Living life with hope: Strategies for reducing teen birth rates
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* Carmen Nevarez

The birth control pill turned 50 this year. I remember when I accidentally found my mother’s birth control pills in the ’60s. She told me they were for a female problem, and the significance of that confession just sailed right over my youthful head. Her explanation to her Catholic daughter — in the age of the church’s “Humanae Vitae,” which condemned artificial birth control — sufficed for then. I still marvel at the importance of this scientific breakthrough that empowered women to decide whether and when to bring a child into this world, privately and with greater safety.

In this country, in spite of relatively easy access to oral contraceptives, patches, intrauterine con-traception and condoms, unplanned pregnancies still occur with great regularity. Of greatest concern to me is the abysmally high U.S. teen birth rate.

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/40/6/3.1/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/40/6/3.1/F1)

A recent report issued by the Guttmacher Institute highlighted the downward trend in teen births in my home state of California, attributing a 52 percent decrease in 12 years to progressive bipartisan social policy that includes comprehensive sexuality education, availability of contraceptives and involvement of the private sector — which is very good news indeed. But the fact remains that many other countries, which highly value education and job stability before parenting, have achieved remarkably lower rates. Italy, France, Germany, the United Kingdom, Greece and Spain — to name a few — all have lower teen birth rates than California.

In 2001, I traveled with Advocates for Youth to visit the Netherlands, Germany and France to observe first-hand national strategies that drive the lower rates and to ask policy-makers, teachers, parents and youth what works and why. There is no question that when nations decide that a greater social good is achieved when parents are sufficiently mature and economically ready to raise a family, and thoughtfully put into place policies and practices that support this goal, the result is that youth will discuss their issues with parents, teachers and other responsible adults, will decide to wait to initiate sexual activity, and use contraception reliably, leading to lower teen birth rates.

The tactics that are being used are no mystery: They include comprehensive sexuality education that is integrated into many areas of curricula, as well as youth-designed, evidence-based messages that are aired on TV, in movie theaters and on billboards. Also key is nonjudgmental availability of contraceptives and the society-wide encouragement of discussion between youth and adults, which form integrated strategies.

Even in California, the teen birth rate is still too high. Clearly, it is not about services alone. Education alone is not enough. Youth need hope. They need to know they are valuable in and of themselves, that they are looking at a future with possibilities where they know they are important.

The lesson for me is that we still have a long way to go in America. Just think: If young people felt valued, believed there was worth in preserving their health and that staying in school would make a difference in their lives, we might find the rush to parenthood would slow down.

*   Copyright The Nation’s Health, American Public Health Association