Teen Pregnancy Part 1: Lets Talk About Sex

You can find part 2 here: https://snjtoday.com/teenpregnancy2/
Community leaders call for an open discussion about Cumberland Countys high teen pregnancy rate. Part 1 of 2
BY: Blake Christy
     Diapers, PediaSure, and baby wipes are not normally found in the office of a college president, but you’ll find these items in the office of Cumberland County College president, Dr. Yves Salomon-Fernandez. She has two kids of her own— ages seven and nine — but the baby products are not holdovers from their infant years. “I often see young parents around campus, so I keep these things in my office for them,” Dr. Salomon-Fernandez said.
     On the college campus, and around Cumberland County, it is not uncommon to find teen parents; the county has the highest teen pregnancy rate of all 21 counties in the state of New Jersey. In Cumberland County, for every 1,000 females between the ages of 15-19, 59 will have a child (teen pregnancy data does not include miscarriages or abortions). To put this in perspective, Ethiopia, a developing country, has a teen pregnancy rate of 60. Compared to the entire state of New Jersey, Cumberland County has almost triple the state’s average of 20. This all begs the question: Why is this happening in Cumberland County?
[caption id="attachment_29927" align="alignnone" width="300"]Teen Birth Rates CC vs NJ Data from Robert Wood Johnson Foundation[/caption]
     Dr. Angel Kelly, Nurse Practitioner of Cumberland Obstetrics, said she meets with a pregnant teen almost every day. During her many years practicing medicine, she has noticed that people are not aware of the extent of the problem. “It is time to change what we have been doing,” Dr. Kelly said. “We have been leading the state in most teen pregnancies per-capita. If you look at the trend, we have been at the bottom almost continually, so clearly everything we have been doing has not worked.”
     When the teen pregnancy rate is as high as Cumberland County’s, it becomes a community issue. Dr. Joseph P. Riley, an obstetrician in Bridgeton, believes it’s a, “complete public healthcare failure.
     “We have to start treating it as the public health problem it is,” he said.
     The National Campaign to Prevent Teen and Unplanned Pregnancies estimates that the average taxpayer costs associated with a child born to a teen is about $1,682 per year from birth to age 15. The 2,280 teen births in Cumberland County in 2015, could cost taxpayers $57.5 million over the next 15 years.
        Teen parents are also more likely to drop out of high school. Only an estimated 40% of teen parents will earn their high school degree. Lower academic attainment means a less productive and lower-skilled workforce, leading to higher unemployment— all factors that could result in a cycle of reliance on public services. Professor of economics at Fordham University, Dr. Kristine-Angela Kintanar notes, “A high teen pregnancy rate may contribute to the economic stagnation of the community since it may take people away from educational and professional opportunities.”
     The majority of teens in Cumberland County will not become pregnant, but simply living in a community with a high teen pregnancy rate is cause for concern. A high teen pregnancy rate is evidence that many adolescents are having unprotected sex, which puts teens in the community at a higher risk of contracting a sexually transmitted disease (STD). In fact, Cumberland County also has the highest STD rate in the state.
     “Teen parenting can happen to anyone,” said Kimberly Friddell, the executive director of Inspira’s Innovative Model for Preschool and Community Teaming (IMPACT). “When you look at the correlation between the rate of teen sex and the STD rates, we do not have healthy young people.”
     Among adolescent development and health professionals, the consensus has been that in order to prevent teen pregnancy, educators need to reach children during their formative years.
     “Education has to start early before the onset of sexual activity has occurred,” Dr. Kelly said. The Guttmacher Institute estimates that the average teen is sexually active by the age of 17. Dr. Kelly added, “This does not mean that we have to go in and start talking about sex in 4th grade, but it does mean that we have to be talking about trust, and talking about relationship building, and confidence building.”
     Friddell has been on the front lines of addressing teen pregnancy in Cumberland County for more than 15 years. When asked if the school systems in Cumberland County are doing enough, she said, “No, we do not do enough.”

