America’s physicians must advocate for comprehensive, evidence-based approaches to pregnancy prevention. This is the best way to ensure that adolescents can achieve their dreams of parenthood — when they are ready.
BY the 12th grade, more than half of young women report having had sex. As doctors who routinely care for adolescents, we witness, every day, how teen pregnancy can disrupt a young person’s education and career trajectory. Our patients benefit tremendously from contraceptive care and counseling. Experience teaches us that comprehensive, evidence-based education is critical to preventing both unintended pregnancies and sexually transmitted infections in adolescents.
That’s why we were extremely disappointed to see the abrupt termination of two successful programs that support contraception access and education.
The Office of Adolescent Health’s Teen Pregnancy Prevention Program (TPPP) supports evidence-based reproductive education by partnering with more than 3,000 community organizations. It has trained more than 7,000 health professionals to reach more than 1 million at-risk youth. The scientific evidence shows that teens who receive this kind of comprehensive reproductive health education delay sexual activity and have decreased sexual risk-taking behavior. If they do choose to have sex, they have fewer sexual partners and are more likely to use contraception and barrier methods to decrease unintended pregnancy and sexually transmitted infections.
On July 1, the U.S. Department of Health and Human Services notified 81 organizations across the country that their grants would end two years prematurely. As many as 600,000 young people are anticipated to participate in these programs for the remainder of the grant period. If organizations are unable to sustain programming, thousands will lose access, resulting in fewer jobs, fewer trained professionals, and reduced partnerships in communities across the country.
Another program facing funding cuts is the Title X Family Planning Program, which would lose its funding in the Fiscal Year 2018 spending bill approved by the House Appropriations Committee on July 12. Health-care centers funded through Title X offer free or low-cost contraceptive care primarily to young and low-income individuals — those most at risk for unintended pregnancies. Without this funding, many will no longer be able to continue, and there are no organizations standing in the wings to fill this gap.
Both decisions have been denounced by the American Congress of Obstetricians and Gynecologists as well as the American Academy of Pediatrics.
If the intent is cost-savings, the calculations are shortsighted. The $500 million savings found by ending funding to these programs is overwhelmed when we compare it to the $9.4 billion U.S. taxpayers spent in 2010 on the costs of teen pregnancy. A cost that’s likely to rise without these vital programs.
The costs of teen pregnancy go beyond this generation. Only half of teen mothers graduate from high school, and their children are more likely to drop out of high school, be in foster care, be incarcerated as adolescents and be unemployed as adults. If we learn from Texas’ cuts to Title X funded clinics like Planned Parenthood, we can expect a sizable increase in teen pregnancies, abortions and maternal mortality in all states. The Title X and TPPP programs are some of the most cost-effective investments that our federal government can make to improve the health and economic security of adolescents, women and families.
The rate of teen pregnancy in King County dropped by 55 percent between 2008 and 2016 through a combination of multiple factors: an increase in reproductive health education, like King County’s FLASH (Family Life and Sexual Health) curriculum, resulting in lower levels of sexual activity in adolescents; increased access to health care; and, most notably, increased use of contraception, especially the most effective long-acting reversible contraceptive methods.
Today’s teen birthrates in the United States are at a historic low. However, the adolescent pregnancy rate in the United States is the highest among developed countries, with a rate in 2010 of 57 per 1,000 girls aged 15-19 years. There are higher rates of birth among black and Hispanic, than non-Hispanic white, adolescents, most likely due to unequal access to adequate reproductive-health education and care. Cutting the TPP and Title X programs will exacerbate this societal inequality.
As political leaders in Washington, D.C., make crucial decisions that will impact future generations, America’s physicians must advocate for comprehensive, evidence-based approaches to pregnancy prevention. This is the best way to ensure that adolescents can achieve their dreams of parenthood — when they are ready.