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CWLA 2008 Children's Legislative Agenda
Teen Pregnancy Prevention
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Action
- Increase funding for the Title X family planning program,
while also maintaining its status as a categorical federal
program that mandates informed patient consent, confidentiality
protection for alls patients, types of services
offered, and medical standards.
- Pass and fully fund the Prevention First Act (H.R.
819/S. 21).
- Encourage more teen pregnancy prevention programs to
serve youth in foster care and require teen pregnancy
prevention programs directed at foster care populations
to specifically evaluate their effectiveness within that
particular community.
- Support funding for comprehensive health and sex education
in our communities and schools that is medically
accurate and includes information about abstinence.
Background
Young people represent our nation's future. Given the right
tools, including proper support and an array of services and
opportunities that promote their health and positive development,
they can make informed decisions and achieve selfsufficiency,
economic independence, and long-term family
stability. Many youth involved with the child welfare and foster
care systems, however, do not have access to these tools
and instead find themselves living in trying circumstances,
likely lacking supportive relationships or combating grave
social problems such as poverty, poor health, and social
injustice. For these disconnected youth, paths forward may
not be clear and may influence the disproportionate rate of
teen pregnancy and birth rates among them.
- While the teenage pregnancy rate and birthrate have
declined nationwide, the United States continues to have the
highest rates of teen pregnancy and births in the industrialized
world. 1 An estimated 1 in 3 young women in the United
States will become pregnant at least once before the age of
20. 2 Youth in the foster care system and those who have transitioned
out of the system appear even more likely to become
pregnant. By age 19, nearly half of the surveyed foster care
females report ever having been pregnant, while only 20% of
non-foster care females have ever been pregnant. 3
Females who have been in foster care also have higher birth
rates (31.6% versus 12.2%) and higher subsequent pregnancy
rates (46% versus 29%). 4 A series of focus groups
with foster youth and foster parents found certain themes
help explain the correlation between foster care and teen
pregnancy, including: Many foster youth lack key relationships
and may, for instance, have no one to discuss sex and
pregnancy with; foster youth, despite hardships and supportive
interpersonal relationships, see many benefits to
having a child of their own; and foster youth, even if they
realize long-term implications, may be more prone to act on
present impulses. 5
Adolescent childbearing, in combination with other
pre-existing factors, is linked to negative consequences for
mother and child and to significant societal costs. Just over
half of teenage mothers complete high school during adolescence
or early adulthood and teen mothers generally are
likely to have limited employment opportunities and to live
in poverty and depend on welfare. 6 In 2004 alone, public
sector costs associated with teen childbearing in the United
States totaled at least $9.1 billion, including $2.3 billion in
increased child welfare costs. 7
As these statistics reveal, the problem is far from solved.
Reducing the nation's teen pregnancy rate is one of the most
strategic and direct means available to reduce persistent
and cyclical child poverty and improve overall child and
family well-being.
Title X
Young people, including youth in foster care, need access
to reproductive health and family planning services. Since
1970, the federal family planning program, Title X of the
Public Health Service Act, has provided resources for
health services and counseling to low-income or uninsured
individuals who may otherwise lack access to health care.
Currently, Title X supports a network of 4,400 family planning
clinics nationwide that provide clinical services to
prevent unintended pregnancies, lower rates of sexually
transmitted diseases (including HIV), detect breast and
cervical cancer at the earliest stages, and improve
women's overall health.
Unfortunately, the Title X program has been systematically
underfunded over the years, considering health care
inflation and the growing demand for subsidized family
planning services without corresponding increases in funding.
This poses very serious challenges to its effectiveness
and survival. Title X received $283 million for FY 2006 and
FY 2007, and $300 million for FY 2008; had Title X funding
kept up with inflation since 1980, it would now be funded at
more than $725 million. 8 Greater financial commitment to
the Title X program is necessary so that low-income women
and men who may have nowhere else to turn can receive
community-based family planning services.
Prevention First Act
The 110th Congress should pass and fully fund the Prevention
First Act (H.R. 819/S. 21). This important legislation would
provide grants to public and private entities to establish
or expand teen pregnancy prevention programs; ensure
federally-funded sex, family life, abstinence, comprehensive
health, or character education is medically accurate and
provides information on both the health benefits and failure
rates of contraceptives; and improve education about emergency
contraception to female victims of sexual assault.
The bill would also increase funding for Title X family planning
services and require that pregnant, Medicaid-entitled
women receive prenatal, labor, delivery, and postpartum
care. Youth in foster care, as well as youth aging out of
foster care, would benefit from these initiatives.
Need for More Foster Care-Specific Programs and
Data to Drive Appropriate Policy
While regional studies have been helpful, more consistent,
ongoing nationwide data about teen pregnancy rates and
trends among youth in foster care is needed to guide appropriate
policy. Programs and interventions for teens in foster
care should start early and address both primary and
secondary prevention, with primary prevention helping the
youth avoid pregnancy in the first place, and secondary prevention
helping parenting youth avoid subsequent pregnancies.