Teaching Abstinence: Old School  

     The Centers for Disease Control and Prevention (CDC) recommends that all high school students be educated in four broad areas of sexual health:  HIV prevention, STD prevention, pregnancy prevention (including contraception), and information on sexuality. In a 2013-2014 report by the CDC, New Jersey high schools ranked the highest; 9 out of 10 high school students say they receive the full list of recommended topics. Because of this, The State of New Jersey’s Board of Education is regarded as one of the more progressive and effective states when it comes to sex education.
     According to the New Jersey Comprehensive Health and Physical Education Core Curriculum Content Standards (NJCCCS), schools should not limit sex education to abstinence-only lessons. In fact, their website explicitly states, “The NJCCCS require instruction regarding multiple methods of contraception; therefore, a school that chooses an abstinence-only curriculum as its only instructional program is not in compliance with the standards that specifically require students to understand abstinence, as well as contraception and disease prevention.”
     This February all federal funding was cut to abstinence-only programs after a study by prominent sexual health researcher Douglas Kirby concluded, “There does not exist any strong evidence that any abstinence program delays the initiation of sex, hastens the return to abstinence, or reduces the number of sexual partners.”
     For years, the Millville School District has been teaching abstinence-only despite NJCCC standards. Dave LaGamba, Millville’s health supervisor, said the District has recognized the ineffectiveness of abstinence-only education and is working towards teaching contraception, starting in the fall.
     “We are looking to go more into an evidence-based program to focus on abstinence, but broaden the horizon to be more about contraception and the different types of contraception,” LaGamba said. “But once again, with a primary base still focused on abstinence being the best way to reduce pregnancies.” An evidence-based program means pregnancy prevention, contraception, STD’s, healthy relationships—with parents, peers, and partners—are discussed.
     Mary Anna Ledden is the director of Millville’s school-based youth service program, LINK, which is managed by Inspira Health Network. She and her team are helping Millville to develop a new sex education. While an evidence-based program should have already been adopted in Millville to be in accordance with the New Jersey standards, Ledden said not speaking about the taboo topic became customary: “It was the norm within this community, and even though you see the norm isn’t working, sometimes that is more comfortable.”
     Ledden is hoping to gain approval from Millville to go one step further than just teaching about contraception, by making birth control and condoms available in school.
     LaGamba said he and the school district have held meetings with parents, clergymen, and staff to involve the community in plans for updating Millville’s sex education curriculum. He said, “The consensus that I gathered was, ‘You know, it seems a little edgy, however, we understand the need.’ I think they were comfortable knowing that it was not going to just be, ‘Hey, let’s just go talk about sex.’ It’s going to be done respectfully, [but] you still want to tell the kids that abstinence is the surefire way to make sure that you are not going to get someone pregnant or you are not going to get pregnant.”  

The Birds and the Bees

     The Vineland and Bridgeton school systems have been teaching about the advantages and disadvantages of contraception. Vineland’s Board of Education website says sex-ed is taught beginning in the 5th grade by encouraging abstinence and by 8th-grade contraception is brought into the conversation. In Bridgeton, sex-ed and birth control are taught in the middle school, and by 9th-grade students are receiving contraception demonstrations in class.
     Community leaders and experts all agree that it is vital to have an open conversation with adolescents about safe sex. “I think it’s a missed opportunity in our publicly funded schools if we are not providing students with the education,” said Dr. Salomon-Fernandez, Cumberland County College president.
     Many feel sex-ed is simply not enough. Dr. Riley has urged for contraception to be available at all public schools in the county.
     Critics argue it is not the responsibility of the schools to provide access to contraception. Young people can go to Title 10 funded family planning clinics and receive birth control without parental consent and on a sliding fee scale. However, while the services are available, they are not always easily accessible. Michelle LaRue, director of education at the Title 10 funded family planning clinic, FamCare, said, “Transportation is a huge issue.” Many sexually active young people cannot drive to clinics for contraception. “They have a hard time getting to us and there’s not public transportation. Our locations are not necessarily at hubs of population.” FamCare has two locations in the county: 80 South Main Road in Vineland and 30 Magnolia Avenue in Bridgeton.  
     Dr. Riley points out, the cost to society of a teen having a child is greater than providing contraception. He argues providing contraception goes beyond personal belief and is rather a matter of financial responsibility.

