Contact Name
Barbara Dietsch
562-799-5126
bdietsc@WestEd.org

55.13.7. A lock combination? A football play? No. These are the birth rates per 1,000 15- to- 19-year-old young women in the U.S., Germany, and the Netherlands. These are the numbers that should be kept in front of us as we craft pregnancy prevention strategies for the next decades. D.C.-based Advocates for Youth and the University of North Carolina at Charlotte joined forces last year to take forty public health researchers and two teenage journalists on a study tour that visited three countries (France was also included) to explore the sociological, cultural and community factors that influence adolescent sexual behaviors.

The approach was new — designed in part to ensure that the study capture media attention, which it did. But the findings were not. The Alan Guttmacher Institute has been making this case, with increasing volume, since the mid-seventies: mentioning it in 11 Million Teenagers in 1976; charting it in Teenage Pregnancy: The Problem that Hasn’t Gone Away in 1981; writing a book about it, Teenage Pregnancy in Industrialized Countries in 1986. And the lessons have remained constant across the decades. Countries with low pregnancy, birth, and abortion rates separate values from responsible sexual behavior. (Abstinence is a laudable value, but it is not a contraceptive choice for the sexually active). They separate church from state, making sure public policies are driven by scientific research on effective pregnancy reduction strategies. They respect youth rights, expect young people to act responsibly, and provide them with affordable, non-threatening access to information and services.

Unfortunately, those lessons are likely to fall on deaf ears. Conservatives and liberals jockey to take credit for the steady decline in birth rates since 1991, but U.S. pregnancy and birth rates are still at least twice as high as those of other industrialized countries. Congress gets on the after-school programming band wagon, offering the "3 to 6" data on when pregnancies and crimes occur as a part of the rationale for increased funding, but continues to waiver on the more basic issues of reproductive health services for teens. What should be done?

I was a staunch advocate for dulling the sharp edges of the pregnancy prevention campaigns when I ran the Children’s Defense Fund’s campaign almost two decades ago. Chanting "problem-free isn’t fully prepared," I pushed for broader youth development language that acknowledged the overlap in prevention strategies and signaled the need to couple targeted prevention strategies with real investments in preparation and opportunities for youth. I am even more passionate today about the need to link prevention and development language and goals. But the strategy is not to dull the edges of one or the other, it is to sharpen the edges on both sides. We need to go into the next round with a double-edged sword.

I want the national and local pregnancy prevention campaigns and coalitions to forge the link between prevention, preparation, and promotion. I want the broader coalitions formed around youth development and youth services to do the same. I want the language and strategies for building teens’ capacity (e.g., information and services) and motivation (e.g., educational and economic supports and opportunities) to get equal billing.

I want youth workers and health workers trained and comfortable talking to teens about sex, drugs, violence, college, jobs, and community service. I want every single-issue campaign to tithe time to the larger messages so that people — policy makers, parents, and practitioners — learn to see these multiple messages as different views of the same picture. The larger messages? Problems (sex, drugs, violence) can be addressed, in the short term, with the same mix of strategies (building skills, relationships, expectations, connections, and providing targeted information and services). In the long run, however, problems dissipate (or are dealt with more easily) only when young people have the broader supports and opportunities they need to prepare and participate in mainstream society. I want the broader "invest in youth" campaigns to ground their larger messages in the specifics.

I want parents, older siblings, and other adults in teens’ lives to talk to them about sex, other issues, their presents, and their futures. A recent issue of Time Magazine for example (November, 1999) acknowledges the reductions in teen births but flags the increases in teen sexual activity. Raising the question "What should parents do?" The answers are quite clear. Keep lines of communication open. Extol the value of delaying sexual intercourse while exploring physical intimacy. Insist that their teens believe that the decision to have sex, and the decision to use contraception are one and the same. If family and religious values are such that it is critically important that that time does not come before marriage, parents have to be doubly vigilant — not in keeping other messages out — that simply won’t work — but in keeping their message in the foreground. All of these conversations have to be offered in the context of their sustained interest in their children’s lives.

Most important, I want policy makers to act responsibly. We simply cannot go into the next century dragging the moral baggage of the last. The government needs to take the pulse of its citizens — all of its citizens, those who vote Democratic, those who vote Republican and those who do not vote because they are too young — and then act on that pulse with unwavering swiftness and clarity. We need to get on with the business of planting services, supports, and opportunities in the middle ground where there is broad agreement — (e.g., making information and contraceptive services freely available to teens when and where they want it, and offering messages about abstinence and responsible sex how and with whom they will hear it).

It is discouraging to have lived through three major national campaigns to prevent teenage pregnancy and still not be ready for retirement. Youth workers have to pick up their banners again on this issue, to argue for more than basketball and leadership training.

Problem-free isn’t fully prepared. Full preparation requires access to information and services that can reduce problems. Without constant, aggressive vigilance, many young people (and increasing numbers of adults) in this country will be denied access to the basic information, guidance, and services that could help them make good decisions about sex, contraceptives, pregnancy and marriage.