Monday, March 17, 2008

Teen Pregnancies

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www.massteenpregnancy.org
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Massachusetts Teen Pregnancy Chart
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"Less affluent areas see increase in teen births: But overall rate in Mass. on decline, state reports"
By Keith O'Brien, Boston Globe Staff, March 16, 2008

The teen birth rate is back on the rise in many working-class Massachusetts communities, mirroring a trend that has seen teen birth rates rise around the country for the first time in 15 years.

Among the Massachusetts communities that traditionally have high teen birth rates, nine showed double-digit percentage increases in 2006, according to new numbers published last month by the state Department of Public Health. The spike in those larger cities and towns stands in contrast to a 2 percent drop in the state's overall teen birth rate.

The increases in Leominster, Fitchburg, and other Massachusetts communities are occurring after years of dropping teen birth rates in many of these towns and cities. The Centers for Disease Control reported a 3 percent jump in the national teen birth rate in 2006.

The national increases remain puzzling to public health officials and may be just a blip. But in Massachusetts, the trend appears to be continuing in some communities in the past year.

In school cafeterias and classrooms from Framingham to Haverhill, officials say they are finding a growing number of teenagers who are soon-to-be mothers. Haverhill's public schools are on pace to have 14 pregnancies this year, nearly double what they recorded in 2006. Gloucester High School reported 10 pregnancies this year, up from the average of three a year. And in Framingham, school officials have recorded more student pregnancies and births this school year - 24 and 10, respectively - than they did all of last year.

"We're definitely feeling the increased workload," said Cheryl Aglio-Girelli, one of two teen pregnancy and parenting nurses for Framingham public schools. "Everywhere we go, people say to us, even the kids in school say to us, 'There are a lot more pregnant kids this year.' It's become an obvious issue to the community now. It's right there in your face."

Dr. Lauren Smith, medical director at the state Department of Public Health, cautions that it is too early to read much into the figures. She notes that the state's overall teen birth rate - which has been falling steadily since 1990 - is still declining and is 49 percent lower than the US rate. And given the fact that a single town's numbers can fluctuate from year to year, Smith cannot say whether the recent increase is just a blip or an indication of a larger trend. But some specialists contend that the latest state figures, combined with the national increase and anecdotal reports from school nurses, may be a sign of continued increases in years to come.

"If we continue in this vein, for the first time in a long time we may see an increase in the overall state rate," said Patricia Quinn, executive director of the Massachusetts Alliance on Teen Pregnancy. "Maybe that's what will get people to wake up."

Sex education varies from school district to school district. In Framingham, for example, teachers focus on abstinence, talking about contraception only if asked to by students, while in Haverhill teachers offer an entire lesson on contraceptives. But the issue is complex, school officials point out, and far bigger than the schools themselves.

Teen pregnancy, according to public health officials, is often a symptom of other problems, including poverty, broken family lives, lack of access to information and contraceptives, and a child's inability to dream of a brighter future. Possible reasons for the national increase, according to the CDC, will require more analysis, but could include changes in teen sexual activity, contraception use, or attitudes. And these factors could be at play in Massachusetts, where some school officials say they are noticing a disturbing shift.

"They used to say that 80 percent of teens who got pregnant didn't want to be teen moms, that it was not a planned pregnancy," said Carol Ireland, the pregnancy and parenting teen specialist for Haverhill public schools. But now, Ireland said, more and more teenage girls are telling her they want to be pregnant.

"There are more girls right now - because of a lack of direction - who say, 'Well, I know I shouldn't be a mom, but I kind of want to be.' Because they don't have the goals, they don't have the direction. And that's what really troubles me," Ireland said.

According to the state Department of Public Health, teenagers expecting a baby are more likely to smoke cigarettes while pregnant and less likely to receive adequate prenatal care than other pregnant women. And once born, according to studies, these children are more prone than their peers to becoming teen mothers themselves or ending up in prison or dropping out of high school.

For these reasons, public health officials are always concerned about teen birth rates and about other aspects of the issue, such as data that show the birth rate among Hispanic teens in Massachusetts is almost six times that of their non-Hispanic peers.

But Quinn worries that the state may be turning its focus elsewhere, cutting valuable money to community programs, given the overall improvement in teen pregnancy prevention over the years.

State funding for teen pregnancy prevention is down 26 percent in recent years, from $5.4 million in 2001 to $4 million this year. And these cuts, combined with the financial crunches facing many communities, have taken a toll in places such as Haverhill, where there is now one health teacher for 1,700 middle school students. With so many children to see, and so much other work to do, Lori Curry, that teacher, said the students get about half as many sex education lessons as they once did and far less contact with a trusted adult who might be able to answer the questions that come with adolescence.

"I feel bad when I do a unit and I see all these kids who want information, who trust me, want to talk to me, want to get facts," she said. "And now, all of a sudden, 'I won't see you for the rest of the year.' I have to go to the next building."

Haverhill school officials said there may be a direct correlation between decreased funding for health education and their rising teen birth rate. But officials in Framingham, Leominster, and Lawrence say they can't explain their recent increases in pregnant youths by pointing to key changes in funding or in curriculum.

For many girls, the biggest problem is often getting access to birth control, said Aglio-Girelli, one of the teen pregnancy nurses in Framingham's schools.

Access to birth control, however, wasn't a problem for Jalisa Luna, a 17-year-old Framingham senior who gave birth to a girl last fall. She knew enough to be on the pill, she said, yet missed a couple of days and got pregnant. She was 16 when she got the news and began to cry. Classmate Janell Ortiz was stunned when she found out about her own pregnancy. Here she was, just 16, Ortiz said, and about to become a teenage mother, just like her own mother before her.

"I had no words," she said. "I guess I was in shock. And then I told my baby's daddy and he was shocked. He just walked away from me."

Ortiz, now 18, gave birth in April to a daughter named Jadalize, a brown-eyed doll of a girl. Jadalize is walking now, and Ortiz, like most any mother, loves her child.

"Dame besos," Ortiz, who is Puerto Rican, told Jadaliz one afternoon last week as they played together after school. "Give me kisses."

But life with her is hard, Ortiz admits. She is raising little Jada on her own, living for now with friends in a public housing development in Framingham. Her dreams of becoming a dancer are dashed. And when she hears classmates frequently wishing that they, too, were pregnant, she scoffs at their naïveté.

"None of them know," she said.

They don't know, she explained, what it's like to juggle school and a baby, what it's like to be a teenager and have to be so grown up. Ortiz said she worries about the future, where they will live next and how they will survive on her $9 hourly wage at a local shoe store.

Sometimes, she said, she feels like giving up. But then she knows that she can't.

"What are you doing, Jada?" she said last week, calling to her daughter. "Vente. Vente.

"Come here. Come here."
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Keith O'Brien can be reached at kobrien@globe.com
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"Teen pregnancy rates trouble Y officials"
(The Springfield Massachusetts Republican Newspaper)
Wednesday, February 27, 2008

Holyoke and Springfield - again - have the highest rates for teen pregnancy in the state, according to statistics released on Feb. 13 by the state Department of Public Health.

Whereas the statewide average is 21 births per thousand teens, in Holyoke it's 95 and in Springfield, 81. According to an article published in The Republican, public officials see "no prospects of marked improvement in sight."

Teen pregnancy is a concern for families and for the society in which they live because the young parents are rarely in a position of independence. They have not completed their education, are not prepared to earn an adequate living, and do not understand how to care for a child.

With rare exceptions they are unmarried, with the father taking little responsibility for care. When families can't or won't assume the burden, the government must step in, a costly and unsatisfactory alternative.

Organizations whose mission is to build strong families and strong communities, like the YMCA, must have a two-fold approach to this problem. They must try to help those teens who are already parents, both for the sake of the teens themselves and to ensure that their babies are healthy and productive members of society. At the same time, they must reach out to other teens at risk, offering them alternatives to a youth cut short by adult responsibilities they are ill-equipped to assume.

The teen parent program at the YMCA, funded this year in large part by the Community Fund of Western Massachusetts, is the Y's answer to the former. Teens get General Educational Development training at the Massachusetts Career Development Institute while their children are cared for in the Y's Magic Years Child Care Center. Life skills and child care are also taught. Participants are placed in area colleges or vocational training programs upon receipt of a GED and graduation from the program.

Amanda Alonzo is one of the recent success stories. She learned about the YMCA's program from a flyer she spotted. What made the YMCA's program unique, she said, was availability of transportation. Other programs were just not workable for her because she couldn't get to them.

After six months in the program, Alonzo obtained her GED. A career aptitude test identified business as her major strength and interest. Recently she started classes at Springfield Technical Community College, majoring in accounting. Alonzo has two children: Alexander, 4, and Daren, 11 months.

"Amanda is very motivated," said program coordinator Sarah Desmarteau. "She attended class every single day. She would walk in the rain if necessary to get here. She's always polite and respectful - overly mature, you might say. She's had to be. Amanda's had many obstacles to overcome - more than most."

Teens currently enrolled in the program were very vocal when asked to respond to the recent newspaper articles. The Republican delivers papers to the program and all of the young women had read the coverage.

Most of them were the children of teen parents themselves. But none would want her own child to be a teen parent.

All of the teens had had sex education classes and were aware of methods of contraception. Although they conceded that more health education wouldn't hurt, they said that the main problem was the way it was taught.

"Most teachers don't care," said one. "School is supposed to prepare you for life, but it has nothing to do with teenagers' real lives. And once you turn 16, they don't care if you drop out. Teachers have favorites; they give up on other kids."

"Teachers don't know how much difference they can make," said another. "One encouraging teacher can motivate you to stay in school."

One teen mother said that she had looked to an intimate relationship to fill a void in her life, because she was so unhappy at home and school. All of the others agreed.

"A lot of teens get pregnant because they're searching for something they don't have and end up having a baby," she said. "They want something from a guy; in some cases they're pressured to have sex. They may want a baby or just want that closeness or think the baby will cement the relationship. But it's not true. The daddy often leaves. He has no responsibility but signing the birth certificate."

The young women felt passionately that their younger sisters, cousins and friends needed to be set straight on the realities of teen parenthood. All felt that they themselves might have been best reached by someone else who had been through the experiences they shared.

James O'S. Morton, chief executive officer and president of the YMCA of Greater Springfield, said the Y is making efforts to prevent teen pregnancy.

"Our programs, like the new track program or the after-school drop-in programs, are not for kids who are already members of the Y," he said. "They are for the ones who have no support system. If we can just get them in here, we can work with them. So we are always looking for a hook, for whatever interests them. Once we have them in a program, we can talk about leadership and scholarship.

"We want to create opportunities for them. The problem is, their vision is narrow. They can't believe that any of those opportunities really exist for them. So we are trying to widen that vision."

Morton found the emphasis on the statistical breakdown of teen pregnancies disturbing.

"It's not about the culture of Hispanics or any other group. We shouldn't think of teen pregnancy in that way. In doing so, we create expectations. It's about a culture of poverty.

"We don't have to be negative. We can instead focus on the beautiful choice these young women have made to do the hard work of creating a good life for themselves and their children. And we can give them a voice, because they are the ones who understand best the choices they have made, the consequences of those choices, and they may have the ability to reach others who are at risk." The YMCA of Greater Springfield was founded in 1852 and is the second oldest YMCA in the USA. Some 30,000 members and program participants are served annually in Springfield, Wilbraham and 11 surrounding cities and towns.

For more information on YMCA programs or how you can get involved, call (413) 739-6951 (Springfield Branch) or (413) 596-2749 (Scantic Valley Branch), or visit www.springfieldy.org

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"Spike in Gloucester High pregnancies alarms officials"
By Kristen Grieco, Staff writer
Gloucester Daily Times

Pregnancies at Gloucester High School have spiked to more than three times the normal number this year, and anecdotes of girls deciding to intentionally become pregnant have been reported by one school official.

"To have this many is extremely unusual," said High School Principal Joseph Sullivan. "The volume frightens me."

To get to the bottom of the problem, Sullivan investigated and came up with a startling revelation: According to his conversations with upperclassmen, some younger students may be becoming pregnant on purpose.

Kim Daly, nurse practitioner for the high school, was unable to confirm specifics but did say that the majority of students reporting pregnancies this school year were in the younger grades.

While high school officials normally see around three pregnancies a year, this year at least 10 girls have become pregnant and appear to be planning to have the children, according to Ann-Marie Jordan, the school district's health coordinator.

Recently released national and state statistics showed the first increase in the teen birth rate in 15 years. However, because of the way statistics are compiled, that information is for 2006 — a two-year lag from the issue with which the high school is now struggling.

Patricia Quinn, executive director of the nonprofit Massachusetts Alliance on Teen Pregnancy, said that, while statistics may be behind, she has heard anecdotal evidence supporting just the issue worrying Gloucester.

"The sense is, there are more pregnant girls in schools," Quinn said. She said she had not, however, heard of girls intentionally becoming pregnant in her conversations with health professionals across the commonwealth.

The idea isn't a new one, though. According to Bill Albert, deputy director of the National Campaign to Prevent Teen and Unplanned Pregnancy, 10 percent to 15 percent of teen pregnancies are intended.

Why it's happening

Sullivan said that he was eyeing Hollywood as one force that may be influencing teens to become pregnant. Nickelodeon star Jamie Lynn Spears, 16, recently announced her surprise pregnancy. Single motherhood or having children out of wedlock has become increasingly popular among celebrities; and blockbusters "Juno" and "Knocked Up" have presented views through rose-colored glasses of unplanned pregnancies.

