence-only approach to sex education last year. Those districts did not include information about condoms or other forms of contraceptives.

“All of these findings make clear that policy makers need to create common-sense, very necessary solutions,” González said.

That would be nice, wouldn’t it? For lots of things. There are lots of reasons why this would be a good thing for the Lege to do, and at least as many reasons why they won’t. We’re going to need a different Lege for that. The Trib and the Observer have more.

We don’t need no (sex) education

Here’s the state of Texas leading the nation in yet another unflattering category.

In Texas and across the country, the rate of teenage births has declined significantly since its peak in 1991. Birth rates among teenagers in Texas dropped 43 percent between 1991 and 2012. In states like California and Connecticut, the drop was even larger, and nationwide, the rate declined 52 percent in that period.

But despite the improvements in the Lone Star State, it is faring worse than most. Texas has the nation’s fifth-highest birth rate among teenagers, behind Arkansas, Mississippi, Oklahoma and New Mexico. And Texas, where schools are not required to teach sex education, has the highest rate of repeat births among teenagers ages 15 to 19. Teenage birth cost Texas taxpayers $1.1 billion in health care, foster care and lost tax revenue in 2010, according to the National Campaign to Prevent Teen and Unplanned Pregnancy. Teenage mothers often drop out of school, specialists said, and their children are also likely to become teenage parents.

Gov. Rick Perry’s office said a drop in the birth rate among teenagers in the last decade corresponded with the state’s abstinence education program.

“Teen pregnancy is a multifaceted issue with many contributing factors,” a spokesman for Perry, Travis Considine, said. Among those factors, advocates said, are race, ethnicity and economic status.

Dr. Janet Realini, president of Healthy Futures of Texas, a nonprofit that works to prevent teenage and unplanned pregnancy, said that Texas’ often ineffective sex education helped explain the state’s comparatively high teenage birth rate. Other factors, she said, include the limited access to health care and insurance for the poor as well as the high rates of school dropouts and poverty.

“It’s this mentality that we’re Texas, we do it our way, we ignore science and kind of go with our gut,” said David Wiley, a professor of health education at Texas State University in San Marcos. “That Wild West mentality about public policy is not helpful.”

One state with similar demographics to Texas is faring much better: California, which cut its teenage birth rate by 64 percent from 1991 to 2012. Melissa Peskin, an assistant professor at the University of Texas School of Public Health in Houston, said Texas could lower its teenage birth rate by following California’s example in areas like sex education and access to contraception.

Others are not convinced. Jonathan Saenz, president of Texas Values, which promotes family values and abstinence-focused sex education, said California’s abortion rate is higher than Texas’.

“In Texas, since when did we think it was a good idea to adopt any policy from California?” Saenz said.

“I don’t think the proper measure is how do we compare to other states,” he added. “It’s undeniable that not only in our state but across the country, teen birth rates are at historic lows.”

The real problem, he said, is the glamorization of sexual activity.

Boy, you couldn’t come up with a better illustration of what Professor Wiley is talking about if you tried. Jonathan Saenz is the perfect distillation of the idiotic theocracy that our state is beholden to. If you need to be reminded what 2014 is all about, think about him.

Anyway. As you might imagine, the recent budget cuts that slashed family planning funds and forced the closure of dozens of clinics didn’t help. It was so bad even some Republicans are now dimly aware that there’s a connection between unprotected sex and pregnancy. As usual, we’re in the position of hoping we can maybe get back to where we were a few years ago, which is better than where we are now but still way behind where we should be given the state’s robust population growth. Which means we’ll fall even farther behind California, and Colorado, too. Happy now, Jonathan?

On a side note, according to the Trib this story is one entry in a 10-part series on the flip side of state leaders’ aggressive pursuit of the “Texas Miracle”. Other entries will be found here, and see also their Hurting For Work series for more. Kudos on the reporting here, because Lord knows there’s a ton of stories like these out there needing to be told.

News flash: Birth control prevents unwanted pregnancies

I know, I’m as shocked as you are.

