By Bernadine Healy, M.D.
There is nothing worse for any physician than to find a dangerous medical problem in a patient and feel powerless to help. That's how the whole country seems to feel as it hears about gloomy statistics on teen pregnancy released this month from the Centers for Disease Control and Prevention. The findings show a 3 percent jump in teens having babies, following 14 years of decline. Many adults seem to have given up even trying to influence teen sexual behavior, and the statistics on teen sex have incited plenty of finger-pointing at sex-education programs as if they are the central solution to this very complex problem. This is the wrong reaction to what is a major public health issue.
Viewing this as a nonpartisan, nonideological, teen health issue—which also affects some 435,000 babies born into woefully disadvantaged circumstances—what emerges in all fairness is that the 3 percent jump between 2005 and 2006 (the most recent analyzed) in births among teens between 15 and 19 years of age equals the 3 percent increase in birthrates for all women. The year 2006 was an especially fertile one in America. And one good trend is that births among girls under 15 actually fell a bit. But, parents, heed this: The birthrate among all unmarried women rose an astounding 7 percent to almost 40 percent of all births—accounting for 1,641,946 little ones. Thus, out-of-wedlock births are a trend in society at large. In fact, the birthrate for all unmarried women has risen almost without interruption for 60 years. In the 1940s, when the first baby boomers were being born, it was closer to 4 percent.
However, unmarried teenagers having babies are most apt to disadvantage both themselves and their babies for life. But still, let's give the bulk of young people some credit. Half of teens get through high school never having had sex, and many others have been largely abstinent. Teen girls in particular are aware of what is happening to their peers when they get pregnant in high school: An unwanted pregnancy puts girls in a mess emotionally, academically, healthwise, and financially.
The Kaiser Family Foundation, an independent health policy group dedicated to providing information and analysis on healthcare issues, has partnered with Seventeen magazine to conduct national random telephone surveys of teens about sex. One survey studied teens ages 15 to 17 who practiced abstinence from sexual intercourse—more than half of all teens. Virtually all of them thought that staying a virgin in high school was a good idea, and said they hoped to wait until they were more mature and had a committed relationship before becoming so involved.
But many factors, not just one, weighed heavily on their decision. They included, in rank order from No. 2 down, concern about acquiring a sexually transmitted disease, their parents' views, sex education, religion, moral values, personal reputational concerns, and having friends who had not had sex. What was No. 1 on the list? Fear of an unwanted pregnancy.
So teens may be smarter than we think. Maybe some of the hand-wringing over sex education needs to be informed by the voices of these young people, particularly the teenage girls who have figured out that the burden of unwed motherhood is not for them or their future children.
As in most things unhealthy, from taking up smoking, using drugs, or having racked up a slew of sexual partners before finishing high school, teenage motivation and behavior ultimately come from within. And young people are clearly more health oriented and sensible than adults often give them credit for.