"There's no data out there that measures this sort of thing," Albert said. "Babies certainly seem to be the latest fashion trend in Hollywood. You would have to be very naive to think that what goes on in the celebrity culture doesn't help shape the social script for teenagers."

Quinn said placing blame squarely on celebrities, however, can be a "smoke screen" for communities that need to become more involved in the problem to solve it.

Experts on all levels say that lack of access to birth control poses a huge problem for areas such as Gloucester.

"Kids have identified that there's not easy, confidential reproductive health care in Gloucester," Daly said.

The closest clinic at which students can access birth control is in Beverly, assuming they do not want to go to their family doctor. While Daly and her associates will discuss birth control with students, they will not prescribe it, and condoms are not offered at the school.

Sullivan doesn't see that situation changing.

"The community won't tolerate access to birth control at the high school," Sullivan said. "The nurse will discuss it, but that's a family and a doctor issue."

Dr. Joanne Cox, director of the Young Parents program at Children's Hospital in Boston, said that in-school programs for birth control are shown to be effective, as is education. Upon hearing of the situation in Gloucester, she said that considering birth control distribution in school would be wise.

"When 10 are pregnant — that's the time to have the political courage to do it," she said. She added that the lack of easily available birth control — which, she said, pediatricians are often hesitant to prescribe — is "probably the No. 1 reason" for an increase in pregnancies.

Quinn said that parental squeamishness in talking to their children about pregnancy could be a large part of the problem.

"I would argue, particularly around sexual issues, we often fail to give good guidance and then we are upset and angry when young people become pregnant," Quinn said. By giving teens a message that planning for sex is bad, she said, youths end up only having "swept up in the moment" sex — often without the forethought of protection.

High school habits

According to the Gloucester 2007 student health survey released in January, condom use at the high school is infrequent while sexual activity is high. Fifty percent of high school students reported having had sex — and, by 12th grade, that number rises to 68 percent.

Perhaps more relevant to the problem of teen pregnancy, however, is the low frequency of condom use that high schoolers report. An average of 65 percent of high school students reported using a condom the last time they had sex, and the number decreases as students age, from 73 percent of freshmen using them to 59 percent of seniors.

For now, Jordan said, the district is focusing on ways to keep the teen girls who are pregnant in school while reexamining its programs to figure out what types of pregnancy prevention methods work.

Currently, Jordan said, students receive sex education in middle school and are required to take a health class that includes the topic during their freshman year. According to Jordan, the program is abstinence-based, but high school classes hear about birth control as well.

"If you can delay sexual activity for kids, they make better choices," Jordan said.

After freshman year, however, there is no required sex education — partially because of cutbacks in the physical education program, which encompasses health classes. Those cuts began in the 2000-2001 school year.

Jordan said she was hoping to get money for another physical education position next year, but in budget discussions Wednesday, the School Committee did not plan to do so.

Jordan agrees with a number of experts who say that a key to preventing teen pregnancies is connecting students to their future.

"How is Gloucester ensuring that all teens see a future for themselves that does not include early parenting?" said Quinn. "They have to have goals. If they don't have them, early parenting can become a default option."

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Kristen Grieco can be reached at kgrieco@gloucestertimes.com.
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Teen pregnancy by the numbers

10: Reported pregnancies at Gloucester High so far this year.*

3: Typical number of reported pregnancies at Gloucester High yearly.*

$9 billion: Amount spent yearly by the federal government to help families that began with a teen birth.**

15: Number of successive years teen pregnancy decreased before increasing in 2006.**

1991: Peak year for teen births in the United States.

*Source: Ann-Marie Jordan, district health coordinator

**Source: National Campaign to Prevent Teen and Unwanted Pregnancy

Teen births in Gloucester

Year#Teen Births

2006#19

2005#10

2004#15

2003#13

2002#18

2001#17

2000#26

Source: Mass. Department of Public Health

Note: Numbers include pregnancies from all Gloucester females under 20.

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Editorial
"Our view: GHS pregnancy spike needs a communitywide response"
Gloucester Daily Times

The stunning news that at least 10 Gloucester High School students have become pregnant this school year — up from the norm of about 3, according to school officials — should set off a number of alarms in the community, particularly considering that it seems a number of the girls have done so intentionally.

And the news may well put added pressure on school and community officials to respond to the problem.

But while the school may be able to take some steps by expanding its sex-education or health curriculum, the truth is, this is a communitywide issue that requires stepped-up attention from city health officials, counselors and — most of all — parents.

Indeed, Gloucester High Principal Joseph Sullivan and Superintendent Christopher Farmer deserve credit for openly raising and discussing a local and social concern that will require a communitywide response through education and especially communication.

The most jarring aspect of the Gloucester High figures is the word that at least some of the girls who have become pregnant have done so of their own choice. And while we tend to doubt many cases in which people blame "Hollywood" or the media when a young person carries out some act of violence, perhaps mirroring a wayward TV show or video game, it makes a frightening amount of sense to hear Sullivan suggest that a part of GHS's problem stems from the Hollywood or celebrity culture in which magazines and TV "entertainment" shows glamorize single and teen moms — like Britney Spears' 16-year-old sister Jamie Lynn, herself a "star" on Nickelodeon, a network aimed at young viewers.

Those aren't "role models" kids see and learn about in school. Let's face it: School officials have students under their wings for little more than six hours a day — and those can't realistically be the hours in which these kids are having sex.

So what can parents do? Ban their high school students from checking out teen magazines, or watching the likes of "Access Hollywood?"

Of course not. For one thing, it's important to remember that — if celebrity culture can be viewed as a factor in this — it's only one of many. Parents can, however, follow the advice of Patricia Quinn, the executive director of the nonprofit Massachusetts Alliance on Teen Pregnancy, who says parental squeamishness and reluctance to talk with their children about sex and the real-world impact of teen pregnancy is another big part of the problem.

Community health officials must also find a more realistic means of providing teens with birth control than they do today. The closest clinic for students to access birth control is in Beverly — assuming they'd be understandably reluctant to go to the family doctor.

Dr. Joanne Cox, director of the Young Parents program at Children's Hospital in Boston, says this may also be a good time for Gloucester to consider dispensing birth control at the high school itself. But Sullivan is probably right to concede the community won't "tolerate" that — and even if it did, it's also frankly hard to imagine that students would feel comfortable getting birth control from the school nurse's office.

Gloucester is not alone in dealing with this issue. State and national figures show increases in teen birth rates for the first time in 15 years. And while those most recent figures are two years old, there are signs, Quinn says, that there is a growing number of pregnant girls in high schools across the state.

The Gloucester School Committee should indeed take a fresh look at its sex-education and high school health curriculums. The fact that sex education is part of a mandated health class in ninth grade — and stops after that — is troubling, especially given that a survey suggests that students who say they have had sex rises to 68 percent by senior year, while the use of birth control declines from 73 percent of those who've had sex by ninth grade to a low of 59 percent of the seniors.

Those figures — even if the survey numbers may be exaggerated, and some national studies suggest they often are — raise some red flags of their own.

But, overall, it's also up to health officials, parents and others to, above all, drive home the awareness of how teen and particularly high school pregnancy affects lives — for the mother, the father, the baby, family members, and more.

And, especially in these days of celebrity culture, it's up to everyone to drive home the point that being a high school-age mom isn't cool — and that getting pregnant at 15 or 16 really isn't OK.

That's a message that all of us — as a community — should do our best to convey.

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A REVIEW OF THE PROLIFERATION TEEN PREGNANCIES IN MY NATIVE HOMETOWN OF PITTSFIELD, MASSACHUSETTS
-By Jonathan Alan Melle

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TEEN PREGNANCY RATES IN PITTSFIELD, MASSACHUSETTS, DOUBLE THE STATEWIDE AVERAGE!...BY DESIGN...as PERVERSE INCENTIVES RULE PITTSFIELD's GOVERNMENT!...The Mayor and communitarian Elites in the Pittsfield/North Adams area are all SELFISH and SICK BASTARDS!
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Saturday, 3 February, 2007

Re: "Teen pregnancy up, youth programs down" (Letter to the Editor of The Berkshire Eagle, by Holly Brouker, Saturday, February 03, 2007): Teen pregnancies are up in Pittsfield by design. Why? As Rinaldo Del Gallo III pointed out in a previous letter to the Editor of The Berkshire Eagle earlier this week, the answer lies in perverse economic incentives!
A poor, post-industrial city government such as Pittsfield, Massachusetts' biggest economic resource is not business, but government. Why is this so and how does it even begin to make sense? Both from many decades of personal experience of growing up in Pittsfield and the surrounding area, and through my studies and personal interests in political science and public administration, the answers lie in the economic principles of both risk and its close second liabilities.
The political system works and is administered as follows: The Federal Government appropriates billions of social service and public educational dollars every fiscal year to the state governments to administer. With these public dollars, the state governments have to meet certain regulatory guidelines and compliance standards or else they will be penalized and funds will be withheld. To see a state not meet federal regulatory standards, just look at what happened to federal funding with the "Big Dig" in Boston. The state governments then receive these federal dollars for social service and public educational dollars and administer them to the school districts, meaning to the city and town governments.
Let us stop here for a brief moment. The state government uses perverse economic incentives instead of rational economic incentives by taking the federal dollars and meeting the minimal federal regulatory standards for social service and public education. Why do the state's do this? So that the states can take the rest of the federal money and complement it to their own state fiscal year budget. Now the state governments can bridge their own budget gaps, vote each other legislative pay raises, allow a new governor to try to buy off the Legislature with another pay raise (see Deval-uator Patrick), and the like.
Going forward. The cities and towns then receive the federal dollars through the state administered programs for their social services and public educational programs. Now, the municipal government uses perverse economic incentives instead of rational economic incentives by taking the state administered federal dollars and only meets the minimal state regulatory standards for social service and public education. Why to the city and town governments do this? So that the municipality can take the rest of the state administered federal money and complement it to their own local fiscal year budget. Now the municipal governments can artificially lower property taxes (to the extent possible), subsidize business tax breaks, and have fancy new theaters and ball parks.
So, back to the economic principles of both risk and its close second liabilities. Now, to a local government, business open and close, move out of town, lay off workers, and the like. What does this all mean to a Mayor? The answer is long-term risks that if lose money through property taxes, jobs, and the like, mean increase liabilities (financial obligations) for the municipal government the Mayor is administering -- meaning Mayor McCheese will be faced with big property tax hikes to fill the annual fiscal year municipal budget gap, which will lead to the end of his time in political office.
So what does Mayor McCheese invest in? You got it, the government! Why? Because it is a sure thing with low risks and low liabilities. Every year, good old Uncle Sam is going to spend billions of social service and public education federal dollars, and every year the state government is going to take that money to administer to the cities and towns.
So what happens next for a city like Pittsfield? In order to for the municipality to receive the government dollars, they need people to fill the slots for social service and public educational public dollars. How does Pittsfield recruit these people to "North Street" or "Social Service Alley"? You got it! By allowing teenage girls and young woman to have unprotected sexual intercourse and become pregnant and receive all of the social service entitlement welfare benefits. Now, you have a mother receiving benefits, a child that will be in need for many decades to come, and going to the local public schools to boot, and "deadbeat dad" tied down to the locality by child support -- one of two payments one can never write off to bankruptcy (the other debt being student loans).
In the end, Pittsfield now receives tens of millions of dollars in federally appropriated and state administered public dollars every fiscal year. Wow, what a profit! In conclusion, Teen Pregnancies are up in Pittsfield by design because of PERVERSE ECONOMIC INCENTIVES! The letter, pasted below, illustrates everything I just wrote. Read on...

-Jonathan A. Melle

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Teen births - BERKSHIRE County
Wednesday, March 22, 2006
Pittsfield's teen birth rate nearly doubles the statewide figure. The following numbers reflect the amount of teen pregnancies for every thousand girls in 2004:
Massachusetts 22
Lawrence 79
Fitchburg 46
Pittsfield 43
Boston 26
Source: Massachusetts Alliance on Teen Pregnancy

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NEWS ARTICLE:
Teen pregnancy up in Pittsfield, Massachusetts
By Jack Dew, Berkshire Eagle Staff
Thursday, January 25, 2007
PITTSFIELD — The teen pregnancy rate rose in Pittsfield in 2005, even as the state and national numbers declined.
The state Department of Public Health conducts an annual survey of all births in Massachusetts. Its report for 2005, released on Tuesday, shows that Pittsfield continues to buck the state and national trend of slowing teen pregnancies.
There were 67 babies born to mothers aged 15 to 19 in Pittsfield in 2005. That equates to a rate of 52.7 babies for every 1,000 girls in that age group, the seventh-highest in the state.
That is an increase of nearly 14 percent over 2004, when there were 59 teen births, or 46.4 per 1,000 in Pittsfield.
Meanwhile, Massachusetts has watched its teen pregnancy rate decline steadily for the past 15 years: In 2005, there were 21.7 teen mothers per 1,000 teen girls, versus roughly 35 in 1990.
'Growing Up Fast'
The Pittsfield numbers perpetuate a worrisome trend in the city, which has been under scrutiny since 2003, when a book, "Growing Up Fast," and a companion documentary movie focused attention on teen pregnancy in the city.
The book and movie concentrated on six teen mothers, telling their stories as they struggled with their young families.
The new numbers show that, while Pittsfield's rate may fluctuate from one year to the next, it has stayed stubbornly high.
And over the five-year period from 2000 to 2005, teen pregnancies increased by almost 24 percent.
The Pittsfield trend sticks out in a state that has a teen birth rate that is 46 percent below the national average of 40.4 births per 1,000 teens.
In fact, Massachusetts is seeing the average age of its mothers increase, with the majority waiting until they are between the ages of 30 and 34 to have children, according to the Department of Public Health report.
Nationally, the majority of women having children fall into the 25 to 29 age range.
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» Teen pregnancy
Teen births in Pittsfield per 1,000 females aged 15 to 19:
2000 — 42.6
2001 — 36
2002 — 44.8
2003 — 52.9
2004 — 46.4*
2005 — 52.7
*The DPH revised this number this year to take into account a change in Pittsfield's estimated population. The number published in 2006 was 43.4.
Teen births in Massachusetts per 1,000 females aged 15 to 19:
2000 — 25.8
2001 — 24.3
2002 — 22.6
2003 — 22.6
2004 — 22.2
2005 — 21.7
Teen births in the United States per 1,000 females aged 15 to 19:
2000 — 48.5
2001 — 45.8
2002 — 42.9
2003 — 41.7
2004 — 41.2
2005 — 40.4
Source: The Massachusetts Department of Public Health

