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Engaging teens in pregnancy prevention may be paying off

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Teen pregnancy prevention
South High School junior Jasmine Powell, right, and seniors Francis Hebres, center, and Elias Mintz, left, talk with their classmates about teen pregnancy prevention Thursday, April 26, 2012 during lunch at the Minneapolis school. The students are part of a group called Sexually Mature and Responsible Teens (SMART) who are using peer-to-peer education to spread their message.
MPR Photo/Jennifer Simonson

Amid the lunchroom hubbub at South High School in Minneapolis, a group of students wearing matching black sweatshirts strikes up a conversation about teen pregnancy with a group of eight boys. 

Jasmine Powell, a confident 11th grader, leads the discussion, asking if the teens have thought about how to prevent a pregnancy. 

"It'd be important to use birth control, right? And to know how to use your birth control?" she says, generating some nervous giggles and a few blank stares.

The group, called Sexually Mature And Responsible Teens (SMART), is one of many projects across the state that are engaging teens in pregnancy prevention efforts. Experts say those efforts are paying off, as the birth rate among Minnesota teenagers has plunged nearly 40 percent in the past two decades.

Some of the more obvious possible explanations for the trend, which is also happening nationally, don't fully explain what's happening, said Mary Jo Chippendale, who follows birth rate statistics for the Minnesota Department of Health.

In the sex education classes teens take in Minnesota schools, abstinence has been touted as the only 100 percent effective way to avoid pregnancy. But survey statistics don't give abstinence the credit.

"We haven't really seen a huge change in sexual activity," said Chippendale, the infant, adolescent and women's health supervisor at the Minnesota Department of Health.

Teen pregnancy prevention
The students in the Citizen Teen project called Sexually Mature and Responsible Teens (SMART) wear sweatshirts with their SMART logo on the front and the question "Are U...?" on the back while they talk about teen pregnancy prevention with their classmates during lunch Thursday, April 27, 2012 at South High School in Minneapolis.
MPR Photo/Jennifer Simonson

The Minnesota Department of Education's Minnesota Student Survey shows the percentage of teens who have had sex dropped about 10 percentage points from the early 1990s to 2001.

But the numbers have remained steady or even increased slightly in the last 10 years while the birth rate continued to drop. In 2010, about 20 percent of ninth graders and half of 12th graders said they had sexual intercourse.

  In addition, the abortion rate among Minnesota teens ages 15 to 19 has declined at a similar pace as the birth rate.

Chippendale said clearly something else is going on. "It's probably more likely that they've increased contraception use," she said. 

Teen advocates like Brian Russ, executive director of the Annex Teen Clinic in Robbinsdale, Minn., said better information about contraception — and smarter use of it — are probably factors. That includes access to emergency contraception, also known as the "morning after pill" or "Plan B."

But Russ said engaging teens in conversations about teen pregnancy in a way that includes also talking about their attitudes and feelings about the future can have a big impact.

"It's so multifaceted, and that absolutely young people need access to preventive health care services, contraceptives and education, but they also need a reason to delay pregnancy. They need a sense that, you know what? I'm not ready," he said.

Teen pregnancy prevention
Junior Misrak Tek, center, explains her group's SMART logo to classmates Thursday, April 26, 2012 during lunch at South High School in Minneapolis. Tek is a member of a Citizen Teen group called Sexually Mature and Responsible Teens, who use peer-to-peer education to talk about teen pregnancy prevention.
MPR Photo/Jennifer Simonson

During the lunchroom conversations at South High School, the teen pregnancy prevention group finds several tables of students who agreed it'd be better to wait to have kids.

While the group of boys Powell approached didn't react much at first to her questions, she gets their attention when she asks them what they think of national survey results showing 20 percent of teen males would be pleased or a little pleased if they got someone pregnant.

The boys are stunned anyone would have that attitude, and one even said it's wrong to feel that way. Another mentions how expensive having a child would be, and how difficult it would be to keep up with friends and schoolwork.

Elias Mintz, a 12th grader who has been part of Sexually Mature And Responsible Teens for three years, said part of his motivation for working to prevent teen pregnancy was seeing first-hand what his parents went through. He was born when they were in high school.

"They didn't know they were going to be together so they have to go through certain things to adjust for me," he said. "I was kind of learning why, by myself, why they'd act certain ways or why they still want to go out with their friends, because they're still young."

Judith Kahn, executive director of Teenwise Minnesota, said understanding the consequences of a teen pregnancy can have a real influence on teens' actions — and ultimately the teen birth rate.

"This is what we understand about youth development: that if young people have a sense of confidence and competence about themselves, if they recognize that they do matter in the world and that they have the ability to make a difference going forward, they're less likely to engage in behaviors that will defer those dreams," she said. 

The South High School group is part of a three-year project of the University of Minnesota's Citizen Professional Center. Funding won't continue next year for a staff person to coordinate the group at South, but Powell said she and others who aren't graduating are hoping to keep it alive on their own.

"I feel like a lot of teens just aren't informed. I don't think they necessarily want to be pregnant, and I definitely don't think it's wrong or bad, but it's just a lot harder," she said. "Hearing it from another teen that we're here for them and that we can inform them and they can trust another teen is super important."

Elsewhere in Minnesota, a group called Project 4 Teens recruits youth leaders from Mankato high schools to make presentations and talk to younger students about healthy choices, including preventing pregnancy.

In Hennepin County, 42 clubs at middle schools in areas that have traditionally had higher teen pregnancy rates are helping teens develop communication skills and talk about healthy relationships through a program called It's Your Future. There's also a component for sexually active high school students.

The program received a federal grant of $16 million dollars in 2010 to use over five years, and organizers hope to add more schools in Hennepin County next year.

Katherine Meerse, who directs the program, said teaching about contraception and pregnancy isn't part of the nine-month curriculum for the middle school students, who participate in weekly meetings as well as a community service project. But Meerse said research has shown the program is still very effective, leading to a 53 percent lower risk of pregnancy. She said the program has other benefits, too.

"They're also less likely to drop out of school, to get suspended from school, or to fail courses," she said. "We got funded to do it because it's been shown to reduce teen pregnancy, but it also has these great academic outcomes."