Right there with them

Free birth control led to dramatically lower rates of abortions and teen births, a large study concludes. The findings were eagerly anticipated and come as a bitterly contested Obama administration policy is poised to offer similar coverage.

The project tracked more than 9,000 women in St. Louis, many of them poor or uninsured. They were given their choice of a range of contraceptive methods at no cost — from birth control pills to goof-proof options like the IUD or a matchstick-sized implant.

When price wasn’t an issue, women flocked to the most effective contraceptives — the implanted options, which typically cost hundreds of dollars up-front to insert. These women experienced far fewer unintended pregnancies as a result, reported Dr. Jeffrey Peipert of Washington University in St. Louis in a study published Thursday.

The effect on teen pregnancy was striking: There were 6.3 births per 1,000 teenagers in the study. Compare that to a national rate of 34 births per 1,000 teens in 2010.

There also were substantially lower rates of abortion, when compared with women in the metro area and nationally: 4.4 to 7.5 abortions per 1,000 women in the study, compared with 13.4 to 17 abortions per 1,000 women overall in the St. Louis region, Peipert calculated. That’s lower than the national rate, too, which is almost 20 abortions per 1,000 women.

In fact, if the program were expanded, one abortion could be prevented for every 79 to 137 women given a free contraceptive choice, Peipert’s team reported in the journal Obstetrics & Gynecology.

The findings of the study, which ran from 2008 to 2010, come as millions of U.S. women are beginning to get access to contraception without copays under President Barack Obama’s health care law. Women’s health specialists said the research foreshadows that policy’s potential impact.

“As a society, we want to reduce unintended pregnancies and abortion rates. This study has demonstrated that having access to no-cost contraception helps us get to that goal,” said Alina Salganicoff, director of women’s health policy at the Kaiser Family Foundation.

“It’s just an amazing improvement,” Dr. James T. Breeden, president of the American College of Obstetricians and Gynecologists, said of the results. “I would think if you were against abortions, you would be 100 percent for contraception access.”

You would think so, wouldn’t you? But of course the same so-called “pro-life” zealots in our Legislature also spent the last session slashing funds for family planning services, thus doing their best to ensure that we have a maximal unwanted pregnancy rate. Sen. Dan Patrick once told Paul Burka that even if he opposed the sonogram bill, he ought to “celebrate if a life was saved because a woman, who chose to see the sonogram, or hear the heartbeat, decided to keep her child, or put it up for adoption”. You’d think people like that would want to take every reasonable step they could to reduce the number of abortions, but clearly their definition of “reasonable” doesn’t include family planning or contraception. Instead, this is what we get from the “pro-life” lobby:

Jeanne Monahan of the conservative Family Research Council suggested contraceptive use can encourage riskier sexual behavior.

“Additionally, one might conclude that the Obama administration’s contraception mandate may ultimately cause more unplanned pregnancies since it mandates that all health plans cover contraceptives, including those that the study’s authors claim are less effective,” Monahan said.

It’s about the sex, you see. It’s always been about the sex. If you’re going to have the kind of sex that the Family Research Council doesn’t approve of, then you deserve whatever consequences you suffer as a result.

Another reason why Texas has a high teen pregnancy rate

We’re lousy at sex education.

In the mid-1990s, California embraced sex education that teaches students the importance of waiting until they’re older to have sex, but also the value of using protection if they don’t wait.

Compare this with classrooms in Texas, where messages around contraception — if they’re delivered at all — have sometimes been shrouded in negativity and misinformation.

Which method has proved most effective?

The numbers are telling: Texas had the fourth-highest teen birth rate in the nation while California was 29th in 2010.

California reduced its numbers despite sharing Texas’ demographics and sky-high teen birth rates in the early ’90s. And while more teens have abortions in California than in Texas, California reduced those at the same time it brought down teen births.

California teachers freely promote condom use and other birth control methods. They demonstrate condom use in class. Classroom talk is frank and open. Many schools have free condom handout programs.

In Texas, where a state code demands a heavy emphasis on abstinence, teaching tends to be more constricted. Condoms can’t be distributed as part of instruction.