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Persistent problem of teen pregnancy
The Berkshire Eagle - Editorial
Tuesday, January 30, 2007

While the rest of the state is celebrating modest progress in the effort to combat teen pregnancy, the problem only grows worse in Pittsfield. This is as puzzling as it is disappointing. Pittsfield is not unique in the socioeconomic programs that lead to a high teen pregnancy rate. There is no giving up, but if current strategies aren't working, what can be done?
According to the state Department of Public Health, the teen pregnancy rate declined 2.25 percent to 21.7 per 1,000 in 2005, while the rate skyrocketed 13.6 percent to 46.4 per 1,000 in Pittsfield. The city's prevention programs and agencies were kept well-funded through the advocacy of former state Representative Peter Larkin, and there is no reason to believe agency personnel are not capable and hard working. If, however, teens don't see having babies as a problem, or if they even see it as a benefit, no amount of money or hard work will make a difference.
Mr. Larkin suggests that part of the problem is drug dealers taking up housekeeping with local girls and winning state-financed housing when a baby comes along, providing the dealers with a base of operations. If this is the case, it is difficult to cut funding for the drug dealer without putting the teen and her child out on the street. It would, however, be just one more reason for law enforcement agencies to clean the city and county of drug-dealing parasites.
In exploring the lives of several Pittsfield teen mothers, author and film-maker Joanna Lipper ("Growing Up Fast") found that the teens in general believed that having babies would boost their self-esteem and give meaning to otherwise empty lives. In reality, becoming a teen mom usually means an end to higher education and a lifetime of poverty. The DPH results suggest that nothing has changed in Pittsfield since Ms. Lipper's revealing book was published in the fall of 2003, and an unrealistic attitude toward having babies by teens will frustrate well-intentioned, well-funded prevention efforts.
The coalition of community groups and social service agencies that sponsored the recently released Berkshire Youth Development Project survey are convinced many youth problems, from pregnancy to alcohol to drugs, can be attributed in part to a lost connection with community, which should provide a sense of right and wrong, as well as outlets like after school activities that build esteem and keep young people occupied. That connection must be restored, and teens, boys and girls, must be more responsible. It isn't enough to throw money at the problem of teen pregnancy.

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Teen pregnancy up, youth programs down
Letters
Saturday, February 03, 2007
To the Editor of THE EAGLE:
Let's review last week's news:
Teen pregnancy rate is up in Pittsfield, the police are teaching health in Lanesborough schools (subject to renewal from state budget), and some school districts claim they cannot afford to support a high school bowling team.
Would you say students do not need health classes or more physical education time? Should they be allowed to experiment in unhealthy behaviors such as sex, alcohol, and drug use? We already know childhood obesity is a rising epidemic which leads to more serious disease. One-third if not more of the children in the United States are considered obese, ticking time bombs. Isn't it just easier to follow the crowd rather than be different, especially when schools and towns don't offer alternative healthy guidance?
You mean to tell me a bunch of motivated kids can't have a bowling team at their high school because there isn't enough money for the important sports teams to exist?
I ask you: What is wrong with this picture? Why isn't the government, national, state and local, looking at our school programs, allotting teachers and coaches who love what they do the money they need to keep our kids bowling, healthy, and not pregnant!
Whatever the activity, families, schools and governments need to look at the big picture and promote a healthier living for life. Kudos to those who continue to try.
HOLLY BROUKER
Pittsfield, Jan. 29, 2007
The writer is a former health/physical education teacher who lost her job because of budget cuts in 2002.
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News Article:
The Washington Post Online
Teen Pregnancy, Birth Rates Plummet Across D.C. Region
By Susan Levine
Washington Post Staff Writer
Monday, October 29, 2007; Page A01
~In Part~
In a country with the worst rates in the industrialized world, officials have focused on teen pregnancies and births because of their distressing, lifelong ramifications.
Adolescent mothers frequently compromise not only their health but also their future, dropping out of school and struggling financially. Their babies are at greater risk for a host of problems, including low birth weight and abuse, neglect and poor academic performance.
"Teen childbearing affects young people at both ends of childhood," the Annie E. Casey Foundation has noted.

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One in four Berkshire moms not getting prenatal care
By Anthony Fyden - February, 23 2006
In stark contrast to other Massachusetts communities, fewer than 75 percent of Berkshire mothers received adequate prenatal care in 2004, according to a new statewide report. That means that at least one in every four pregnant women failed to get the care needed to safely deliver healthy babies.
From a statewide perspective, the Massachusetts Births 2004 report, released on Wednesday, held some good news, including that the state's teen birth rate reached an all-time low. In fact, the teen birth rate of 22.2 births per 1,000 women ages 15-19 was 46 percent lower than the national rate. (The teen birth rate for Berkshire County was 25.8 percent).
Also, smoking rates during pregnancy reached an all time low statewide, 7.4 percent, 28 percent below the national rate. And in 2004, Massachusetts had the second lowest Infant Mortality Rate in its history: 4.7 infant deaths per 1,000 live births.
But the report raised some startling red flags for Berkshire County, particularly in the area of prenatal care. The report noted "less than 75 percent of mothers received adequate prenatal care in the Community Health Network of Berkshire County.”
In contrast, over 90 percent of mothers living within the Beverly/Gloucester health network received adequate prenatal care.
In Pittsfield, only 69.4 percent of mothers received adequate prenatal care, compared to over 90 percent of mothers living in Brookline and Arlington.
Pittsfield's Berkshire Medical Center (64.6 percent) was among facilities with the lowest reported rate of adequacy of prenatal care among mothers delivering in 2004. Other hospitals in this category were Boston Medical Center (53.9 percent), Tobey Hospital (62.8 percent), Lowell General Hospital (64.5 percent).
The hospitals with the highest rates of prenatal care included Beverly Hospital (93.3 percent), Saint Vincent Hospital (94.8 percent), Beth Israel Deaconess Medical Center (95.1 percent), and Brigham and Women's Hospital (98.1 percent).
According to a summary issued to the press, other key findings of the report include:
"In 2004, there was a 2 percent decrease in the number of births statewide. The number of births has decreased by 15 percent from 92,461 births in 1990 to 78,460 in 2004.
"The percentage of low birth weight infants (LBW) (less than 2,500 grams or 5.5 pounds) was 7.8 percent, the highest rate ever, although it is 4 percent below the national rate. Two important factors that account for this increase are the ages of mothers giving birth and the increase in multiple births.
"Older women are more likely to deliver LBW infants. The average age of a woman giving birth in Massachusetts is increasing. In 1980, about 1 in 4 births was to a woman aged 30 or older. In 2004, 56 percent of women giving birth were 30 years or older.
"Multiple births accounted for more than one half of the increase of low birth weight since 1990. The percentage of multiple births remained high in 2004. In 2004, 1 out of 21 births was a multiple birth. In 1990 1 out of 38 births was a multiple birth.
"Teen birth rates were highest in Lawrence (79.4 per 1,000 women ages 15- 19), Holyoke (76.0) and Springfield (70.9).
"Disparities in birth outcomes continue. The Black non-Hispanic IMR is 3 times that of white non-Hispanics (11.4 verses 3.8).
"The report in its entirety is available at www.mass.gov/dph/pubstats.htm . The data is also available through MassCHIP at www.masschip.state.ma.us ."

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NEWS ARTICLE:
THE BERKSHIRE EAGLE-
Pittsfield graduate rates low
Ranked in bottom 13% in state
By Matt Murphy, Eagle Boston Bureau
Friday, February 02, 2007
Pittsfield graduated only 67.6 percent of its students who entered high school in 2002, a number that climbed to 72.9 percent among students who spent all four years at Pittsfield high schools.

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Bump looks to address job losses in Berkshires
2/19/2007
By: Karen Honikel
Governor Deval Patrick's new Executive Director of Workforce Development isn't wasting any time getting down to business.
Former State Representative Suzanne Bump is working to introduce herself to the local business communities and let them know she will make sure the Berkshires are not forgotten on Beacon Hill. She says a major concern right now is addressing the loss of jobs in the Berkshires.
Currently the Berkshires have the highest rate of job loss in Massachusetts. Bump says this can be changed with the right policies in place. She says she will be meeting with the Governor once a week to work on bringing skilled workers and higher paying jobs into the area.
Bump says a key part to local job growth and development will be finding a way to keep the younger workers in the Berkshires.
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The Boston Globe, New England in brief, May 27, 2008
"2 resign in school contraceptives fight" - GLOUCESTER, Massachusetts

Two top officials at Gloucester High School's health center have resigned in a fight over distribution of contraceptives. Medical Director Dr. Brian Orr and chief nurse practitioner Kim Daly support confidentially giving birth control to students, but they departed after encountering resistance to the practice from Addison Gilbert Hospital, which administers state public health grants that pay for the high school clinic. This year, 17 Gloucester High School students are pregnant. Normally, the school has about four pregnancies per school year, The Associated Press reported. The hospital's executive director, Cindy Donaldson, expressed concern about community reaction to confidential contraceptive distribution, as well as liability issues. (AP)

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"Gloucester birth control flap prompts resignations"

By Mike Underwood, Tuesday, May 27, 2008, www.bostonherald.com, Local Coverage

Two fed-up medical officials have quit Gloucester High School’s health center amid a teen pregnancy “crisis” in a fight over handing out condoms and birth-control pills.

Medical Director Dr. Brian Orr and chief nurse practitioner Kim Daly resigned in outrage after their recommendation to confidentially give contraceptives to students was rejected by Addison Gilbert Hospital, which administers state funding for the school clinic.

“We had 17 teen pregnancies this academic year . . . a real worsening of the problem,” Orr told the Herald yesterday. Normally, the school has about four pregnancies per school year.

“We wanted a comprehensive program that would address this crisis, including giving condoms to the guys and oral contraceptives for teen women.”

But, Orr said, the hospital rejected his proposal over fears it could be held liable if teen women suffered health complications after being given the pill.

“This risk is almost nil,” said Orr, a pediatrician for 18 years.

He said the confidential distribution of contraceptives is practiced at many other school clinics in the state.

The hospital’s executive director, Cindy Donaldson, expressed concern about community reaction as well liability if a teen had ill effects from taking contraceptives.

“I’m surprised to hear of the resignations,” Donaldson told the Gloucester Daily Times.

“When the issue came up of confidential contraception around February, we said ‘yikes,’ ” Donaldson was quoted as saying by her hometown paper.

Orr, who will continue to work for Cape Ann Pediatricians, said he felt he had no choice but to resign Friday from the school clinic.

“This was not an easy decision for me at all,” he told the Herald. “I believe in this (program).”
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Article URL: www.bostonherald.com/news/regional/general/view.bg?articleid=1096567
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"Lowell middle schools stick with teaching abstinence: Officials cite funds as a major reason"
By Connie Paige, (Boston) Globe Correspondent, June 8, 2008

LOWELL - The Lowell middle schools use sex education courses that promote abstinence from sex before marriage and steer clear of information about sexuality, contraception, and sexually transmitted disease.

Critics say the schools should switch to comprehensive sex education, to teach students who choose to have sex how to protect themselves from pregnancy and disease.

But school officials say they do not have the money: While state backing for the abstinence-only program lapsed this year, the schools will continue to use them next year, since they are offered for free under a federal grant, the officials said.

"Right now we're trying to prioritize," Mayor Edward "Bud" Caulfield said recently, after the School Committee voted last month to cut 10 teachers to help erase a $3 million budget deficit. "We're operating on a shoestring."

Caulfield, who also is chairman of the School Committee, said he believes in comprehensive sex education. "I can't see anything wrong with trying to educate the students about the perils of getting pregnant," he said.

Anita M. Downs, who stepped down recently as Lowell City-Wide Parent Council chairwoman and remains on the board, feels the same way and said she believes the schools should restore comprehensive sex education, which was dropped for budgetary reasons in 2003.

Downs acknowledged money is scarce, but said the district should create partnerships with outside organizations that might provide comprehensive sex education for free. "It is very important, because it's going to affect our future in a lot of ways," she said.

Lowell had the ninth-highest rate of teen pregnancy and births in the state in 2006, according to the latest data from the Massachusetts Alliance on Teen Pregnancy, an advocacy organization working to prevent teenage pregnancy and help pregnant and parenting teens and their children.

Proponents say abstinence-only sex education helps students make sound choices about their lives, and refrain from sex before marriage. But critics say the just-say-no approach doesn't work, and leaves students ignorant and vulnerable to early pregnancy and sexually transmitted diseases.

Claire H. Golas, who oversees the just-say-no program in Lowell, said neither teachers nor parents have registered formal complaints about the abstinence teaching. She described the program, called Healthy Futures, as "effective, because it's hands-on, down to the kids' level. It's empowering the children to make their own choices."

