Teenage Pregnancy… An educator's role in prevention Brian L Mudd

Scope of Problem How many teens have engaged in sexual intercourse? Half (49.9%) of all students have had sexual intercourse Hispanic male students (62.9%) were significantly more likely than Hispanic female students (45.5%) to have had sexual intercourse Black students (71.2%) were significantly more likely than Hispanic and white students (54.1% & 45.1%, respectively) to have had sexual intercourse Female students in grades 11 and 12 (53.8% & 65.8%, respectively) were significantly more likely than female students in grades 9 and 10 (32.5% & 42.6%, respectively) to have had sexual intercourse Male students in grade 12 (63.9%) were significantly more likely than male students in grades 9 and 11 (44.5% & 51.4%, respectively) to have had sexual intercourse

Sexual intercourse before age 13? 8.3% of students had initiated sexual intercourse before age 13 Male students (12.2%) were significantly more likely than female students (4.4%) to have initiated sexual intercourse before age 13 Black students (20.5%) were significantly more likely than Hispanic and white students (9.2% & 5.5%, respectively) to have initiated sexual intercourse before age 13 years Black female students (11.4%) were significantly more likely than white female students (3.5%) to have initiated sexual intercourse before age 13 years. Black male students (29.9%) were significantly more likely than Hispanic and white male students (14.2% & 7.5%, respectively) to have initiated sexual intercourse before age 13 years

Four or more sexual partners during their lifetime? Nationwide, 16.2% of all students had had sexual intercourse during their lifetime with 4 or more sex partners Male students (19.3%) were significantly more likely than female students (13.1%) to have had 4 or more sex partners Black students (34.4%) were significantly more likely than Hispanic and white students (16.6% & 12.4%, respectively) to have had 4 or more sex partners. Black male students (48.1%) were significantly more likely than Hispanic or white male students (23.0% & 12.1%, respectively) to have had 4 or more sex partners Female students in grade 12 (20.6%) were significantly more likely than female students in grades 9 and 10 (7.9% & 10.1%, respectively) to have had 4 or more sex partners Female students in grade 11 (15.1%) were significantly more likely than female students in grade 9 to have had 4 or more sex partners

Currently sexually active? Nationwide, 36.3% of all students had had sexual intercourse during the 3 months preceding the survey (i.e., currently sexually active) Black students (53.0%) were significantly more likely than Hispanic and white students (36.3% & 33.0%, respectively) to be currently sexually active Both female and male students, students in grade 12 were significantly more likely than students in grades 9, 10, and 11 to be currently sexually active Among students who had had sexual intercourse during their lifetime, 27.3% had been abstinent during the 3 months preceding the survey (i.e., currently abstinent) Overall, male students (30.5%) were significantly more likely than female students (23.9%) to be currently abstinent

Use of Birth Control among those sexually active? 58.0% reported that either they or their partner had used a condom during last sexual intercourse Male students (65.5%) were significantly more likely than female students (50.7%) to report condom use 16.2% reported that either they or their partner had used birth control pills before last sexual intercourse Female students in grade 12 (31.4%) were significantly more likely than female students in grades 9, 10, and 11 (12.8%, 12.8%, & 18.4%, respectively) to report birth control pill use Male students in grade 12 (17.3%) were significantly more likely than male students in grade 10 (5.9%) to report birth control pill use

Have been pregnant or gotten someone pregnant? Nationwide, 6.3% of students reported that they had been pregnant or had gotten someone else pregnant Female students in grades 11 and 12 (8.1% & 13.8%, respectively) were significantly more likely to have been pregnant than male students in grades 11 and 12 (3.7% & 6.7%, respectively) were to have gotten someone pregnant. Black students (13.4%) were significantly more likely than white students (4.3%) to have been pregnant or to have gotten someone pregnant

Among girls under 15 years pregnancy rates are four times higher than any other Westernized country.

Simply providing teenagers w/information has not been shown to be effective in changing behavior.

Accurate information has not been shown to be effective in stimulating adolescents to use contraception

Risk Factors of Teen Pregnancy http://www.dhfs.state.wi.us/Children/pregnancyplan/factors.htm Physical or sexual abuse Single parent family Permissive parental values regarding teen sexual behavior Use of alcohol and other drugs A history of involvement in illegal behaviors Early puberty A mother or female sibling that is or was a teen parent Limited religious affiliation Poor academic performance Poor parental communication about sex No hope Perception of peer's sexual activity Poor or no parental monitoring Early dating A physical or mental illness Feeling differently than others or not belonging No significant or caring adult Having already had a first birth Gang Activity

In his research review, No Easy Answers: Research Findings on Programs to Reduce Teen Pregnancy, Douglas Kirby reports that, “Adolescent sexual risk-taking behaviors, like the behaviors of adults, are caused by a large number of risk and protective factors involving individuals themselves, their partners, their friends, their families and their communities….this review suggests that to have a more dramatic impact programs will need to effectively address a greater number of risk and protective factors over a long period of time.”

Types of Teen pregnancy prevention curriculum Abstinence only Abstinence-based programs

Abstinence only Assert that abstinence until marriage is the only acceptable behavior. Information on contraception is either not provided or discussed only in reference to failure rates. Further, some of these curricula not only perpetuate medical inaccuracies, but are fear-based as well, focusing primarily on negative consequences of premarital sex.

Abstinence-based programs Encourage abstinence as the most effective form of pregnancy and disease prevention. However, recognizing that nearly all people eventually become sexually active, these programs include contraceptive information as well as coverage of other sexuality issues and skill-building to resist social/peer pressures.

Kirby’s analysis of scientifically evaluated programs, effective sexuality education: Focuses clearly on reducing sexual behaviors that lead to unintended pregnancy and/or HIV/STD's. Uses behavioral goals, teaching methods, and materials that are appropriate to age, culture, and sexual experience of students. Is based on theoretical approaches that have proven effective in influencing other health-related risky behaviors. Is long enough to allow for the completion of important activities. Employs a variety of teaching methods, focusing on greater participation and personalization of information. Provides basic, accurate information about the risks of and how to avoid unprotected intercourse. Includes activities about social/peer pressures relating to sexual behavior. Provides practice of communication, negotiation, and refusal skills and utilize teachers/peers who believe in the programs being implemented and provide training for them.

Comprehensive Approach to Teen Pregnancy Prevention