States such as Idaho and Texas have public schools designed specifically for pregnant and parenting teens, which provide in-school daycare. Deborah Hedden-Nicely, head teacher at the Marian Pritchett High School in Boise, Idaho, says schools designed specifically for teen parents make a difference by pushing them to finish high school and go to college.
"Our mascot is a mortar board and a diploma," Hedden-Nicely said. "We have speakers who come in and tell them, 'yes, life is going to throw down roadblocks. You've got to get around them.'"
Advocates say that fighting teen pregnancy ultimately requires a lot more than sex education classes.
"It really circles back to education and job opportunities, it circles back to health care, to generational poverty," said Jamie Bardwell of the Mississippi Women's Fund. "These are all interconnected issues with lots of different players. Good people are working on it, but we have to realize for the teen birthrate going down, we need more than people talking about it. We need legislative action. We need more funding for this issue."
Research by Levine and Kearney underscores this message. When poor young women are pessimistic about their chances of reaching the next economic class, researchers say they tend to care less about whether they'll get pregnant.
The Delta Health Partners know they must fight this ambivalence and instill in the girls hope that they can accomplish their goals. To do this, they visit the girls both in 17 Delta high schools and at their homes.
A recent visit to Hollins' school, Madison S. Palmer High School in Marks, was the last day the case workers would see some of the girls in school before graduation.
Jodi Bailey, a nurse and case manager, read off some statistics to the students. Half of high school students who get pregnant don't graduate. Three in 10 girls in the U.S. will get pregnant before age 20.
"We want to keep you in high school, we want you to graduate and say 'I did it,'" Bailey said. "If you're having problems, we're here. We'll help you any way we can, OK?"
For its part, the Marks school district plans to adopt a curriculum to include more comprehensive sex-education, which will still emphasize the benefits of abstinence.
Some in the small town about 70 miles south of Memphis, Tenn., still think teen pregnancy should be addressed in the home, not the classroom. Harold Smith, a local evangelical pastor, said sex outside marriage is a sin and parents — not educators — should teach children to avoid it.
"You've got to spread the gospel," Smith said. "If they get a hold of God just right, they won't have (children)."
But limiting discussion to the home didn't work for Hollins: "I wish my mom would have talked to me more about sex."
That's why Delta Health Partners is seeking to change the pattern.
"You've got to do something different," said social worker Debra McGee. "You cannot keep doing the same thing and expect a different result."
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