The program started under former governor Mitt Romney, who used federal grants to the state to fund just-say-no initiatives to set up free workshops in schools. Healthy Futures also received a separate stream of money directly from the federal government.

Last year, Governor Deval Patrick decided to stop accepting the money from Washington, but Healthy Futures survived this year on its direct federal grant.

Healthy Futures director Rebecca M. Ray said her organization, based in Dorchester, receives $600,000 yearly directly from the federal government to provide free workshops in 10 to 12 Eastern Massachusetts school districts, including Lowell, but no longer gets $500,000 in funds formerly distributed by the state. The state pass-through grant would have been used to expand her program, she said.

"We have very strong support from school districts," Ray said. "They'd like to see us increasing the number of students we work with."

Rhea Gordon, who teaches the abstinence-only workshops, said she works with the Lowell Mission Church, a subcontractor of Healthy Futures that receives $156,000 to mount five one-hour workshops per year at each middle school. She said the program's motto, "The choices you make now will affect you later," can be applied to decisions about joining gangs, using alcohol and drugs, and becoming sexually active.

The workshops, said Gordon, address pregnancy and sexually transmitted diseases but stress the best way to avoid them is to abstain from sex. She said she teaches that condoms are not 100-percent effective in preventing pregnancy or disease.

A spokesman for Planned Parenthood League of Massachusetts, which opposes the Healthy Futures approach, called it "dangerously unrealistic" to teach students that condoms don't work.

"What these programs fail to do - and are prohibited from doing under federal regulation - is to convey to young people that condoms are an extremely effective method of preventing unintended pregnancy and sexually transmitted infections," said the spokesman, Angus McQuilken.

McQuilken said he hopes state lawmakers will fund comprehensive sex education, so that communities like Lowell can afford it.

"Access to comprehensive sex education right now is an accident of geography," he said. "If you live in a school district that has resources and makes it a priority, you have access to it. If you live in a school district that doesn't, you don't."

Massachusetts Department of Public Health spokeswoman Donna Rheaume said the state "does not have the funding to provide every school district with grants to engage in comprehensive health education," but local systems could make it a priority, and the federal government should provide money for it.

Lowell switched from comprehensive sex education taught by health teachers in 2003, after budget problems forced schools to cut 14 of 17 of the teachers, said Lowell deputy superintendent for curriculum Jean Franco.

Healthy Futures approached school officials and offered the workshops for free, Franco said. The workshops are now given to about 800 sixth-, seventh-, and eighth-graders, she said.

Neighboring Lawrence also has abstinence-only sex education, both in middle and high schools, taught by classroom teachers.

Lawrence Deputy Superintendent Mary Lou Bergeron said the schools there chose the approach at the urging of the city's large religious evangelical community.

Lawrence also ranked high in teen pregnancies and births in 2006, with the third-highest rate in the state, after Holyoke and Springfield, according to the Massachusetts Alliance on Teen Pregnancy.
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Connie Paige can be reached at cpaige@globe.com.
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Reports: "Teen girls made pact to get pregnant"
via The North Adams Transcript Online Newspaper, June 20, 2008

GLOUCESTER (AP) - A pact made by a group of teens to get pregnant and raise their babies together is at least partly behind a sudden spike in pregnancies at Gloucester High School, school officials said.

Principal Joseph Sullivan told Time magazine in a story published Wednesday that the girls confessed to making the pact after the school began investigating a rise in pregnancies that has left 17 girls at the school carrying a child. Normally, there are about four pregnancies a year at the school.

Sullivan told Time that nearly half of the expecting students, none older than 16, were involved. Sullivan said students were coming to the school clinic multiple times to get pregnancy tests, and "seemed more upset when they weren't pregnant than when they were."

Some of the girls reacted to the news they were pregnant with high fives and plans for baby showers, Sullivan said. One of the fathers "is a 24-year-old homeless guy," Sullivan told the magazine.

Superintendent Christopher Farmer confirmed the deal to WBZ-TV, saying the girls had "an agreement to get pregnant."

He said the girls are generally "girls who lack self-esteem and have a lack of love in their life."

Christen Callahan, a former Gloucester High School student who had a child when she was 15, said on NBC's "Today" show that some of the girls would ask her about her own pregnancy.

"They would say stuff like, oh, I think my parents would be fine with it and they would help me, stuff like that," Callahan said.

But she said she had no firsthand knowledge of a pact between the girls to get pregnant.

"They were just kind of like curious about it, they never actually came out and said it," Callahan said.

The first reports of the students' apparent plan to get pregnant were in the Gloucester Daily Times in March, when Sullivan said students were reporting that the girls were getting pregnant on purpose.

The rash of pregnancies has shaken the seaside city about 30 miles north of Boston. Last month, two officials at the high school health center resigned to protest the resistance from the local hospital to the confidential distribution of contraceptives. The hospital administers the state money that funds the clinic.

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(A Boston) GLOBE EDITORIAL
"Pact or not, pregnant too soon"
June 27, 2008

THE STORY of teenage girls in Gloucester making a secret pact to get pregnant has been irresistible fodder for TV talk shows and water cooler speculation. But it is a lot easier to blame the influence of celebrity teen mother Jamie Lynn Spears than it is to engage in a sober discussion about teaching responsible behavior in the public schools. Whether the students at Gloucester High made a pact or not, 17 young girls are pregnant too soon, likely condemning themselves to lifetimes of dependency and sharply narrowed horizons.

The pregnancy spike at Gloucester High is an aberration. Overall the number of teenage girls (ages 15 to 19) giving birth in this state is 21.3 per thousand, which is half the national rate, according to the state Department of Public Health. Gloucester's rate of teen births had been declining through 2006, the most recent year of DPH statistics.

But state and local policymakers failed the Gloucester students, by cutting off teen pregnancy prevention grants when revenues got tight on Beacon Hill, by offering spotty health education classes in the middle schools, and by not offering comprehensive reproductive healthcare in the high school clinic that the state does fund.

The clinic's partner, Northeast Health System of Beverly, also failed by not promoting access to birth control, including condoms, at the clinic, where the students' confidentiality could be assured. One hospital administrator was quoted worrying about liability should a teenager suffer ill health effects from taking birth control pills. But pregnancy is a greater health risk to a teenage girl than birth control medication.

Also, despite a recommendation from its own subcommittee, Governor Patrick's school readiness project does not include comprehensive health education, which includes sex education, even though pregnancy is a high risk factor for girls dropping out of school. What sex education there is in the Gloucester schools ends in ninth grade.

With the media circus whirling about them, Gloucester officials have struggled to regain their footing and are beginning to take some positive steps. The city will convene a meeting of nationally recognized experts in adolescent health over the summer, to help the Gloucester school committee adopt a clear, standardized policy for comprehensive health education this fall.

Also, Planned Parenthood of Massachusetts is offering free training for teachers and parents in a health curriculum that includes a focus on abstinence, comprehensive sex education where abstinence fails, wise decision-making, and parental involvement. These are the four elements - along with traditional education, college preparatory courses, and career training for today's job market - that have the power to combat an overwhelming cultural bias toward sexual activity at a young age.

Dr. Lauren Smith, medical director of the state DPH and a pediatrician, says that adolescents "tend to have a degree of magical thinking when it comes to the consequences of their life choices." The Gloucester girls may have romanticized what it means to be a mother at 16. That's no reason for the adults to engage in their own magical thinking: that teenagers won't have sex if no one talks about it.

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The Boston Globe, Op-Ed, ELLEN GOODMAN
"The real 'mommy pact' outrage"
By Ellen Goodman, June 27, 2008

WELL NOW, isn't that a relief. The infamous "pregnancy pact" at Gloucester High School turns out to be an urban legend. The media mobs that descended on the fishing town may now pack up their cameras and their moral outrage.

It's all over, folks. Except for the 17 Gloucester girls in the late stages of pregnancy or early stages of motherhood. And except, of course, for the 140,000 other American girls between 15 and 17 who'll be having their own babies this year.

Let us review the feeding frenzy that seemed to please so many palates. The natives of the town already knew there had been a bump in the number of baby bumps. High school pregnancies had quadrupled in one year. But this didn't get much outside notice until the high school principal told Time magazine that nearly half the girls "made a pact to get pregnant and raise their babies together."

Pregnancy Pact! "Sisterhood of the Maternity Pants!" "Jailbait Girls in Tot Pact!" Quick, ride your favorite hobbyhorse over to the nearest cable station, network, or blog.

The tale of the pregnancy pact led all the usual suspects to cast all the usual blame. It was because the state rejected abstinence-only funds. No, it was because the school couldn't dispense condoms. It was because the celebrity culture bred Jamie Lynn Spears wannabes. No, it was because the town was in the economic dumps. It was because the school had day care. No, it was because of an "absolute moral collapse."

Just when the dudgeon rose high over the outrage levee, along came the beleaguered mayor of her struggling city to tell a packed news conference that there was no evidence of a "blood oath" and that the high school principal had gotten a bit "foggy in his memory." Next, some of the pregnant girls spoke up, and the pact fell apart at the seams. Maybe some got pregnant intentionally, maybe some bonded before or after the pregnancy test, but there was no mass plunge into motherhood. Phew.

Uh, phew? Before we comfortably return to ignoring reality, may I remind you that the "Girls Gone Wild in Gloucester" merely raised this school's pregnancy rate up to 3 percent, or just under the national average for teens from 15 to 17. Are there no cameras on, say, Holyoke, where the pregnancy rate is 9 percent?

The Gloucester 17 have real troubles, but some 4,000 teens gave birth in Massachusetts (in 2006), and we're near the bottom of the chart, with a 2 percent teen birth rate. If you want real numbers, go to Texas, top of the teen birth heap at 6 percent. And if the gee-whiz factor was that some girls got pregnant intentionally, guess what? About 15 percent of all teen pregnancies are intentional - not counting those in that gray zone between intention and accident.

So why does it take the myth of the mommy pact to get attention? Patricia Quinn, head of the Massachusetts Alliance on Teen Pregnancy, figures that the story touched some deep fear. "We are terrified that we don't actually decide for our kids when they have sex. We don't decide when they become parents," she says. The notion that a group of girls made that decision together and without us caused a freak-out.

Indeed, the pregnant girls of Gloucester were described by one social worker as "socially isolated." How many teens are in fact isolated, particularly from the adult world?

"In our fear, we fail to do what we can do. Parents need to aggressively articulate their values," says Quinn. About two-thirds of our children have had sex before they graduate high school. Have they heard what we believe about sexuality, about relationships, about pleasure and responsibility?

If this is still a "teachable moment" - a phrase used to make us feel better when we've been gobsmacked by reality - what is the lesson from this media frenzy? That we're spending way too much time arguing with each other in public about sex education, abstinence, condoms, and shame. We're spending way too little time talking to kids over the kitchen table about sexuality and sexual values.

Anyone ready to make a new pact?
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Ellen Goodman's e-mail address is ellengoodman@globe.com.
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"Principal put into spotlight resigns: Faulted for citing 'pregnancy pact'"
By Kathy McCabe, (Boston) Globe Staff, August 13, 2008

Gloucester High School principal Joseph Sullivan, who drew worldwide media attention to his community when he told a reporter in June that a number of teenagers in his school had a pact to get pregnant, abruptly resigned yesterday.

In his resignation letter, which was obtained by the Globe, Sullivan said Mayor Carolyn Kirk had "publicly slandered my reputation, my integrity, and my intelligence," referring to a press conference in which Kirk had said his memory had failed when he was pressed for specifics about how he learned about the pact.

Kirk did not return messages left on her home telephone or cellphone yesterday seeking comment.

Sullivan wrote that he had been forced to "recognize that I have neither the trust, confidence, or respect of the mayor nor the superintendent."

"My instinctive reaction to this realization has been to soldier on, but I have too much respect for myself, my family, the school, the students, the faculty, and the staff to continue," he said.

Without the support of the mayor and superintendent, Sullivan said, "the already difficult and challenging job of being the high school principal becomes next to impossible."

Sullivan, 70, did not return a phone message left at his home last night.

Greg Verga, chairman of the School Committee, said: "It's a loss for the community. I think Joe was an excellent principal. My only concern is that people will remember only this most recent episode."

The School Committee is slated to meet tonight and Verga said Sullivan's resignation would be discussed.

"I imagine that some residents would also like to be heard on this issue, as well," Verga said. Superintendent Christopher Farmer, who notified committee members of Sullivan's resignation, is making a contingency plan for the 1,200-student school when it opens on Sept. 3, he said.

"We have less than three weeks to go before we start school," Verga said. "We don't have much time."

Gloucester High School has one assistant principal, he said.

Sullivan's resignation letter was dated Aug. 11, but administrators received it yesterday afternoon, Verga said. It takes effect Friday.

Seventeen girls at the high school, about four times the average annual figure, became pregnant during the past school year. In an article published in Time magazine in June, it was reported that Sullivan described a pact between girls who planned to get pregnant and raise their babies together.

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"Some are resigned to news of principal: Residents ready to end imbroglio on teen pregnancy"
By Tania deLuzuriaga, (Boston) Globe Staff, August 14, 2008

GLOUCESTER - Residents in this seaside fishing city responded wearily yesterday to news of the abrupt resignation of the man who drew worldwide media attention to his community when he said in June that teenagers in his school had a pact to get pregnant.

In the eyes of several people interviewed on the streets of Gloucester yesterday, the resignation of Gloucester High School principal Joseph Sullivan was simply another chapter in what many consider to be a story that has already dragged on too long.

