Forum; Teen pregnancy and contraceptive education

You From the Center for Telecommunication Services, the University of Texas at Austin, welcome to Forum. I walk into a store, even sometimes when I walk into school, everybody just turns and stares at you like, hello girls, pregnant, I can't believe it enough for some bearers, that's when I hide my face. At 15, Susan is just one of the many teenage girls who become pregnant. In a society where birth control is readily available, there were over a million teenage

pregnancies last year, and the problem is on the rise, affecting young girls from all walks of life. In this week's program, we'll examine the obstacles concerning contraceptive education and the problems facing these young mothers, who are still in a sense, children themselves, all coming up on forum. Oh, God, why me? The majority of the reasons that teenagers give for getting pregnant, if they can define a reason, is one to get away from home, that's a very common reason, one way or the other.

The other is to have children of their own that they can care for, which is not as common, but is given. Another one is to please their boyfriend, because again, the boyfriend is so important in their life that they feel like they have to please him, or they will lose the boyfriend. That would be very hard for them to do. And then it was just plain accidental, it was unplanned and totally an accident. The majority don't say I got pregnant on purpose. The majority say it was an accident that they didn't realize they were going to get pregnant and all of a sudden they were pregnant. Normal Wilkerson is an assistant professor of nursing at the University of Texas at Austin. Over the years, she has done extensive work in counseling with teenage mothers. And she has experienced firsthand many of the problems they face. Well the first problem is the denial of the pregnancy. Denial usually lasts until the girl begins to show that she's pregnant. And that's one of the problems also about the choice of abortion for a teenager.

Many of these girls could never have an abortion because they wait too long. It's not safe for an abortion to be performed beyond a certain point in the pregnancy. And most of these girls go past that point before they can even face the reality of the pregnancy. Then once they face the reality of the pregnancy, they are faced with decisions if they're still living at home and if they're still in school. Who are they going to tell? How are they going to get the care that they need? That's going to happen to them many times. Their first feeling is what's going to happen to me. Then they begin to think about a baby is involved here. So getting them to the place of being able to talk about the reality is the next big step. Then they have to decide what they want to do about it. And this is where we have a very big problem in our society because some people feel it's

the girl's pregnancy, it's the girl's problem and what she decides should be respected. Other people feel the parents are still responsible for the girl and they should be a part of this decision and what is best for their family perhaps should be what is done even if the girl can't go along with it. The ideal thing is for the parents, the girl and her parents to be able to work something out together and that takes a certain amount of maturity and a tremendous amount of love. Teenage pregnancies fall into the high risk category due to a variety of factors. Dr. Peggy Smith is an assistant professor of obstetrics and gynecology in the College of Medicine at Baylor University and deals extensively with teen services and teenage pregnancies. I do a lot of volunteer work for the March of Dimes who has chosen adolescent pregnancy as a priority and the reason is basically medical.

That for the younger adolescent, the girl who is under 15, she is at high risk for something called toxemia. She's at high risk for being anemic. She is also high risk for having what we call a low birth weight baby which again correlates with a whole gamut of bad conditions, anything from mental retardation to cerebral palsy. The issue that confounds all the medical problems is a very natural one. These are teenagers who don't eat right, even in an on pregnant state, who aren't going to take care of themselves, who don't regularly see the doctor and it's hard to reconcile a person growing with a baby growing and getting them to doctors. That's about the best thing about being pregnant is I could come to the school and I felt I felt kind of comfortable, but I went to Travis and taught us four months and you know I didn't show until about the middle of my fifth month, but I felt like everybody at Travis knew that I was pregnant and I didn't feel comfortable.

If it wasn't for this, I would have dropped out of school. For the past five months, Susan has been attending the Keeling Learning Center. Through their teenage parent program, girls like Susan can continue their education during their pregnancy and learn the elements of childcare through the program developed by this school. Tina Juarez is the program coordinator at Keeling. One of the main objectives of the program is keeping the girls in school while they're pregnant. If they drop out while they're pregnant, then the chances of them going back to school are almost nil. So if they can come here and keep up with their studies through this difficult period and then continue for one semester after they've had their baby, I think they've had it made. And also secondly, we would hope that this program would be a preventive, they would learn some preventive things so that a second unwanted pregnancy does not occur. Everybody was over, it was pregnant, so I said, she like me, huh, too? You know, so kind.