Across the U.S. there are essentially two types of sex ed curricula — comprehensive programs that promote abstinence and contraception, and programs that promote only abstinence, many of which historically cast contraceptive use in a negative light, if it was included at all. Texas has been called the “poster child” for the latter.

But the buzzword in sex education now is “evidence-based” — programs that are proven to positively change teen behavior — most of which are comprehensive, at least for now.

As the tide turns toward such rigorously tested programs, once firm lines are blurring. Some so-called abstinence-only programs teach more than “just say no” — decision-making skills and the like — and some now address contraception in a more neutral way. Meanwhile, some so-called comprehensive programs spend more time teaching abstinence than contraception.

In Texas, parents, teachers and administrators are rethinking sex education.

It’s a fairly long story, and it’s worth your time to read. As we know, there are more factors involved in the teen pregnancy and birth rates than just the quality of sex education, but we’re not in good shape with any of them. You might also be surprised to learn that “abstinence only” sex education can be evidence-based, too. I have philosophical issues with the concept of “abstinence only”, but if such a curriculum can be shown to be effective in reducing teen pregnancy and STD transmission, I can live with it.

One more thing:

Teaching birth control, especially in middle school, “is a sad message, almost like giving up,” said one mother who asked not to be named so as not to identify her children. Her two teen sons took vows to remain virgins until marriage.

“Teaching that condoms provide safe sex isn’t true,” she said. “But the real problem is it makes you think you’re entitled to do whatever you want. You’re not entitled to have sex just because you want to.”

Kyleen Wright, president of the Texans for Life Coalition, agreed.

“We don’t tell kids, ‘Try not to be too fat or too drunk when you drive or just smoke a little bit,’” she said. “In Texas, we have a clear and singular message. We don’t change that message just because not everyone is getting it.”

But Cheyenne Armendariz, 12, who attends New Frontiers, said kids can discern the difference between information and permission. “I mean, like, duh, we have our own brains,” she said.

You tell ’em, Cheyenne. As the story notes, the facts are on your side. For more information, see these Texas Freedom Network reports.

The teen birth rate in Texas

The good news is that it’s declining. The bad news is that as with so many other things, Texas ranks among the lowest in the country.

Birth rate for women aged 15–19, by state: United States, 2010

Despite a slight improvement from 2009, Texas still had one of the nation’s highest teen birth rates in 2010, data released Tuesday show.

Texas took a baby step in the newest report, moving from having the nation’s third highest birth rate for teens between the ages of 15 and 19 in 2009 to the fourth highest in 2010, according to the U.S. Centers for Disease Control and Prevention.

Teen birth rates have been falling nationally and are now at an historic low going back to 1946, according to the CDC.

Texas has made dramatic strides in two decades, when its birth rates for teens 15 to 19 fell from 78.4 per 1,000 in 1991 to 52.2 in 2010, according to the CDC data. That’s a drop of 33 percent. But teen birth rates for the nation as a whole have been falling faster, from 61.8 per 1,000 in 1991 to 34.3 per 1,000 in 2010, a 44 percent decline.

“This is good news, but it’s not as good as it could be,” said David Wiley, a health education professor at Texas State University and founder of the Texas Campaign to Prevent Teen Pregnancy. “This isn’t anything to throw a party over.”

Chris Van Deusen, a spokesman for the Texas Department of State Health Services, said teen birth rates and teen pregnancies in the state “have been on a fairly steady decline.”

He provided data on teen pregnancies for girls ages 13-17 and said the state does not have quick access to the birth data used by the CDC.

“While the teen pregnancy rate has been declining, there is still room for improvement,” Van Deusen wrote in an email, “and we’re going to continue working toward that.”

You can see the CDC report here. I’m not sure what specifically Mr. Van Deusen has in mind for that, but it probably doesn’t matter. Via Sarah Kliff, who has some charts to illustrate the CDC’s data, we get the following:

In a new working paper, Kearney and Levine looked at international differences in birth rates, as well as variations among American states. There are widespread differences in rates: New Hampshire’s stands at 16.4 births per 1,000 teens, while Mississippi’s is 64.4. The researchers found a state’s level of economic inequality to be a significant influence in the birth rates. All other things being equal, “teens in the highest-inequality states are roughly 5 percentage points more likely to give birth as teens in the lowest-inequality states,” Kearney and Levine wrote. This was true even when the researchers controlled for the individual teenager’s economic status.

