Small-Picture Teen Pregnancy Prevention: Four Things to Do When Teen Birth Rates Don’t Decline

Young people socializing at a park.

On the U.S. teen pregnancy prevention front, good news seems to be all around. From 1991 to 2012, the national rate of teen births plummeted by more than 50 percent, and most individual states followed suit. But as anyone in the field knows, progress is sometimes bumpy and rates can be affected by many factors. Especially in small communities, an extra few births can mar year-to-year statistical improvement.

A small increase in teen births from one year to the next doesn’t constitute a failure. Setbacks do happen, and teen pregnancy prevention programs can weather them by building a community-wide culture of adolescent health that doesn’t hinge on fluctuations in percentages or funding.

“When the numbers come out, we share them and keep talking,” says Michelle Nimmons of the Bamberg County School/Community Sexual Risk Reduction Project in Denmark, SC. “But I never allow [the greater community] to think it’s just my job. You have to remind them that it’s their responsibility too.”

Despite the Bamberg County project’s long-term achievements, Bamberg is one of 19 South Carolina counties to experience a slight uptick in teen birth rates from 2011 to 2012, despite a statewide 47 percent decline in the rate over the last 20 years. Here are four things some local programs in those counties do to keep up the positive momentum:

1. Keep young people involved. One of the Bamberg County School/Community Sexual Risk Reduction Project’s most important partners is its group of 14 “teen ambassadors.” The ambassadors are volunteer peer educators who serve as liaisons between the project and local teens. When birth rates recently went up, Nimmons and her colleagues asked the ambassadors, “Tell us what’s happening. Where do we need to reinforce this message?” The young people have an ear to what obstacles their peers are facing, and what might work to help them make healthier choices.

2. Find new partners. When local rates go up, it's often because of the loss of an important local resources. For example, Nimmons' teen ambassodors told her that their peers had trouble getting contraception after a local health clinic closed. Nimmons needed to find new partners, places that young people would be comfortable visiting. She and her colleagues found a few willing barber and beauty shops that now offer free condoms supplied by the project.

3. Recognize what you can do with limited resources. Like the shuttering of a local partner, a sudden loss of funding can certainly increase the teen-pregnancy rate in any area. Pam Rush, director of prevention services for Axis 1, a teen pregnancy prevention agency in Barnwell County, SC, says her community saw a small uptick in teen births over the last two years of available data, in part due to a tight state budget. With less funding, Rush and her colleagues cut back on the school-based curriculum they offered to middle schoolers and high schoolers, and are focusing on maintaining as much face-time as possible with the 9th-grade and 10th-grade students they are still able to serve.

“For us, consistency is the thing,” says Rush. “The rates improved because we were there. When we’re not there, the influence they get from TV, from music, becomes the norm.”

4. Broaden the discussion. Rush finds that putting teen pregnancy into the bigger context of teen health and wellbeing helps keep parents and local leaders from losing hope when rates increase year-to-year.

“We’re no longer talking only about pregnancy, it’s HIV prevention and STDs [too],” says Rush. She and her colleagues also try to spend less time talking about rates and percentages, because they don’t want the community to think those are the only things that constitutes success. Particularly in a small community, Rush says, “big-picture talk about rates doesn’t tell the whole story.”

The real work of teen pregnancy prevention, she says, happens through a gradual change in community values that numbers can't always capture.

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