And I talked to her, I can talk to her, and we're all in the same boat, we all blooms. Because all the girls at Keeling are in the same situation, it provides a comfortable setting where the girls can continue their lives and education without the speculation and stairs of the outside world. After the baby is six weeks old, the girls go back to their previous school, but many apprehensions exist in returning. I just feel like that's my main problem. I feel like when I go back to my regular school, people are going to look at me and everybody knows that I'm not with that guy and everybody's going to look at me and say, you know, she's got a baby and the baby's father isn't even around. There's the problem of facing your peers and a lot of the girls said that first day, you know, it's rather difficult because everybody knows why you were out and everybody's staring. But you know, most of them cope very well with it and they don't have any problems once they get in there.

They can stay that one semester, I guess very crucial, you know, after they leave us if they can stay in there for one semester, then I think their chances for staying in school will be a lot better. During or after the pregnancy, the young mother must make the decision to keep the child or give it up for adoption. In the 11 years Tina Juarez has been with the Keeling program, she has seen little variation in the girls' decisions. Maggie Smith confirms the findings of Keeling and explains the problems related. Unfortunately, the trend in the United States is that 9 out of 10 adolescents who find themselves pregnant will keep the baby and raise it, in most cases, as a single parent. The raising of the child is difficult because of several things. One, there is no daycare across the board in our country that will accept a newborn, the medical and the health risks are too great. The welfare roles, if the mother cannot provide or obtain adequate daycare, then she cannot go into the job market as a porter-self, and so the welfare roles become the only salvation.

For some reason, adolescents have problems controlling future fertility, so the cycle just continues and goes on. There have been some studies that indicate that children of adolescent mothers may have be at high risk for delinquency, so the problem just begins with the pregnancy and never ends. Now, there are some young girls who have the opportunity to have mothers who will help them in the daycare, but with the economics, the non-working housewife is a vanishing species. The role the parents and family play in helping the girl cope with her situation cannot be underestimated. For without their aid and support, the problems many of these teens face can seem overwhelming.

Many times the girls are, they get over the crisis of the pregnancy during the pregnancy, and if the parents accept them and accept the infant, they have a lot, they have fewer problems than if they've been totally rejected. If they've been totally rejected by the family, the problems are almost insurmountable. They have to quit school, they have to get a job, they have to raise the child alone financially. That's a burden. Many of these babies are victims of child abuse neglect, failure to thrive, because you have a teenager who is herself still a child in a sense, is not an adult, doesn't have an economic security, and many times fantasizes that the child will meet her dependency needs, and babies don't meet your dependency needs.

These take and you have to meet their needs, and this gets very difficult for them to handle. These girls are at risk for abnormal parenting. The babies are at risk for child abuse, failure to thrive, and neglect, and or neglect. In situations where there's more acceptance, then there may be some economic security provided by the family. The girl can stay in school, and this is a help. If they can go to a school like Keeling, where they're all able to bring their babies to the school, and learn infant care in the context of a normal school day, take turns with the infant care so they don't get tired of it. All they long with a baby can be a real burden, especially if you've got a lot of energy and you want to be doing other things, which the normal teenager has. So I think it depends on the situation they find themselves in.

They're going to have problems, no matter how you look at it, and dropping out of school and having an insecure situation financially, these are the two biggest problems. The effects of pregnancy on these young mothers are lasting. With a baby to care for, these young girls have lost their opportunity to lead their lives like other junior high or high school students. Now they hold the responsibility of another human life, and their concerns can no longer center around themselves. I wanted to do like I was trying to roll my hair Monday night, and he was crying and when nobody holding, so I couldn't do my hair because I had to get it, and I had to feed him. When nobody else does, I can't tell my mom would do everything. She didn't have me get pregnant, it kind of gets to me, gets on my nerves, I know that. I have him to worry about, I have to work all my life, I have to take care of him all my life. I mean, I said anything about a lot of stuff, you know, because I have to do it, and now you have to do it.

And like, I used to have money just to throw away, I can't throw no, I was, I can't throw no money away, because he needs this and he needs that. So, yeah, man, it's just a big problem, and I thought, you know, when I was pregnant, you know, just pregnant, smiling to your friends, you pregnant, which I wouldn't have seen half of, you know, and smiling in their faces, I said, I'm going to cry a lot. That dude, I cry. That's where I go, I'm going to cry, because I think about, why did I get off into this, you know, because I say, you know, I used to, you know, like, my mom says something to me, I yell back at her, and I know, you know, she said, you know, she get mad at me, she'd be fussed at me, she'll tell me, like, she went nine months with me and stuff, and I grow up the first setting stuff, and I say that to my own child now, I tell them that, you cry at me and I try to kiss you and stuff, and obviously, I've just been playing, but I know how it feels for, you know, young teenage to yell and stuff that they play, it's because it really hurts them, because I know I've, now that I got here,