"We want to put this behind us," said longtime Gloucester resident Nino Ciaramitaro, who was chatting with a friend outside Caffe Sicilia on Main Street. "It's old news for us."

Others said they would be sad to see Sullivan go after 10 years in Gloucester.

"Everyone there respected him," said one woman who was at Niles Beach with her children yesterday afternoon and declined to give her name but said she had two daughters who attend Gloucester High.

"We're all going to miss him," she said. "My daughters said this morning that it won't be the same without him as principal there."

In June, Sullivan was quoted in Time magazine saying that the school's spike in teen pregnancies was the result of a group of girls who made a pact to get pregnant and raise their babies together. The story made headlines across the globe, thrusting this community into the media spotlight.

A few days after the story was published, Mayor Carolyn Kirk held a press conference denying that there had been a pact and calling Sullivan's memory "hazy." But Sullivan stood by his interview, asserting in his resignation letter that he gave, "a direct, truthful, and honest answer."

He said the mayor publicly slandered him and said he came to realize he lacked the confidence of Superintendent Christopher Farmer.

"I fully appreciate the fact that without the mayor's and superintendent's unqualified support, the already difficult and challenging job of being the high school principal becomes next to impossible," Sullivan wrote in his letter.

Kirk did not return messages left at her office or on her cellphone yesterday. Though Sullivan's resignation is effective tomorrow, he was not in the office yesterday and did not return a message left at his home.

With about three weeks left until school starts, Gloucester officials need to act quickly to fill Sullivan's post.

"I will start talking with people," Farmer said at a school committee meeting last night. "I'm certainly not in a position to say what the interim arrangements will be at this point."

Opinions were mixed in this city yesterday on Sullivan's resignation and Kirk's handling of the matter.

"She's getting punched in the nose and rightfully so," said Lin Chandler, a massage therapist. "With the mayor not talking about it, this became something dark and shameful that we're not learning from."

Others said that Sullivan never should have given the interview to Time.

"To find out you're pregnant at 15 is enough; you don't need it broadcast to the world," said Shannon Valle, a Gloucester mother who had a baby in high school.

"I don't know how I would have dealt with it."

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"Teen mothers see parallels in Palin: But note stark contrasts in plight"
By Tania deLuzuriaga, (Boston) Globe Staff, September 9, 2008

Caridad, a 16-year-old Lawrence girl expecting her second child, felt a rush of recognition in Bristol Palin's plight as it unfolded on national television. Like the 17-year-old daughter of the Republican vice presidential pick, Caridad has had to cope with the turn her life took and learn the daunting responsibilities of motherhood at an age when most girls are still years from such cares.

And yet, from her grandmother's Lawrence apartment, where she lives and struggles to pay for diapers while expecting another child in February, the differences could not be more stark, or painful: Palin has a stable family and plenty of money to help her.

"I'd say she's lucky," Caridad said of Palin. "Not a lot of teen parents have the kind of support she has."

Caridad, who grew up poor and whose parents now play only intermittent roles in her life, is more typical of teen pregnancies across the country than Palin. While mothers between the ages of 15 and 17 are generally becoming more rare than they were a decade ago, social workers say they are quietly fighting a tide of young mothers in poor communities caught in a self-perpetuating cycle of poverty and poor education in which early pregnancy almost always plays a part.

In Massachusetts, where overall teenage pregnancies have declined in recent years, communities like Holyoke, Brockton, Chelsea, and Haverhill have all seen increases in the birth rate of mothers between ages 15 and 17.

"There's lots of young mothers sitting at home alone in an apartment or living in a shelter, maybe with a boyfriend who's helpful, maybe with a boyfriend who's abusive," said Anne Teschner, executive director of the Care Center of Holyoke, a high school equivalency program for teen mothers that has 130 mothers attending this year. "She's probably not going to school, and she's probably not working."

Angie Spears, who runs a program for teen parents at the Robert F. Kennedy Children's Action Corps center in Lawrence, said she is struck by the difference between the rosy portrait painted for Bristol Palin and what she sees at work each day: teenage mothers living in cars because they have nowhere else to go, girls coming to her in tears because they can't afford baby formula, and children as young as 14 with multiple pregnancies.

"I don't think people realize what a serious problem teens are going through," she said.

Teen mothers are less likely to finish high school and more likely to experience complications during pregnancy, health officials said.

"This isn't a bump in the road. This is a real roadblock," said Patricia Quinn, executive director of the Massachusetts Alliance on Teen Pregnancy. "I don't think it takes much to see that if you don't finish high school, you're going to struggle."

Taxpayers foot some of the bill. A 2006 study by the National Campaign to Prevent Teen Pregnancy estimated that each teenage mother in Massachusetts between the age of 15 and 17 costs taxpayers $6,000 a year.

In 2004, the Bay State spent $65 million on child welfare for teenage mothers, $37 million in public healthcare, and $29 million for incarceration. Nationally, the report says that teen childbearing costs taxpayers at least $9.1 billion a year.

"We have an especially important stake in their success," Quinn said.

Even before Governor Sarah Palin of Alaska, the Republican vice presidential nominee, caused a national stir last week by disclosing that her 17-year-old daughter is pregnant, teen pregnancy had made national headlines this year. Once was over a report that high school girls in Gloucester made a pact to get pregnant and raise their babies together. Another was when 17-year-old actress Jamie Lynn Spears proclaimed on the cover of OK! magazine that "Being a mom is the best feeling in the world!" Health officials say such headlines have tended to skew national perceptions about teen pregnancies; black teens are three times as likely and Hispanic teens are almost six times as likely as white teens to give birth, according to the Massachusetts Department of Health and Human Services. And, overwhelmingly, the teen mothers are poor.

"This is something that really centers around poverty," Quinn said. "Most young people confronting this challenge won't have these advantages in place and they will struggle."

Beatriz, a 16-year-old Lawrence girl about to start her junior year of high school, said her parents took the news of her pregnancy hard. "I disappointed my parents," said Beatriz. "My mom cried for three or four days. My dad didn't talk to me the whole time I was pregnant."

She struggles to buy diapers and formula with the money she earns as a waitress. Though she takes parenting classes through Angie Spears's program, Beatriz knows she has a tough road ahead.

"I'm doing everything alone now," she said. "My parents don't think I'll finish school, but I'm going back."

How to respond to and prevent teen pregnancy has been the subject of controversy from town halls to legislative chambers. Federal lawmakers have been debating whether to continue funding abstinence-only sex education programs after a study commissioned by Congress showed the programs don't keep teens from having sex.
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Tania deLuzuriaga can be reached at deluzuriaga@globe.com.
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"Gloucester schools draft teen pregnancy policy"
The Associated Press, Wednesday, September 24, 2008

GLOUCESTER, Mass. (AP) — The Gloucester schools have released the first draft of a new policy put together in response to a dramatic rise in teen pregnancy in the city that drew international media attention.

The draft released yesterday includes maintaining in-school child care services and offering sex education that teaches contraceptive use as well as abstinence.

It also offers three options on whether to offer birth control at the school health clinic. They are confidential student access to contraceptives; no distribution of contraceptives; or contraceptive availability only with parental consent.

The school committee is scheduled to discuss the draft today.

The city gained attention when the former principal said some of the 17 pregnant students at the high school last spring formed a "pact" to get pregnant.


Information from: Gloucester Daily Times, www.gloucestertimes.com


"Pregnancy draft policy to be aired"
By Patrick Anderson, Staff Writer, Gloucester Daily Times (Online)
September 24, 2008

The first draft of Gloucester Public Schools' policy responding to a rise in teen pregnancy includes maintaining in-school, day-care services for students, offering sex education that teaches effective use of contraceptives as well as abstinence, and laying out three choices on its most challenging question: whether to offer birth control in the school-based health clinic.

The options, which include blanket student access to confidential contraceptives, no distribution of contraceptives (either condoms or birth control pills) and an in-between choice of contraceptive availability only with parental consent, are outlined in the draft as a starting point for public discussion and School Committee deliberation.

Written by Superintendent Christopher Farmer and released yesterday, the draft is based on the comments of the School Committee and testimony of a three-expert panel that spoke on teen pregnancy in July. The School Committee is scheduled to discuss the draft tonight and make any desired changes before posting it on the district Web site.

It was created as a guide for the special public meeting discussion on teen pregnancy scheduled for next Wednesday as well as for the policy deliberations and vote expected from the School Committee later in the fall.

School Committee Chairman Greg Verga said yesterday that the draft represented a summary of the recommendations and thinking on teen pregnancy to date and could be added to based on the concerns or feelings of residents. It is in no way meant to limit public discussion next Wednesday, he said.

"The purpose of this is to summarize what we have heard to this point," Verga said. "Nothing is off the table as long as it relates to the issue. These are the key components of discussion and the purpose of the meetings is to see if we need to add anything to it."

Positions that conflict with the recommendations in the draft — such as providing abstinence-only sex education or closing the in-school, day-care center — will be fair game at the meeting, Verga said.

The schools have been working to codify a policy on teen pregnancy since staff at the Gloucester High School health clinic last year reported soaring numbers of students seeking pregnancy tests and becoming pregnant. In all, 18 girls in the high school were reportedly pregnant during the last school year, and reports that a number of the pregnancies were intentional — topped by a Time magazine report of an alleged pregnancy "pact" — thrust the school and the city into the global media spotlight.

An advisory board made up of health clinic staff, representatives from Addison Gilbert Hospital, the schools and city intended to issue recommendations on a response to the pregnancies, but dissolved after hospital officials expressed reluctance to consider providing confidential access to contraceptives.

The draft document keeps language about reproductive health services extremely general, with the most expansive option being the provision of "a comprehensive range of reproductive health services" and the most limited being the provision of "a restricted range of reproductive health services at the GHS health clinic (to exclude the prescription or provision of contraceptives)."

That option could likely reduce reproductive health services to things such as pregnancy tests.

The middle option in the draft document would provide contraceptives, but require parental permission.

During discussions this summer, School Committee members have discussed a number of variations on parental consent, including clauses requiring parents to sign if they want their children to receive reproductive health services or sign if they don't want them to.

Another option discussed has been to refer students to the soon-to-be-opened Gloucester Family Health Center on the campus of Addison Gilbert Hospital for services.

One reason cited for not providing contraceptives at the school-based clinic is to keep confidence and trust of parents in the clinic high, something that may be compromised if birth control is distributed without their consent.

The draft recommends working to "maintain the confidence of parents" in the health center.

Farmer said yesterday the draft was only a starting point — and he had already been contacted by School Committee members about making language changes to the sections about contraceptives.

"My view is that the public meeting will be much more useful if those attending have an idea of some of the issues the School Committee is interested in," Farmer said. "But that isn't to say they will be the only issues discussed."

In addition to dealing with the contraception issue, the draft recommends identifying students in need of counseling services, examining programs that teach healthy relationships and a program of comprehensive sex education. A working group has been established this year to review the current sex education curriculum in Gloucester and decide how best to supplement it.

In discussions with the School Committee earlier this year, Farmer has said he favors a sex education curriculum that teaches abstinence but also safe sex.

The School Committee earlier this month issued a vote of confidence for the in-school day-care program, but has said the subject can still be discussed.

The School Committee is scheduled to meet at 7 tonight at City Hall.
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Patrick Anderson can be reached at panderson@gloucestertimes.com
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Carolyn Kirk, mayor of Gloucester, fielded a barrage of questions in June when national attention focused on the city and its spike in teenage pregnancies. (Dominic Chavez/Globe staff/file)
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"After teen pregnancy spike, Gloucester weighs its options: Contraceptives at school clinic considered"
By Steven Rosenberg, (Boston) Globe Staff, September 25, 2008

GLOUCESTER - Three months after a teenage pregnancy scandal rocked this seaside community, the mayor and school committee chairman are calling for contraception to be made available at Gloucester High School.

"I think the eyes are on Gloucester to see what we do, because a lot of communities are wrestling with it," said Mayor Carolyn Kirk, who along with other School Committee members will debate over the next two weeks whether to allow contraception at the school.

The high school, which operates one of 47 health centers authorized by the state Department of Public Health, currently does not offer contraception to students. At present, 43 high schools around the state provide reproductive health services.

Since the spring, school and health officials have been concerned about a spike in teen pregnancy. With the national teen birth rate up 3 percent in 2006 - the first jump in 15 years - some city residents believed it was time for teens to have easy access to contraception. But after the city balked at allowing contraception to be distributed at the school, the school health center's medical director, Dr. Brian Orr, and his assistant, nurse Kim Daly, resigned.

Then, in June the city and the high school became the focus of national and international media attention after Time magazine reported that several teenage girls from the school had entered into a pregnancy pact. Kirk contested the report, for which the school's principal was the main source, and said a city investigation led by her office showed no pact.

But still, city officials and residents say the fallout from the story has been severe.

For weeks, media crews interviewed residents, and the city became the focus of a national debate about teenage pregnancy. In July, Gloucester was ridiculed by Beverly residents during an Independence Day parade that mocked Gloucester's pregnant teens.

The revelation that 18 girls had become pregnant also has led to several personnel changes at the high school. Since June, the school's longtime principal, Joseph Sullivan, resigned. The school has a new principal, and assistant principal, and recently Northeast Health System, which manages the health clinic, named a new medical director.

On Tuesday, the School Committee released a set of options that it will use to help formulate its policy on contraception. The options include allowing contraception for any student without parental approval, permitting contraception for students with parental consent, or keeping the existing policy of no contraception in school.

