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Teach your children well: Teen pregnancies rise as debate continues about sex education, Part One

This article first appeared in the St. Louis Beacon: September 16, 2008 - Along with flashing cameras and the intense eye of the public, here are a few more things Bristol Palin will have to deal with in the months ahead -- queasiness in the morning, afternoon and evening, exhaustion, strange cravings and a growing belly.

As the media have widely reported, the daughter of Sarah Palin, No. 2 on the Republican presidential ticket, is 17 years old, a high school senior and pregnant. Palin’s daughter is in the unfortunate spot of not only becoming a teen mom, but doing so in the midst of a political campaign.

But her pregnancy brings sex education back in to the headlines -- a place it hasn’t been for a while as teen pregnancy numbers have dropped nationwide.

Until recently.

Bristol Palin’s school reportedly promotes an abstinence-based program. Palin and Sen. John McCain support abstinence-only sex education. Sen. Barack Obama supports comprehensive sex education.

In St. Louis and St. Louis County, programs vary from district to district, but pregnancy numbers rose here in 2006 and 2007 as well. Some educators warn that ordinary teens may see high-profile teen pregnancies, like Bristol Palin or Jamie Lynn Spears, as more glamorous than cautionary.

Still, Alexa Boulton thinks most teens get the seriousness of parenthood, but sex is everywhere, says the 16-year-old Clayton High School junior. And she thinks students need the knowledge to protect themselves.

“It wasn’t like, ‘Oh my God, sex,’” Alexa says. “You listen to any rap song and you get it.”

RISE OF THE NUMBERS

From 1991 to 2005, the national adolescent birth rate dropped from 61.8 births per 1,000 to a rate of 40.5 live births per 1,000 young women aged 15 to 19, according to the Centers for Disease Control's National Center for Health Statistics. In 2006, that number rose 3 percent.

Researchers aren't sure if the numbers are a single-year blip or the beginning of a trend, and if so, what's causing that trend. "I wish I could tell you because if we could tell you, then we'd basically have the answer to preventing teen pregnancy," says Jessica Sheets, manager of communications programs with the National Campaign to Prevent Teen Pregnancy in Washington, D.C.

In St. Louis County, pregnancy numbers went down and back up again, as well, from 837 for girls under 18 in 1990, to 439 in 2005, to 513 in 2006, according to the Missouri Department of Health and Senior Services. In the city, there were 1,156 pregnancies in 1990 for girls under 18, 394 in 2005, and 448 in 2006.

Recent final data from the Missouri DHSS looked at teen pregnancies in 2007. For girls under 18, there were 403 pregnancies in the city. In St. Louis County, there were 514, says Doug Schramm, project specialist with the Bureau of Health Informatics. Even in the low years, it averages out to at least one young woman getting pregnant every day.

The numbers for 2006 could be cyclical fertility rates, Sheets says, but with a drop in teen pregnancies, the issue isn't talked about as much as it used to be. "It's no longer considered an emergency," she says.

One number that hasn't changed much is the number of teens having sex. Healthy Youth, a CDC program, surveys teens every year on risky behaviors. In Missouri, 51.5 percent of high school students questioned reported having sex in 1997. In 2007, that number was 52.1 percent.

While many parents find it horrifying to think about their teenagers are having sex, Sheets says knowledge is essential. "You would never just put your kid behind the wheel of a car and tell them to just go."

And many school districts in St. Louis seem to offer courses both to keep kids away from the car entirely while still making sure they know how to drive safely once behind the wheel.

TO TEACH OR NOT TO TEACH

Advocates for abstinence-only programs make the point that abstinence is the only sure way to prevent pregnancies, STDs (sexually transmitted diseases) and HIV infection. Missouri has a federal abstinence education program, which was first established by Congress in 1996.

But abstinence programs themselves don't prove as effective, according to a several studies. In 2007, the Campaign to Prevent Teen Pregnancy released results on an evaluation of 115 sex education programs nationwide. Two-thirds of the reported programs used a two-tier approach, teaching both abstinence and contraception. Those programs were shown to have a positive effect, delaying sex, improving the use of contraception, or both, the report says.

The report also found no strong evidence that abstinence-only programs delayed sex, and none of the programs using abstinence and contraception sped up the rate of sexual activity.

According to state law, when Missouri schools teach sex education, they must stress abstinence as the preferred behavior and "present students with the latest medically factual information regarding both the possible side effects and health benefits of all forms of contraception, including the success and failure rates for the prevention of pregnancy and sexually transmitted diseases," according to chapter 170 of Missouri Revised Statues.

School districts in St. Louis and Clayton both follow that approach, offering what's referred to as comprehensive sexuality education.

"We also teach that the safest and best choice is abstinence," says Doris Smith, a health teacher at Clayton High School. The unit is part of a health class curriculum for high school students, but Smith says the education starts in the 5th and 6th grade with puberty, and picks up again in 8th grade.

<“Like, this is a penis and this is a vagina,” Boulton says. “By that point, everybody knows about sex. It’s not like it’s a big secret.”

And rarely do students opt out of the high school sections, though that is an option at both Clayton and in St. Louis schools.

According to Doug Bray, communications specialist with the Ritenour School District, sex education is a part of the health classes at Ritenour and the class is required for graduation.

Barb Anderson teaches family and consumer science at Oakville High School in South County. "We do stress abstinence," she says, but like the other schools, contraception is part of the curriculum.

Condoms aren't available in any of the schools, contrary to some myths about comprehensive sex ed.

Smith believes the program is working. She says pregnancies in the school are rare and the school doesn't track the numbers.

But the program is not explicit, Alexa says. “They slip it in between ‘Don’t do crack and don’t smoke.’”

Anderson sees the most light bulbs over students' heads during sections on HIV and STDs, which all three programs include. But she also sees students who've sat through many of her classes walk in the door five months pregnant and not knowing how it happened.

They know, she says, but never thought it would happen to them.

Kristen Hare is a freelance writer in Lake St. Louis.

Kristen Hare