Proactive, Not Reactive
By Mary Edlow, Ph.D.
Although the rate of unintended pregnancy has declined, the U.S. rate is still significantly higher than in many other developed countries. In 2011, nearly half (45%, or 2.8 million) of the 6.1 million pregnancies in the United States were unintended. However, traditional estimates understate the risk of unintended pregnancy among adolescents because these estimates typically include all women, whether or not they are sexually active. When rates are recalculated, including only those women who are sexually active, adolescents ages 15–19 have the highest unintended pregnancy rate of any age group.
Early parenthood puts adolescents at risk for a wide range of clinical issues, mental health outcomes, and educational challenges. Teen mothers have a higher incidence of preterm babies and postpartum depression. More than 50% of teen mothers will not graduate high school; 25% will become pregnant again within two years; and less than 2% will earn a college degree by age 30. These early, unintended pregnancies profoundly contribute to future educational and financial difficulties for young women.
According to Laura Lindberg, a principal research scientist at the Guttmacher Institute and co-author of “Sexual Behavior and Contraceptive and Condom Use Among U.S. High School, “many young people become sexually active during high school.” Ms. Lindberg strongly emphasizes that “it is critical to ensure that all young people have access to comprehensive sexuality education and sexual and reproductive health care services to support their sexual and reproductive decision making.”
Studies have shown that comprehensive sex education lowers rates of teenage pregnancy and sexually transmitted diseases, while abstinence-only education actually increases such risks. The Guttmacher Institute, which focuses on reproductive health, specifies that 37 states require that abstinence be covered, while only 13 states require sex education to be medically accurate. Astonishingly, more than half of middle schools and more than three-quarters of high schools concentrate on abstinence. Debra Hauser, President of Advocates for Youth, a nonprofit, sexual health organization in Washington, D.C., notes a recent trend in which the teenagers themselves and young adults are mobilizing their communities on behalf of comprehensive sex education. She elaborates, “they want to take it into their own hands.”
The Sex Education Initiative (SEI) at Teachers College, Columbia University, is a new professional training program for teachers with an emphasis on intentional pregnancy and family planning. Its focus is on the overlooked psychosocial dimension of reproductive decision making for adolescents as a critical component of comprehensive sex education. Professionals will learn how to engage their own personal process and in turn assist adolescents to explore their reproductive identities and its impact on their sexual behavior.
The SEI project at Teachers College aims to support adolescent development at the intersection of sexual/reproductive and psychological literacy or reproductive well-being literacy. The hallmark of all literacy is the ability to access, understand, and use information in ways that promote and maintain, in this case, the reproductive well-being of our youth. A particularly important, yet often left out dimension, is the attainment of psychological insight into one’s experiences around sexual/reproductive issues that could substantively increase awareness, behavioral management and prevention. The Edlow Sexual/Reproductive Literacy Project offers a platform for school-based sexual/reproductive health educators to design holistic curricular programming for youth, ages 12–18 that would include their unique biological, developmental, social, psychological, and spiritual identities. Effective reproductive well-being literacy programs that address both the physical and the psychological dimensions will lead to a heightened awareness of the risk-factors of sexual engagement; increased medical knowledge of bodily functions; insight into beliefs and attitudes that influence decision making; and deeper understanding of family of origin and family planning expectations. It is anticipated that intentional and planned pregnancies will result in healthier children who are welcomed into loving families that are more prepared for the joys and challenges of parenthood, one of the most important life experiences any of us will ever undertake. Every Child a Wanted Child.#