The School Committee will hold two special meetings, on Oct. 1 and 2, at which the public will be allowed to weigh in on the matter. According to the School Committee chairman, Greg Verga, the board will vote on the contraception issue at its Oct. 8 meeting.

Like Kirk, Verga wants the school's health clinic to distribute contraception, but only with parental approval.

"I think it's become obvious that there's an issue that there's sexual activity with teenagers," Verga said. "It seems like a preventative measure that would help us in our mission."

The list of options was compiled during the summer after several experts on teenage pregnancy were consulted, including Dr. Lauren Smith, medical director of the Department of Public Health, and Patricia Quinn, executive director of the Massachusetts Alliance on Teen Pregnancy. Both Smith and Quinn recommended that the school allow the distribution of contraception.

For a contraception option to pass, it needs four out of seven school board votes, and only Kirk and Verga have indicated how they will vote.

In downtown Gloucester, residents had mixed opinions about the idea of allowing contraception in schools.

"I would say no to it," said Everett Saulnier, who believes that the measure would encourage teens to have sex.

Shane Murphy, who graduated from the school four years ago, said contraception is needed by Gloucester's teens. "So many kids are having sex and their parents don't even know about it," he said.

Outside Gloucester High yesterday, 15 teens, including five girls, agreed that they should be able to get contraception at the school.

"A lot of people would feel a lot safer," said Alexis Starbird, who is 16 and a sophomore.

Lisa Barry, 16, a junior, said she would ask for contraception if it was offered by the school. "Gloucester is sexually active," she said.
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Steven Rosenberg can be reached at srosenberg@globe.com.
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"Gloucester OK's contraceptives: Will allow distribution at high school"
By Jeannie M. Nuss, Boston Globe Correspondent, October 9, 2008

GLOUCESTER - The School Committee voted unanimously last night to allow contraceptives to be distributed at the high school after a report of a pregnancy pact pushed Gloucester into the spotlight earlier this year.

The plan allows parents and guardians to withdraw their children from the contraceptive program. The new policy will take effect after the school board votes on the final language of the parental consent form.

About 20 parents and students gathered at City Hall to discuss providing contraceptives, with parental consent, through the school's health clinic or continuing the current policy of no contraceptives.

Gloucester made national headlines in June when Time magazine reported that several teenagers entered into a pact to get pregnant and raise their babies together.

Although Mayor Carolyn Kirk said the pact did not exist, the controversy pushed the School Committee into a series of debates about the merits of providing contraceptives at the school's health clinic.

School Superintendent Christopher Farmer agreed with last night's decision.

"People are increasingly realizing the lives of adolescents now are very complex," he said. "We have a significant number of teenagers who are sexually active."

After some debate, the seven School Committee members agreed on the importance of health and sexual education and an informed student and parent population.

"The parents need to be mindful of their obligation to their children," said Val Gilman, secretary of the committee.

Gloucester has been trying to decide how to deal with the 17 pregnancies reported at the high school last academic year. The number was four times the average for the 1,200-student school.

Dr. Lauren Smith, medical director for the state Department of Public Health, said the city's teen birth rate declined from 45.7 per 1,000 residents in 1990 to 21.1 in 2006, almost the same as the state rate of 21.3.

The school board also cautioned parents to consider the options.

"I put out a challenge to the parents to self-reflect," said Melissa Teixeira, a committee member. "Ask yourself are you approachable? . . . Please strongly consider your choice to opt out or not."

A recent Gloucester school survey conducted by students indicated that 86 percent of students support the distribution of contraceptives and 49 percent felt uncomfortable talking to their parents about sex.

"I'm happy about it," Pam Tobey, a 16-year-old junior and the secretary of the Student Advisory Council, said last night. "This is what everyone wanted. It's a big issue. I do think the majority [of students] would want it, but there should be limits - age, routine check-ups."

"Freshmen can barely keep up with their classes let alone learn to take the pill."

Fran Palmer, grandmother of Gloucester High student Kyla Brown, a 17-year-old who recently had a child, said she supports the distribution of contraceptives with parental consent.

"I think it should be done the proper way, which would require education," she said.

At the meeting last night, Kirk acknowledged the importance of education and said there is a clear message that the majority of students support the contraceptive distribution and that parents need to be informed.

Several board members voiced uncertainty about distributing the birth control pill, but the committee agreed it would impossible to allow some forms of contraception and not others.

"I think we all know this is a controversial issue," said Greg Verga, committee chairman.

"We are not going to please everybody."

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"Sexually Charged TV Might Raise Risk of Teen Pregnancy"
By Randy Dotinga, HealthDay Reporter, Monday, November 3, 2008

MONDAY, Nov. 3, 2008 (HealthDay News) -- New research suggests that teens who spend the most time watching sexually charged television shows are twice as likely to become pregnant or impregnate someone else.

The findings, reported in the November issue ofPediatrics, don't prove that sexy programming leads directly to pregnancy.

Still, parents should pay close attention to what their kids watch, said study author Anita Chandra, a researcher with Rand Corp.

"Not a lot of content on TV talks about the potential negative consequences of sex," Chandra said. "Characters engage in sexual talk or activity, give positive attributes to sex, and there's little discussion about the risks and contraceptive use."

As a result, she said, kids might become interested in sex without realizing the potential pitfalls.

Previous research has linked the watching of sexually charged TV programs to sexual activity in teens, Chandra said. The new study aimed to look for a possible link to teen pregnancy.

About one in every three girls in the United States gets pregnant before age 20, according to the U.S. Centers for Disease Control and Prevention. In 2006, more than 435,000 infants were born to mothers aged 15 to 19, and more than 80 percent of the births were estimated to have been unintended.

Federal statistics show that while the pregnancy and birth rates have declined by about a third among girls and women in that age group since 1991, birth rates in that group actually grew in 2006.

In the new study, researchers surveyed 2,003 children aged 12 to 17 in 2001, and then followed up with many of them in 2002 and 2004.

Researchers narrowed down the teens surveyed to those who were sexually active. After adjusting the survey results to take into account factors like race and parents' education, they found that those who watched the most sexual programming were still twice as likely to have gotten pregnant or gotten someone else pregnant since the start of the survey, compared to those who watched the least of that kind of programming.

The researchers declined to mention the TV shows that they considered to be sexually charged. Disclosing the shows would divert attention "from our core message that this kind of programming can have an impact on teen health, including pregnancy risk," Chandra stressed.

Overall, 14 percent of those in the survey reported getting pregnant or impregnating someone else after they were first interviewed.

The findings "add to the growing body of evidence that what children see on screen affects their behavior in real life," said Dr. Dimitri A. Christakis, a professor of pediatrics at the University of Washington who studies kids and television.

"We know that children imitate the behavior they see on screen, and that makes these results much more credible," he said.

Still, it's possible that there's some other reason for the findings, he said, adding that "no one can be positive that there isn't some other explanation."

More information

Learn more about teen pregnancy from the U.S. National Institutes of Health.
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SOURCES: Anita Chandra, Dr.P.H., researcher, Rand Corp., Arlington, Va.; Dimitri A. Christakis, M.D., M.P.H., professor, pediatrics, University of Washington, Seattle; November 2008,Pediatrics
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Teen or Adolescent pregnancy:

www.nlm.nih.gov/medlineplus/teenagepregnancy.html

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The Boston Globe, Op-Ed, ELLEN GOODMAN
"The truth about teens and sex"
By Ellen Goodman, Boston Globe Columnist, January 3, 2009

I HATE TO bring this up right now when the ink is barely dry on your New Year's resolution. But if history is any guide, you are likely to fall off the assorted wagons to which you are currently lashed.

I don't say this to disparage your will power. Hang onto that celery stick for dear life. And even if you stop doing those stomach crunches and start sneaking out for a smoke, at least you can comfort yourself with fond memories of your moment of resolution.

Compare that to the factoid in the newest research about teens who pledge abstinence. The majority not only break the pledge, they forget they ever made it.

This study of about 1,000 teens comes from Johns Hopkins researcher Janet Rosenbaum, who compared teens who took a pledge of abstinence with teens of similar backgrounds and beliefs who didn't. She found absolutely no difference in their sexual behavior, or the age at which they began having sex, or the number of their partners.

In fact, the only difference was that the group that promised to remain abstinent was significantly less likely to use birth control, especially condoms, when they did have sex. The lesson many students seemed to retain from their abstinence-only program was a negative and inaccurate view of contraception.

This is not just a primer on the capacity for teenage denial or the inner workings of adolescent neurobiology. What makes this study important is this: "virginity pledges" are one of the ways that the government measures whether abstinence-only education is "working." They count the pledges as proof that teens will abstain. It turns out that this is like counting New Year's resolutions as proof that you lost 10 pounds.

We have been here before. And before that. And before that.

When he was running for president, Bush promised, "My administration will elevate abstinence education from an afterthought to an urgent goal." Over the last eight years, a cottage industry of "abstinence-only until marriage" purveyors became a McMansion industry. Funding increased from $73 million a year in 2001 to $204 million in 2008. That's a total of $1.5 billion in federal money for an ideology in search of a methodology. And half the states refused funds to pay for sex mis-education.

By now, there's an archive of research showing that the binge was a bust. Programs mandated to teach only "the social, psychological and health gains (of) abstaining from sexual activity" and to warn of the dangers of having sex have been awarded failing grades for truth and effectiveness. As Rosenbaum says, "Abstinence-only education is required to give inaccurate information. Teens are savvy consumers of information and know what they are getting."

Our investment in abstinence-only may not be a scam on the scale of Bernie Madoff. But this industry has had standards for truth as loose as some mortgage lenders. All in all, abstinence-only education has become emblematic of the rule of ideology over science.

The sorry part is that sex education got caught in the culture wars. It's been framed, says Bill Alberts of the National Campaign to Prevent Teen Pregnancy, as a battle between "those who wanted virginity pledges and those who wanted to hand out condoms to 14-year-olds."

Meanwhile, six in 10 teens have sex before they leave high school and 730,000 teenage girls will get pregnant this year. We see them everywhere from "Juno" to Juneau - or to be more accurate, Anchorage, where Sarah Palin, advocate of abstinence-only education, just became an unplanned grandparent.

What the overwhelming majority of protective parents actually want is not a political battle. They want teens to delay sex and to have honest information about sexuality, including contraception. The programs that work best combine those lessons.

Soon Congress and the new administration will be anteing up annual funding for abstinence-only programs. As Cecile Richards of Planned Parenthood says, abstinence-only education was "an experiment gone awry. We spent $1.5 billion and can't point to a single study that says this helps. If it doesn't help, why fund it?"

Teens are not the only masters of denial. But we are finally stepping back from the culture wars. We are, with luck, returning to something that used to be redundant - evidence-based science. That's a pledge worth signing . . . and remembering.
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Ellen Goodman can be reached at ellengoodman@globe.com.
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"Sarah Palin on Daughter's Pregnancy: 'Life Happens'"
blogs.abcnews.com/theworldnewser, February 17, 2009

Bristol Palin, the 18 year-old daughter of Governor Sarah Palin, is becoming a high profile messenger about the trials of teen pregnancy. In her interview last night, the young Palin told Fox News that teenagers should "wait 10 years...I hope people learn from my story."

Bristol Palin remains unmarried. She describes the teen father of her baby, Levi Johnston, as a "hands-on dad." Her mother, the Governor, was there for the interview last night, though it seems the interview itself was kept a secret from mom until the day before.

What exactly is the takeaway message of the Bristol Palin story? Back during the campaign the episode became a point of contention. Governor Palin said given the circumstances she was proud of her daughter's decision to go ahead and have the baby. In other words to not have an abortion.

There was lots of speculation on the part of writers and internet pontificators that had the Palins been a black family things would have been very different. Their view: an out-of-wedlock pregnancy of a black teenager and the subsequent birth, would not have been viewed as a heroic life choice.

Now we hear from Bristol herself: "It's so much easier if you're married, have a house and career. It's not a situation you want to strive for."

And we hear from Governor Palin, who in the past has supported abstinence-only eduction for teens: "Get beyond the ideal of abstinence," the new grandmother said. "Hey, life happens."

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"Rise in teenage pregnancy rate spurs new debate on arresting it"
By Rob Stein, Washington Post Staff Writer, A04, January 26, 2010

The pregnancy rate among teenage girls in the United States has jumped for the first time in more than a decade, raising alarm that the long campaign to reduce motherhood among adolescents is faltering, according to a report released Tuesday.

The pregnancy rate among 15-to-19-year-olds increased 3 percent between 2005 and 2006 -- the first jump since 1990, according to an analysis of the most recent data collected by the federal government and the nation's leading reproductive-health think tank.

Teen pregnancy has long been one of the most pressing social issues and has triggered intense political debate over sex education, particularly whether the federal government should fund programs that encourage abstinence until marriage or focus on birth control.

"The decline in teen pregnancy has stopped -- and in fact has turned around," said Lawrence Finer, director of domestic research for the Guttmacher Institute, the nonprofit, nonpartisan research group in New York that conducted the analysis. "These data are certainly cause for concern."

The abortion rate also inched up for the first time in more than a decade -- rising 1 percent -- intensifying concern across the ideological spectrum.

"One of the nation's shining success stories of the past two decades is in danger of unraveling," said Sarah Brown of the National Campaign to Prevent Teen and Unplanned Pregnancy. "Clearly, the nation's collective efforts to convince teens to postpone childbearing must be more creative and more intense, and they must begin today."

The cause of the increase is the subject of debate. Several experts blamed the increase in teen pregnancies on sex-education programs that focus on encouraging abstinence. Others said the reversal could be due to a variety of factors, including an increase in poverty, an influx of Hispanics and complacency about AIDS, prompting lax use of birth control such as condoms.