“We conclude that women with low socioeconomic status have more teen, nonmarital births when they live in higher-inequality locations, all else equal,” they said. “Our estimates suggest that income inequality can explain a sizable share of the geographic variation observed in the teen childbearing rate, on the order of 10 to 50 percent…To the extent that greater levels of inequality are associated with a heightened sense of economic despair and marginalization, our empirical findings support this claim.”

That economic inequality can produce high teen birth rates would align with what we know about disparities in wealth here and abroad. The World Bank has consistently found a greater level of economic inequality in the United States than in Europe.

Some other factors may also be behind the discrepancy. American teens tend to have intercourse at lower rates than some of their international counterparts, yet they are also less likely to use contraceptives. About one-third of American teens terminate their pregnancies, which is an abortion rate similar to that of Germany (31.3 percent) but slightly lower than other countries, such as the United Kingdom (38.8 percent).

I predict with great confidence that the state of Texas will do nothing to address this. Indeed, the budget cuts of 2011 did about as much as humanly possible to exacerbate it, in the short term as well as in the long term. If and when the subject of teen pregnancy comes up in the next legislative session, I predict this won’t even be part of the conversation. So don’t be surprised when not much has changed when the next batch of data gets released.

Helping teen parents in schools

Interesting article about how HISD high schools helps the moms and moms-to-be among its students. Two points to make:

Most teen moms don’t graduate high school, and national statistics show that far fewer — only 2 percent — go on to earn a college degree before age 30. The problem is particularly profound in Houston — where more girls under 15 give birth than in any other U.S. city, according to a report last week from the research nonprofit Child Trends.

While many pregnant girls used to be shipped off in shame to special schools, districts these days report a full-court press to try to keep expectant students and young moms coming to class.

Like Lee High School, several Houston-area campuses offer free on-site day care, as well as more flexible school hours. Some districts have night classes, for example, while others offer online courses students can take at their own pace.

“The cynic in me might say that because it’s so relatively common nowadays that young people get pregnant that schools are just, out of sheer repetition, better at dealing with it,” said Bill Albert, chief program officer for the National Campaign to Prevent Teen and Unplanned Pregnancy.

Schools must walk a fine line, Albert said, between condoning teen pregnancy and supporting teen parents. “We have to send a message that teen pregnancy is not OK and be able to help young mothers succeed,” he said. “That’s tough.”

I guess I don’t quite get the worry about glamorizing teen pregnancy. I mean, all you really have to do is make sure everyone sees just how much time and effort it takes for these girls to care for their babies while still working towards completing their studies. Seems to me the reality is a stronger message than any a teacher or principal or counselor could give. And not to put too fine a point on it, but I don’t think the girls who are taking care of their business need to be stigmatized or shamed, certainly not by the very schools that are trying to help them graduate. It’s clear they get enough of that from their daily lives – just read the comments on the Chron story (yeah, I know, I should know better, but I couldn’t help myself), where the prevailing opinion seems to be that it would be better to just throw them all out onto the street, for a taste of that. In short, I think there’s more than enough people telling them that they shouldn’t have done what they did.

The other point is what about the fathers of these girls’ children? That’s a complicated issue.

Sylvia Cook, who has overseen Cy-Fair’s program for about a decade, said she thinks even more pregnant girls aren’t coming forward statewide. Some, she said, are scared off because they have to register the baby’s father with the Texas attorney general’s office to get state aid.

I presume that’s because a nontrivial number of those fathers would be in legal jeopardy if their identities were revealed in that fashion. It’s not exactly a secret that a lot of these baby daddies are significantly older than the mommies, which would make them guilty of statutory rape. The reality of that is more complicated than the usual rhetoric would have you believe. If there’s a delicate balancing act that the schools need to do here, it would be in making sure the fathers are taking responsibility as well, at least in the situations where the mother wants them to be responsible.