SHEILA HURST: Empowering school clinics can lower teen-pregnancy rates

GRAND FORKS — Teen pregnancy is an issue of ongoing concern. Some 31 out of every 1,000 Americans ages 15-19 gave birth in 2011, the Centers for Disease Control reports.

The good news is that this rate is beginning to decline; it’s down about 10 percent from 2010.

But the bad news is that the rate remains alarmingly high as well as significantly higher than the rates in other developed nations. America’s teen-pregnancy rates are twice as high as those in Australia and Canada, three times as high as the rate in France and seven times higher than in Japan.

Our high rate has consequences, including heavy social and economic costs. For example, teen pregnancies likely cost U.S. taxpayers about $11 billion a year in public assistance, child health care, foster care and criminal-justice costs. Other consequences include:

• A higher infant mortality rate.

• Lower high-school graduation rates, as only 50 percent of teen mothers get a high school diploma.

• Higher rates of public assistance; some 80 percent of teen mothers get government help.

• Health complications, in that babies born to teen mothers are 17 percent more likely to have low birth weights and other health problems.

• Difficult social developments, because offspring of teen mothers are at higher risk of being jailed during adolescence, being unemployed as a young adult and becoming a teen parent themselves.

• And an increased risk of other poor outcomes, given the fact that the children of teenage moms are more likely to be abused or neglected and less likely to get adequate nutrition, health care and cognitive and social stimulation.

Given these consequences, it’s vital to examine the factors behind the recent decline in teen birth rates as well as the lower rates in other countries.

For example, a 2011 analysis from the Guttmacher Institute suggests that the drop in teen birthrates is linked to improvements in teens’ contraceptive use.

And in other countries, the lower teen birthrates are attributed to:

• Mandatory, medically accurate sex-education programs that give comprehensive information and encourage teens to make responsible choices.

• Access to contraception and other forms of reproductive health care.

• Acceptance of adolescent sexual expression.

• Straightforward media campaigns.

• Government support for teens’ rights to accurate information and confidential services.

In short, countries with lower teen pregnancy rates share a common approach: support and access to confidential, accurate information about birth control and reproductive health.

In countries that use this approach, the higher costs and heavy impacts associated with teen pregnancy all are reduced.

So, how can the United States decrease its own teen pregnancy rates? The answer lies in removing barriers and improving access to contraceptive services and accurate information.

Currently, American teens may get these services confidentially if they access them through a federally funded clinic. Each state offers different services or restrictions, but if the care is provided in a federally funded facility, the federal laws supersede state laws.

An even more effective method would be to let school-based health clinics offer reproductive health services. A school-based clinic is a perfect venue for increasing access to contraception for teens while giving them the essential nursing follow-up, evaluation and education.

School nurses have better rapport and trust with students, increasing the potential for encouraging communication between the teen and his or her parents.

And this service can be provided whenever the child is in school, therefore increasing access to information, counseling and birth control.

Despite opposition to the distribution of contraception and reproductive education without a parent’s consent, federal law already protects all women of childbearing age and lets them get these services without parental consent.

So, here’s my question: Because we know that increased access will bring down the rate of teen pregnancy, wouldn’t it be better to let teens get these services at their school health clinics, rather than send them to less-familiar and less-accessible federally funded clinics, where it also will be harder for the teens to get follow-up care?

As a nurse and a parent of a young teenager, my answer is yes.

Hurst is a graduate student in nursing at UND. She has had worked in school nursing as well as labor, delivery and teaching for 16 years.

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