"It could be a lot of things coming together," said Rebecca Maynard, a professor of economics and social policy at the University of Pennsylvania. "It could be we just bottomed out, and whenever you are at the bottom, it tends to wiggle around. This may or may not be a sustained rise."

The report comes as Congress might consider restoring federal funding to sex-education programs that focus on abstinence. The Obama administration eliminated more than $150 million in funds for such groups, but the Senate's health-care reform legislation would reinstate $50 million.

The new findings immediately set off a debate over funding. Critics argued that the disturbing new data were just the latest in a long series of indications that the focus on abstinence programs was a dismal failure.

"Now we know that after 10 years and over $1.5 billion in abstinence-only funding, the U.S. is lurching backwards on teen sexual health," said James Wagoner of Advocates for Youth, a Washington advocacy group.

Supporters of abstinence programs, however, said the findings provided powerful evidence of the need to continue to encourage delayed sexual activity, not only to avoid pregnancy but also to reduce the risk for AIDS and other sexually transmitted diseases.

"Research unmistakably indicates that delaying sexual initiation rates and reducing the total number of lifetime partners is more valuable in protecting the sexual health of young people than simply passing out condoms," said Valerie Huber of the National Abstinence Education Association, who blamed the increase on several factors.

"Contributors include an over-sexualized culture, lack of involved and positive role models, and the dominant message that teen sex is expected and without consequences," Huber said. The Obama administration is launching a $110 million pregnancy prevention initiative focused on programs with proven effectiveness but has left open the possibility of funding some innovative approaches that include encouraging abstinence.

The rate at which U.S. teenagers were having sex rose steadily through the 1970s and 1980s, fueling a sharp rise in teen pregnancies and births. That trend reversed around 1991 because of AIDS, changing social mores about sex and other factors, including greater use of contraceptives, which pushed the U.S. teen pregnancy rate to historic lows.

The U.S. rates still remained higher than those in other industrialized countries.

The decline in teen sexual activity had leveled off starting about nine years ago, and the teen birth rate began to increase in 2005. It wasn't known before if the increase was due to more pregnancies or fewer abortions and miscarriages. For the first time, the new analysis uses those factors in calculating the teen pregnancy rate.

The analysis examined data on teenage sex and births collected by the federal Centers for Disease Control and Prevention's National Center for Health Statistics and data on abortions collected by the CDC and Guttmacher -- the two best sources of such data.

The abortion rate among teenagers rose 1 percent in 2006 from the previous year -- to 19.3 abortions per 1,000 women in that age group, the analysis found. Taking that and miscarriages into account, the analysis showed that the pregnancy rate among U.S. women younger than 20 in 2006 was 71.5 per 1,000 women, a 3 percent increase from the rate of 69.5 in 2005. That translated into 743,000 pregnancies among teenagers, or about 7 percent of women in this age group.

"When birth rates go up and down, it could be the result of kids getting fewer abortions," said John Santelli, a professor of population and family health at Columbia University. "This shows that it's a true rise in pregnancies."

The rate increase was highest for blacks. Among blacks, the rate increased from 122.7 per 1,000 in 2005 to 126.3. For Hispanics the rate rose from 124.9 per 1,000 women to 126.6. Among whites, the rate increased from 43.3 per 1,000 women to 44.0.

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"Why Teen Pregnancies Are on the Rise"
By Deborah Kotz, U.S. News & World Report, January 26, 2010

Last year I reported that, after a decade of steady decline, teen birth rates were increasing in 26 states. So it's no great surprise that teen pregnancies are on the rise too, as a report issued Tuesday by the Guttmacher Institute, a nonpartisan research organization that focuses on sexual health, found. The report found that the pregnancy rate among American teens rose 3 percent in 2006 (the latest year for which statistics are available), teen birth rates rose 4 percent, and abortion rates were up 1 percent. Overall, about 7.2 percent of girls ages 15 through 19 became pregnant in 2006, compared with nearly 7 percent in 2005.

We're still doing better than we were in 1990, when nearly 12 percent of teenage girls became pregnant. (About 80 percent of teen pregnancies are unintended.) Still, some states, including New Mexico, Nevada, Arizona, and Texas, have current rates hovering near 10 percent, And in New York, which has the highest abortion rate, 4 percent of teens and nearly 9 percent of black teens have terminated a pregnancy.

If you believe the already whirling political spin, the reasons for the uptick are simple. "This new study makes it crystal clear that abstinence-only sex education for teenagers does not work," Cecile Richards, president of Planned Parenthood, said in an E-mailed statement. "It should serve as a wake-up call to anyone who still believes that teenagers aren't sexually active or that abstinence-only programs curb the rate of teen pregnancy." She's happy that President Obama eliminated abstinence-only education funding and has instead set aside $100 million for comprehensive sex education programs to prevent teen pregnancies.

Spinning in the opposite direction, Valerie Huber of the National Abstinence Education Association told the Washington Post that she blamed the increase on "an oversexualized culture, lack of involved and positive role models, and the dominant message that teen sex is expected and without consequences."

But Heather Boonstra, Guttmacher's senior public policy associate, tells me the reasons for the increase are probably complex and multifold. "We've been seeing declines in contraceptive use," she says, probably at least in part because of complacency about the HIV virus that fueled a rise in condom use among teens in the 1990s. She also says teen pregnancy seems to be more acceptable in many American towns and cities as teens flock to blockbuster movies like Juno (which positively portrays a pregnant teen) and see pregnant peers in their classes, something that was rare several decades ago.

Still another reason could be a purported surge in domestic violence in teenage relationships. One third of teens say they've been in an abusive relationship at some point, and a study in the current issue of the journal Contraception finds that women in these relationships are twice as likely to have an unintended pregnancy. That's often because their partners coerce them to become pregnant by, say, flushing their birth control pills down the toilet or refusing to wear a condom, says Boonstra.

But, she adds, "it's certainly reasonable to believe that changes in policy [during the Bush years] that provided funding for abstinence-only education programs played a role in a subsequent flattening out and reversal of [the decline in] teen pregnancy rates." And it's possible that increased funding for comprehensive sex education programs that encourage abstinence while also teaching about contraception could start preventing some of these pregnancies in the next few years. But parents can make a difference, too. My colleague Dr. Bernadine Healy has identified these 8 traits of teens who abstain from sex.

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"No picnic for teen mothers"
By Yvonne Abraham, Boston Globe Columnist, February 28, 2010

If only there had been a Gloucester pregnancy pact. Everything would be so much simpler.

The national hoopla surrounding the supposed plan by 18 Gloucester High students to get pregnant at the same time would have been justified, not a made-for-TV distraction. And the girls might have been “just dopey kids,’’ as a disgusted Bill O’Reilly so compassionately proclaimed on Fox at the time. We would have been right to just tsk-tsk and dismiss it all as a bizarre local aberration.

But the storyline of summer 2008 wasn’t real. There was no pregnancy pact. Depending on the girl, the reality was worse, or sometimes better, than that - and infinitely more complicated.

“It was all about that p-word,’’ said Kyla Brown, one of the young women who got pregnant that year. “It ruined the summer, the stress of it. That media thing will never happen again, but girls are still going to keep getting pregnant.’’ Brown, now 18, appears in a film called “The Gloucester 18.’’ Not to be confused with the recent, lame Lifetime docudrama based on the story, this documentary catches up with some of the girls two years after the hysteria. The film, being shown at the Kendall Square Cinema this Thursday, should be mandatory viewing for every teen in the country.

In it, we learn what happened to some of the girls after the cameras went away.

Six of them had abortions. One girl was placed in foster care with the baby son she delivered three months early, and who battles severe health problems. One sweet, shy girl lost her 1-month-old son to sudden infant death syndrome.

Several of the girls have embraced motherhood.

“I realize, some of the things I used to do, how stupid it was and how pointless,’’ Brown said when I talked to her last week. “Now my life has so much more meaning. No, I didn’t plan this, but you know what? I love it.’’

Life isn’t exactly a picnic. Brown is lucky enough to live with two helpful parents, but she has to work at a supermarket to support her 17-month-old son, and is finishing school at night. She’s cut off from many of her old friends.

“It’s a lot harder than I thought it would be,’’ she said.

Brown, like everybody else in the film, finds the notion of a pact laughable.

She and the others got pregnant for the same reasons girls get pregnant in cities and towns all over the state, some of them with teen pregnancy rates that make Gloucester’s spike of two years ago look minuscule.

They got pregnant because they were careless; because they felt like they couldn’t be good at anything else besides being mothers; because they needed the stability and love they thought a baby would bring.

Brown falls into the it’ll-never-happen-to-me category. Others were more deliberate. In one of the film’s gut-wrenching scenes, it becomes clear that one girl, Hallie, wanted to start a family to care for after being present when her best friend’s parents died in a murder-suicide. Alivia, who had been in foster care for years, said she was excited to learn she was pregnant “because I would have somebody close to me.’’

In Gloucester, like everywhere else, lowering the teen pregnancy rate means hard, uncomfortable work: making contraception more accessible, and delaying sex more attractive; making teenagers feel less alone, and that they have options beyond early motherhood.

The problem is a lot messier, and more intractable, than a crazy plan hatched by a bunch of bubbleheaded girls and blared across the talk shows.

But that’s not very sexy, is it?
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Yvonne Abraham is a Globe columnist. She can be reached at Abraham@globe.com.
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www.gloucester18.com
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www.boston.com/ae/tv/articles/2010/01/22/sex_lies_and_sensationalism_in_pregnancy_pact
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www.boston.com/news/local/massachusetts/articles/2010/02/28/no_picnic_for_teen_mothers/?comments=all#readerComm
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"Data: U.S. teen birth rate on decline"
By Rob Stein, Washington Post Staff Writer, April 6, 2010

The rate at which teenage girls in the United States are having babies has dropped, according to the latest government statistics released Tuesday, raising hopes that an alarming two-year increase in teen births was an aberration.

Births among U.S. girls ages 15 to 19 fell 2 percent from 2007 to 2008, according to the federal analysis of birth certificates nationwide, reversing two consecutive years of increases that had interrupted a 34 percent decline and caused alarm that one of the nation's most successful social and public health successes was faltering.

"This is good news," said Stephanie J. Ventura of the National Center for Health Statistics, which released the preliminary analysis. "It might come as a surprise because people were concerned the teen birth rate was on a different course."

Ventura and others said it was too early to know whether the trend would continue in 2009 figures. But she speculated that it might because it was part of a broader drop in the birth rate for women of all ages -- except those 40 and older -- and that appears to have continued at least another year.

The reason for the drop remained unclear, though experts offered several possible explanations, including the poor economy.

"The economy may have had some role," Ventura said. "The economic downturn has been so severe that many people may be rethinking a lot of things, including having children."

But others argued that it was unlikely the economy was to blame and said it was likely due to a combination of factors.

"It is not possible to fully explain what accounts for changes in the teen birth rate, especially in any given, single year," said Sarah S. Brown of the National Campaign to Prevent Teen and Unplanned Pregnancies. "It went up a bit between 2005 and 2007 and now is down a bit in 20008. In fact, one view is that the rate has sort of plateaued and is now varying -- bouncing around a flat line."

Whatever the cause, the trend was hailed by advocates across the ideological spectrum.

"We are very pleased with this good news," Brown said. "If there had been a third year of increase in the rate, the two-year 'uptick' in teen births would have become a troubling trend."

Others cautioned that the trend may instead represent a stalling in the decline in teen births.

"I think it is hard to make any pattern out of the last three years, other than to say that we are no longer making steady progress," said John Santelli of Columbia University. "The trend from 1991 to 2005 was steadily downward. We now seem to be stuck."

The rate dropped the most -- 4 percent -- for the oldest teens: those 18 and 19. The rate had increased 6 percent between 2005 and 2007 for this group, halting a 26 percent decline between 1991 and 2005. The rate fell 2 percent -- for those 15 to 17. The rate for this age group had increased 4 percent between 2005 and 2007, interrupting a 45 percent decrease between 1991 and 2005. The rate among those 10 to 14 remained unchanged.

The rate fell among all races, but hit a historic low for Hispanics.

The report comes as President Obama is launching a $110 million teen pregnancy prevention program that is being closely watched to see whether it includes funding for any controversial programs that focus on encouraging abstinence until marriage.

Advocates on both sides expect Obama's program to eliminate most funding for abstinence programs because $75 million was targeted only at curricula that had produced convincing scientific evidence that they work. But $25 million was set aside for more experimental approaches, which could potentially include some abstinence programs. And the new health-care legislation includes $50 million a year for five years for abstinence programs.

"The downward trend is encouraging and gives us reason to believe that the 2006-07 slight uptick in teen births may have been a hiccup, rather than the start of a troubling new trend," said Valerie Huber of the National Abstinence Education Association.

"It is a shame that abstinence education opponents too early use any statistics to denigrate an approach that offers teens the best skills to avoid all the consequences of sex, including teen pregnancy," Huber said.

But opponents of abstinence funding urged caution.

"We don't yet know whether the new data for 2008 showing a decline constitutes a blip or a trend. What we do know is that the federal government is about to launch one of the largest teen pregnancy prevention efforts in decades and if we are to ensure that this decline continues, it is critical that federal funds go only to the programs that work. The fact that Democrats included nearly a quarter-billion of failed abstinence-only-until-marriage programs in health-care reform is alarming," said James Wagoner of Advocates for Youth, a Washington advocacy group.

The report also had another piece of good news -- a significant decline in babies born preterm, which fell 3 percent. That was the second consecutive year of decline, following a 20 percent increase between 1996 and 2006.