These programs should attempt to pinpoint and subsequently
avoid the factors that motivate foster teens to
become pregnant in the first place; cover multiple aspects
of sexuality, conception, contraception, and the nature and
benefits of healthy, respectful relationships; inform both
teenage boys and girls; and be evaluated specifically for
their effectiveness with foster care youth.
In addition to better educating teenagers in foster care,
service providers need additional support and training on
teen pregnancy prevention and related issues. This is necessary
because the providers, in turn, can and should offer
much-needed assistance to foster youth and foster parents
and caregivers.
Comprehensive and Accurate Education
Congress must ensure all federally funded pregnancy prevention
programs do not contain false, misleading, or distorted
information about reproductive health, particularly
in abstinence-only-until-marriage programs. A 2006
Government Accountability Office (GAO) report found that
abstinence-only programs were not being monitored sufficiently
to ensure the scientific accuracy of curriculum materials. 9
The same GAO report also indicated a lack of evidence
that abstinence-only-until-marriage programs are effective.
Similarly, a congressionally authorized multi-year, experimentally-
based impact study that followed more than 2,000
elementary- and middle-school children into high school
found that abstinence-only sex education simply does not
stop teenagers from having sex; the youth that had received
abstinence-only education were just as likely to have had
sex as the youth who had not. 10 In view of these reports,
Congress should suspend funding for abstinence-untilmarriage
programs until the necessary accountability is in
place or until they are proven effective.
Key Facts
- Despite the United States' teenage pregnancy and birth
rates decrease, 1 in 3 teen girls in the United States
becomes pregnant by age 20. Most of the pregnancies
are unplanned. 11
- Females who have been in foster care are 2.5 times more
likely than those who have not been in foster care to
have become pregnant by age 19. 12
- Females who have been in foster care have higher birth
rates than their non-foster care counterparts (31.6%
versus 12.2%) and higher subsequent pregnancy rates
(46% versus 29%). 13
- Teenage mothers are less likely to complete high school
and only 1.5% earns a college degree by age 30. This, in
turn, influences their earning capacity and likelihood to
live on welfare. 14
- In 2004 alone, teen childbearing cost United States taxpayers
$9.1 billion, including a $2.3 billion increase in
child welfare costs. 15 Between 1991-2005, the U.S. birth
rate for teens, age 15 to19, declined 35% to 40.4 births
per 1,000 teen girls in 2005, after reaching its highest
point in two decades (61.8 births per 1,000 teen girls, age
15 to 19 in 1991). Between 2005 and 2006, preliminary
data suggest that rates have risen approximately 3%. 16
Sources
- Guttmacher Institute. (2006). U.S. teenage pregnancy statistics: National and state trends and trends by race and ethnicity. Available online. New York: Author; Hoffman, S.D. (2006). By the numbers: The public costs of teen childbearing. Available online. Washington, DC: National Campaign to Prevent Teen Pregnancy. back
- National Campaign to Prevent Teen and Unplanned Pregnancy. (2007). National teen pregnancy and birth data. Available online. Washington, DC: Author. back
- Bilaver, L.A., & Courtney, M.E. (2006). Science says: Foster care. Available online. Washington, DC: National Campaign to Prevent Teen Pregnancy. back
- Ibid. back
- Thiessen Love, L., McIntosh, J., Rosst, M., & Terzakian, K. (2005). Fostering hope: Preventing teen pregnancy among youth in foster care. Washington, DC: National Campaign to Prevent Teen Pregnancy. back
- Maynard, R. (Ed.) (1996). Kids having kids: Economic costs and social consequences of teen pregnancy. Washington, DC: Urban Institute Press. back
- Hoffman, By the numbers: The public costs of teen childbearing. back
- Planning & Reproductive Health Association. (2007). Title X (ten) national family planning program: Critical women's health program struggles to meet increasing demand. Available online. Washington, DC: National Family Planning and Reproductive Health Association. back
- Government Accountability Office. (2006). Abstinence education: Efforts to assess the accuracy and effectiveness of federally funded programs (GAO-07-87). Available online. Washington, DC: Author. back
- Trenholm, C., Devaney, B., Fortsen, K., Quay, L., Wheeler, J., & Clark, M. (2007). Impacts of four Title V, Section 510 abstinence education programs: Final report. Available online. Princeton, NJ: Mathematica Policy Research, Inc. back
- National Campaign to Prevent Teen and Unplanned Pregnancy, National teen pregnancy and birth data. back
- Bilaver & Courtney, Science says: Foster care. back
- Ibid. back
- Maynard, Kids having kids: Economic costs and social consequences of teen pregnancy. back
- Hoffman, By the numbers: The public costs of teen childbearing. back
- National Campaign to Prevent Teen and Unplanned Pregnancy, National teen pregnancy and birth data. back
CWLA Contact
Laura Weidner
703/412-3168
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