and I know I hurt my mother too, by yelling at her, feel bad, because when I used to yell at her now, I got somebody to yell at, and plus, then one week, two week, three days, and all that, just a whole lot, you know, oh, for the time, I did cry, because I think about it a lot, miss, I'm playing, I did. Now, people don't think about you, they thought you was a good little girl and come up with a baby, you know, you know, I'm married, I'm very sensitive towards talking, I can't stand it. And I used to go to phases all the time, with my friends, and I'd be looking so stupid only once in a decade with stomach this big, and they up on the floor dancing, and somebody asked me to dance, no thank you, I'm too swollen, you know, you know, before I had them, I went to phases, and this man asked me to dance, and I said, I'm sorry, my poor life is over, I don't know why I'm sitting here, I felt so bad for myself, I just went to come

home, you know, they are dancing, yeah, do you know? Yeah, miss, I don't know, I don't know if they're my friends, or what, who called you when they know you can't go somewhere, you know. I'm not with the baby's father, you know, I'm afraid, you know, that my social life will be over completely, that's my main worry. They've been pushed to get married, you know, your mother's told her, you know, because you do is to get married, get married, like, you know, she's 20, and the guy she married was 15 when she married him, and he's still a baby, you know, and he's 16, and he can't get no grown man out of here. In the seemingly permissive society, and with the availability of birth control, it is often

difficult to understand why unwanted pregnancies exist. Sex education and family planning clinics offer information about contraception and sexuality. Yet one obstacle and contraceptive teaching is that teens are reluctant to consciously admit their sexual activeness. The important thing is that the decision is made freely, and that the girl is doing what she is doing, because that's what she really wants to do, and because she believes that it's best for her, and if a girl is trained to think about the implications of the decision to be sexually active, many of them will choose to not be sexually active, to wait until, you know, later, when they could either support a child if they would get pregnant, or until they have the emotional equipment to deal with a relationship that makes that kind of demand on them. But until they've really faced that issue, they can't make a choice. Once that choice is made, then you can work with the girl to find a method, and to use

it effectively, to prevent unplanned pregnancy. There are many federally funded family planning clinics around the country. Here, teens can receive information about sexuality and obtain their desired form of contraception. The most well-known clinic is Planned Parenthood. As a client, if you look at the poster boards over there, that includes your right to confidantiality, which means that any information you give us would not be given out to anyone else without your written permission. Your right to be treated courteously, and if you're not treated courteously, we'd like to know. The confidentiality provided by Planned Parenthood has allowed many teens to seek birth control, who otherwise would not, if parental notification were necessary. Yet that privilege may be violated by a federal regulation proposed by Secretary of Health and Human Services, Richard Schweiker. The proposal would stop 5,000 federally assisted family planning clinics from offering confidential services to teenagers under the age of 18.

Currently, more than 675,000 sexually active teenagers annually seek help from clinics that receive federal funds. We are not opposed at all at Planned Parenthood to communication between parents and their teenagers about sexuality. As a matter of fact, we encourage that. And we have many programs here at Planned Parenthood to support parents and teens talking to one another. But in reality, we know that that is very difficult to do, and in fact in some families, it is so difficult to do that they don't do it. We've done surveys at our own agency, and the surveys here at Planned Parenthood at Boston are similar to some national surveys, which indicate that about half of the teens which come in for family planning services have talked to their parents about that decision and are coming here with their parents' notification, and indeed consent. But about another half have not informed their parents and would not have come to family

planning clinic if such notification were to have been required. And national survey that was done by the Alan Goodmacher Institute, which is probably the leading institute of research in the area of teenage sexuality, indicated that more than 80% of the teens who were sexually active and whose parents did not know that they were sexually active would not come in for birth control services if parental notification was required. I'm not sure if I stated that clearly or not, but what it means is of those half that said that their parents did not know that they were required, did not know that their teens were coming in for birth control services, 80% of them said that they would not come into

a family planning clinic if their parents were to be notified. But yet of that 80%, only 2% said that that would stop them from having intercourse. So the consequences would be, as you earlier described, a great increase in the number of unwanted pregnancies among teens and amongst the number of abortions that those teens would likely have. And we, of course here, at Planned Parenthood do everything we can to prevent unwanted pregnancies because once they occur, no matter what the choices of the teen, it usually involves a great deal of unhappiness but for the teen and for their family and in general for society. Dr. Larry Brownstein is director of counseling and social services at Planned Parenthood of Austin. Many myths exist that obstruct the delivery of sex education and birth control. A prime example is the fear that the discussion of sexuality will promote sexual activity. About 80% of our teen clients who come here for the first time are already sexually active

and have been active for several months on the average before they come here for birth control services so that the decision whether or not to be sexually active is made before or independently of the availability of birth control services and that seems to be fairly national norm. In 1979 there were over a million teenage pregnancies in that year and of those million there were over 500,000 births. An interesting statistic from those births is that over 90% of those 500,000 were unintended. That doesn't mean they were unwanted at the time of delivery but that they were unintended and unplanned pregnancies over 90% of them. In that same year there were over 400,000 abortions. And also within that year there were over 400,000 pregnancies, unintended pregnancies prevented by the use of birth control services to teens.