At the same time, the report also found the "total fertility rate" fell 2 percent, pushing it below 2.1 per woman, meaning the nation was no longer giving birth to enough children to keep the population from declining.

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"High teen birth rate tied to lack of sex ed"
By Amanda Korman, Berkshire Eagle Staff, January 21, 2012

New government data showing the prevalence of teenage girls not aware of their chances of getting pregnant rings true in the Berkshires, local leaders say, where an intractable teen birth rate is tied to sexuality education that is not yet consistent or comprehensive.

In a survey by the Centers for Disease Control between 2004 and 2008, half of teen moms whose pregnancies were unintended did not use any method of birth control, and a third said they didn't use contraception because they didn't realize they could become pregnant.

While the report does not encompass Massachusetts, those attempting to address teen births in Berkshire County say that the theme of misinformation among teens applies locally.

"When people say ‘I didn't think I could get pregnant,' it shows a general naiveté, but if they do have information it's myth-based," said Kristine Hazzard, CEO of Berkshire United Way, which has created the Berkshire County Teen Pregnancy Prevention Initiative to address the 27.2 births per 1,000 teen females in the county.

The CDC highlights misconceptions like a teen believing that she or her partner were sterile, or that they could not get pregnant during a certain time of the month. Hazzard pointed out that some young people also abide by false hearsay that, for instance, showering after sex can prevent a pregnancy.

Lack of access and side effects were other reasons teens in the study cited for not using contraception.

In the Berkshires, the Teen Pregnancy Prevention Initiative has been analyzing the cluster of reasons that the county's teen birth rate, and specifically the rates of Pittsfield and North Adams, have risen dramatically while statewide and nationally, the numbers are falling.

A broad look at sexuality education in the county -- in schools, households and health clinics -- shows a lot lacking, said Christa Collier, executive director of the Berkshire County Kids Place and a co-chair of the sex education subcommittee for the pregnancy initiative, including not a lot of programs beginning in middle school.

"There are definitely some schools within particular districts that aren't doing anything, so it's been very hit or miss," Collier said. "It's not a real solid curriculum that's consistent and comprehensive."

Collier pointed out that one of the county's strengths is a number of trained sex educators through organizations like the Railroad Street Youth Project, Northern Berkshire Community Coalition, and the Brigham Center -- but the connections between these teachers and schools hasn't yet been fully realized.

Frank LaFrazia, the other co-chair of the sex ed committee and director of the Playwrighting Mentoring Project at Barrington Stage Co., pointed out that kids are often more influenced by what they hear through the rumor mill than in health class.

In addition to strengthening school programs and parent involvement, the whole community dialogue about sex needs to be more open, LaFrazia -- "That we're not afraid to talk about sex, not in a taboo way, but that this is a part of human nature, and let's talk about ways to protect ourselves if this is the choice you start to make."

Hazzard added that there needs to be targeted work in populations like the children of teen parents and the Hispanic community, where there isn't a custom of discussing sexuality in the home.

To reach Amanda Korman: akorman@berkshireeagle.com, or (413) 496-6243.

The facts ...

Teens in the Berkshires were asked about their method for preventing pregnancy the last time they had intercourse.

Never had intercourse -- male: 60%; female: 62.6%

No method was used -- male: 6.5%; female: 7.9%

Birth control pills -- male: 7.2%; female: 11.6%

Condoms -- male: 20.1%; female: 14.7%

Other/not sure -- male: 6.3%; female: 2.7%

-- 2011 Berkshire County Prevention Needs Assessment Survey

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"Ignorant on pregnancy"
The Berkshire Eagle, Editorial, January 24, 2012

It's distressing that in an age when so much factually based information is readily accessible that teenage girls remain sexually uneducated, which leads to the high teen birth rates that have long been a Berkshire reality. Support groups are out there with that information, but there is only so much that can be done if teens are determined to remain blissfully ignorant.

A Centers for Disease Control study revealing that half of teen mothers whose pregnancies were unintended didn't use birth control, and a third didn't do so because they didn't think they could become pregnant, attests to both a lack of information and misinformation. In Saturday's Eagle, Kristine Hazzard, CEO of Berkshire United Way, which has created the Berkshire County Teen Pregnancy Initiative, says that many teen moms have information that is "myth-based." The presence of these sexual myths cited by the CDC indicates that the social networks increasingly employed by young people are spreading misinformation at the speed of light, with destructive consequences.

In an Eagle story last year, Ms. Hazzard spoke of the high teen birth rate in the Berkshires, now 27.2 births per 1,000 teen females, which has unfortunately become an "accepted reality." This acceptance, combined with misinformation, creates formidable obstacles for the many Berkshire organizations confronting a problem with significant social costs. Another reality is that teen mothers frequently drop out of school for good, depriving themselves of career opportunities and consigning themselves to a life of poverty. While teen fathers share responsibility, statistically they don't face the same bleak futures as their girlfriends and children do.

If teenage girls are to avoid this fate they must get information from good sources, not misinformation from the rumor mill or a social network, and apply that information. Schools and parents must do more to assure that teen girls have access to this information, so they are hearing much more than myths and rumors.

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"Drop in teenage pregnancies is due to more contraceptives, not abstinence"
By Julie Rovner, Kaiser Health News, September 9, 2016

WASHINGTON - Teenage pregnancy is way down. And a study suggests that the reason is increased, and increasingly effective, use of contraceptives.

From 2007 to 2013, births to teenagers ages 15 to 19 dropped 36 percent; pregnancies fell by 25 percent from 2007 to 2011, according to federal data.

But that wasn't because teens were shunning sex. The amount of sex being had by teenagers during that time period was largely unchanged, says the study, which was published online in the Journal of Adolescent Health. And it wasn't because they were having more abortions. Abortion has been declining among all age groups, and particularly among teenagers.

Rather, the researchers from the Guttmacher Institute and Columbia University found that "improvement in contraceptive use" accounted for the entire reduced risk of pregnancy over the five-year period.

"By definition, if teens are having the same amount of sex but getting pregnant less often, it's because of contraception," said Laura Lindberg, the study's lead author and a Guttmacher researcher.

No single contraceptive method stood out as singularly effective, said the researchers. Instead, they found that teens were using contraceptives more often, combining methods more often, and using more effective methods, such as the birth control pill, IUDs and implants.

Also, the use of any contraceptive at all makes a big difference, said Lindberg. "If a teen uses no method they have an 85 percent chance of getting pregnant (within a year). Using anything is way more effective than that 85 percent risk."

The downturn in teen births actually dates back to the early 1990s, the authors say, with the rate dropping by 57 percent between 1991 and 2013. The increase in contraceptive use dates to the mid-1990s, with the use of any contraceptive at the most recent sexual encounter rising from 66 to 86 percent from 1995 to 2012.

Valerie Huber, who advocates for programs that urge teens to wait to have sex rather than provide information about contraception, says the study is biased toward birth control.

"As public health experts and policymakers, we must normalize sexual delay more than we normalize teen sex, even with contraception," said a statement from Huber, president and CEO of Ascend, a group that promotes abstinence education. "We believe youth deserve the best opportunity for a healthy future."

More recent policy changes could help drop the teen pregnancy rate even more. One is the Affordable Care Act requirement that boosted insurance coverage for contraception, starting in 2012. The other is the 2014 recommendation from the American Academy of Pediatrics that sexually active teenagers be offered "long-acting reversible contraception" methods such as implants and intrauterine devices, which are highly effective and do not require any additional action, such as remembering to take a daily pill.

But Lindberg noted that just as for older women, teens should be offered a full choice of contraceptives. "In the end, the best method for anyone is one that they are willing and able to use."

Visit Kaiser Health News at www.khn.org

Link: www.unionleader.com/health/drop-in-teenage-pregnancies-is-due-to-more-contraceptives-not-abstinence-20160905#sthash.3UktkFbj.dpuf

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“Asking this question can help prevent unplanned pregnancies among teens”
By Elise Devore Berlan, MD, December 9, 2016

Would you like to become pregnant in the next year?” Asking teenage girls that question is one simple way to prevent unplanned pregnancies.

The remarkable drop in birth rates among teenagers hides a large gap between urban and rural teens. Between 2007 and 2015, teen birth rates dropped 50 percent in large urban counties and just 37 percent in rural counties. We can do better.

Most teen pregnancies are unplanned and unwanted. Increased use of birth control is the primary driver of fewer teenage pregnancies in urban and rural areas. So what explains the demographic difference? Formal sex education for teen boys and girls has fallen off since 2006, more in rural than urban areas. Participants in comprehensive sexuality education programs are more likely to delay starting to have sex, have fewer unprotected sexual encounters, and are more likely to use condoms and contraception. In addition, teenage girls and young women in rural areas may have reduced access to medical care and pharmacies compared to their urban peers.

Here are a few things that health care organizations and communities can do to help young women make good choices for their sexual and reproductive health.

Ask the question

Primary providers, obstetricians, and gynecologists routinely ask their adult female patients, “Would you like to become pregnant in the next year?” The Oregon Foundation for Reproductive Health has helped popularize that question through its One Key Question Initiative. Pediatricians rarely ask it. But they should.

Most teens who are sexually active don’t want to become pregnant. Most have plans to finish school, perhaps attend college, and find a career and a partner before starting a family. Before we started asking teens that question, our county, Franklin County in central Ohio, had high rates of premature births and infant mortality. Teen pregnancies contribute to both. That was the driving force behind an idea for an outpatient birth control clinic that would offer comprehensive, teen-friendly contraceptive counseling that focused on improving access to the most effective birth control methods.

In 2014, we launched the Young Women’s Contraceptive Services Program, also known as BC4Teens, at Nationwide Children’s Hospital in Columbus, Ohio. It provides a place for young women to talk about sex, birth control, sexually transmitted diseases, and more with medical experts, and get access to contraception. Because many clinicians do not have the knowledge and skills to provide teens with the most effective methods of contraception in their offices, our program also focuses efforts on educating and training medical professionals.

Listen to the answer

The question “Would you like to become pregnant in the next year?” is part of reproductive life planning. For women who answer “No,” the ensuing conversation, often called contraceptive counseling, has become the standard for guiding a discussion of lifestyle, future plans, and birth control options. A health professional trained to provide contraceptive counseling can help a woman choose the birth control method that is right for her.

In the BC4Teens program, we don’t presume to know how our patients will answer the question. We encourage open discussion among our teen and young adult patients, their parents or guardians (if they are minors), and health care providers. With the use of supportive education, myth busting, teen-friendly educational materials, parental support, and more, this “difficult” discussion has become much less awkward.

Engage the community

Many teens and young adults don’t routinely see a doctor. That’s why meeting adolescents where they are is an important part of the effort to reduce unplanned pregnancies. Our team uses community engagement as a platform to educate young men and women about preventing teen pregnancy while also encouraging young women to discuss birth control options with their partners. Offering training and online education for health care providers, holding education sessions for schools and community groups, and being a presence at local events and activities provides the opportunity to deliver the most accurate information to young people.

Offer effective options and make it easy

The medical community must move beyond simply offering teens the option of oral contraceptives and condoms to prevent unplanned pregnancy. The American Academy of Pediatrics recommends that sexually active teens be counseled about the full spectrum of essential contraceptives.

BC4Teens follows that advice, and provides information about, and immediate access to, all available types of prescription birth control methods, starting with the most effective ones — intrauterine devices (IUDs) and the contraceptive implant (Nexplanon). These methods are highly effective at preventing pregnancy in part because they eliminate the potential for human error, like missing a dose of an oral contraceptive or properly using a condom.

We also provide counseling on the correct use of condoms for prevention of sexually transmitted infections, and provide condoms to our patients.

Because we know it’s difficult for many teens to get an appointment with a family planning provider, we make available same-day appointments and evening appointments. In most cases, teens in the program are able to start their chosen contraceptive method, including IUDs and implants, on the day of their appointment.

The BC4Teens program has helped us more than double the birth control outreach at sites across the Nationwide Children’s Hospital system. One signal that it may be working is a decline in infant mortality, which is related to teen pregnancy, in Franklin County, where most of our patients live.

More than 200,000 American teenagers become pregnant each year. Most of these pregnancies are unplanned and unwanted. Unwanted pregnancy is a leading cause of girls dropping out of school and may perpetuate generational poverty. Better sex education and access to contraception can improve the lives of teens and the overall health of communities.

Elise DeVore Berlan, MD, is a physician in the Section of Adolescent Medicine at Nationwide Children’s Hospital and an associate professor of clinical pediatrics at The Ohio State University College of Medicine.

Source: www.statnews.com/2016/12/09/teen-pregnancy-prevention-question/

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"Understanding teen sex"
The Boston Globe, Letter, January 8, 2018

The recent Centers for Disease Control and Prevention survey results describing a decline in teenage risky sexual behaviors is misguided (“Decline in number of teens having sex continues,” Nation, Jan. 5). If adults want to truly understand the sexual world of teenagers, we need to shift our lens. While a decline in sexual intercourse among teens is encouraging, since it indicates a decrease in teen pregnancy and sexually transmitted infections, it’s essential to examine whether this decline is correlated with an increase in virtual sexual activity. Sexting and online sexual activity present serious risky factors of their own, including decreased intimacy, sexual addiction, access to violent pornography, exploitation, and trauma. If adults don’t adapt to this brave new world, we will miss the opportunity to help a new generation develop healthy attitudes toward sexuality and intimacy.

Karen Seif
Medford [Mass]
The writer is a clinical social worker specializing in work with children, adolescents, and families.

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