Bridgeton Baby Boom

     Bridgeton High School has consistently had the most teen pregnancies in the county. Bridgeton’s state-funded Adolescent Pregnancy Prevention Initiative (APPI), which is managed by Complete Care, started providing birth control and Depo-Provera shots (a shot that prevents pregnancies for three months) in Bridgeton High School six years ago, and noticed the benefits almost immediately.
     When the program started, in the 2010-2011 school year, there were 34 documented pregnancies. In the subsequent years, the number of pregnancies continually dropped. By the 2014-2015 school year there were only 14 reported pregnancies. This decrease in pregnancies, from 34 to 14 births, possibly saved taxpayers $504,600 over the next 15 years, based on the aforementioned National Campaign to Prevent Teen Pregnancy’s data. The results indicated that providing methods of contraception, and educating students about their advantages and disadvantages, might have worked.
     However, in this past school year, 2015-2016, something changed; Bridgeton reported 31 known pregnancies— almost the same number in Bridgeton before contraception was offered. “It was very frustrating to all of us,” APPI’s director Megan Vengenock said. “We don’t know if it was just an off year [or what].”
     In fact, eight of the 31 pregnant students had transferred into the school district this year from Mexico and Guatemala already pregnant.

The Bigger Picture

     The spike in pregnancies seen in Bridgeton confirms Friddell’s belief that the challenge is not simply whether to teach abstinence-only versus evidence-based sex education. She said the issue runs much deeper than that. Dr. Kelly agreed with Friddell. “You cannot only throw out facts about STDs, and anatomy, and sex,” she said. “You have to give teens a sense of self-worth, you have to give them goals, you have to give them something other than seeking attention from a sex partner… and these lessons need to start early, before the onset of sexual activity.”
     Friddell has recently applied for a federal grant to develop a comprehensive sex-education program to address the larger issues of teen pregnancy. If the grant application is successful, the program will start in the 5th grade at Vineland’s Veterans’ Memorial Intermediate School, Millville’s Lakeside Middle School, and Bridgeton’s Broad Street Elementary School. The grant is provided by the Administration on Children, Youth, and Families— Family and Youth Services Bureau. If Cumberland County becomes one of the 13 counties in the nation awarded the grant, Friddell’s program will teach those children— who are most at risk— about five adulthood preparation subjects: healthy relationships, adolescent development, financial literacy, parent-child communication, and educational and career success.  
     Unlike Bridgeton’s Broad Street Elementary School, school-based youth service programs are not available at Vineland’s Veterans’ Memorial Intermediate School and Millville’s Lakeside Middle School. School-based youth service programs are established to, “Help young people navigate their adolescent years, finish their education, obtain skills leading to employment or continuing education, and graduate healthy and drug-free.” Friddell’s program would bring youth service programs to the two middle schools in the county that do not have one, to do exactly what Ledden, Dr. Kelly, Dr. Salomon-Fernandez, and other community leaders have been urging—start educating earlier. The grant would allow Friddell to go one step further and provide an after-school program to 90 students most at-risk of becoming pregnant. Hispanic, Latino, American Indian, and socioeconomically disadvantaged youth of any race or ethnicity are most at risk of becoming a teen parent. Friddell’s grant would potentially address adolescent pregnancy in what she said is the most effective way— by being consistent, on-going, and comprehensive.
     As Cumberland County College’s new president, Dr. Salomon-Fernandez is thinking about teen pregnancy more than ever, and not just because she has to keep track of her inventory of Pediasure and other baby supplies.
     Dr. Salomon-Fernandez said, “I think what we need to remember is that if a young woman has a child, life does not stop.” Dr. Salomon-Fernandez added, “It is in our best interest as a community to make sure that those who choose to move forward are supported fully.”  ?
By reporting on teen pregnancy, The Grapevine and SNJ Today aim to raise community awareness and work toward educating and supporting our youth. By being conscious of the issue, understanding what is in place and who is helping to make changes, and contributing ideas and actions, we all can come together with a goal to improve the health of the community.