What would happen if the teen services were reduced because of the notification requirement is that there would be an increase as estimated by the Ellen Gutenmacher Institute of over 200,000 unintended pregnancies and or abortions each year and of course that statistic that is of great concern to us. If Schweiker's proposal is enacted the results would be more unwanted pregnancies, more out of wedlock births and more abortions. Sharon Ursch, executive director of Planned Parenthood in Austin, explains that the resulting costs alone would far exceed the funding provided to family planning clinics. Economically, I mean we've been aware for a long time that family planning is one of the most just considering it from an economic perspective and not at all from a human perspective. The latest study indicates that every governmental dollar that's spent on family planning services, the next year saves two dollars in direct medical and social service programs.

And you spend that over a 12-year period, you know figuring 12-year average for dependency or whatever. You're really talking about a much more expensive program than family planning ever was. And then when you start adding into it the human element and the non-measurable costs like lost education, lost job potential, that kind of stuff that just isn't measured in that two dollars, it's really mind boggling that a conservative or liberal administration would not support family planning programs on some level with a whole lot of visible support because it is cost effective, it saves, I mean it just from the human suffering condition is just monumental the effect that we have. And so it's just it's amazing to me that people continue to not support it, not only not support it but to try and put obstacles in service delivery, it's just amazing to me.

Until the day when teens can go to their parents, Planned Parenthood remains a place that allows them the opportunity to ask questions and obtain birth control without the fear that their confidentiality will be violated. We are a safe environment, a lot of teens see us that way and we can give them factual information, we can give them birth control methods, they don't feel like we're going to jump on them or do some kind of negative message to them, we're not going to say you shouldn't be here, we're going to say stuff to them like you've been sexually active, you want a birth control method, here's what you need to know about that and we're going to encourage them in different ways to speak to their parents without forcing it. One of the things that we do here is try and encourage through our sex ed programs, kids going back to their parents and parents going to their kids, a couple of the posters which you may or may not have seen, we have two, once as I'm a parent who's willing to talk with my child about sex or anything else for that matter and the parent signs and

puts it on the refrigerator door and we've also got one as as I'm a young person who's willing to talk with my parents about sex or anything else for that matter and just having that sort of acknowledgement that you can say that and put it someplace where people can see it might be a step towards opening communication. I think if we could have the world be the way that we wanted it to be, it would be that we give information to kids and parents and then they together set their own values because we're not in the business of determining values for people but only providing information and services and we're trying to do that through some of our parents as sex educator programs through some of our sex ed programs, helping encourage that kind of communication, swikers bill forces it and in fact doesn't force it at all, tries to force it but the result will be that those kids will not talk to their parents, the ones who will are already doing it, the ones who aren't already doing it won't what the end result will be that

is that those kids get pregnant, large majority of them will continue having sex and will not use a prescribed birth control method and they won't talk with their parents. So it's not going to obtain the results that he wants, the 60% or 50% that are already telling their parents won't affect them at all, they'll continue to come here because they've already involved their parents, the ones who haven't must not have for some particular reason, they were afraid, they didn't think their parents would let them come whatever and so those are the kids who aren't going to come, that's scary, that's real distressing to think about the number of people that that's going to affect in the course of just one year. The Schweiker proposal endangers the freedom of many teens who choose to be sexually active and want to use birth control but are afraid to tell their parents, the results will unfortunately produce more girls like Susan who will face unwanted pregnancies that will alter their lives forever, sometimes I feel kind of lonely, just lonely feeling like I'm going through it by myself, but I mean no we'll see I've got my parents and everything but I feel like

I'm just, it's just, sometimes it feels like it's the end of my life but it's not life that can go on whether a matter how I feel and I just have to realize that. I'm Mary Sullivan and you've been listening to Forum. Cousette copies of this program are available and may be purchased by writing, Forum, the Center for Telecommunication Services, University of Texas at Austin, 78712, that address again is Forum, the Center for Telecommunication Services, University of Texas at Austin, 78712. Forum is produced at Public Station KUTFM and distributed by the Center for Telecommunication Services, all at the University of Texas at Austin. This is the Longhorn Radio Network.