Seventeen-year-old Gaby Rodriguez recently made national news when she revealed to her entire Toppenish High School that the baby bump she had been slowly developing over the last six months was actually a modified basketball with cloth and netting inside. Rodriguez, an enterprising Latina senior, told everyone she'd set out to do a social experiment. She lives in a town that is 75 percent Latino, making teen pregnancy an important issue for her community--half of Latinas nationally will become pregnant as teenagers (the same is true for black teens).
But Rodriguez's project wasn't focused on trying to prevent teen pregnancy. Her presentation, entitled "Stereotypes, Rumors and Statistics," was instead about highlighting the stigma she experienced as a high-achieving student who was thought to be pregnant. She told her classmates about how perceptions of her suddenly changed, generating comments like this one: "Her attitude is changing, and it might be because of the baby or she was always this annoying and I never realized it."
Rodriguez isn't alone in experiencing this stigma. Shows like MTV's "16 and Pregnant" and "Teen Mom" may make some think that teen pregnancy is becoming glamorized, but girls who actually live through the experience speak of much less supportive circumstances. Adriann Barboa, Executive Director of Young Women United, who gave birth to her first child at 18, had this to say on the National Day to Prevent Teen Pregnancy, which fell on Wednesday of this week.
"I had heard dire predictions about teen pregnancy at school assemblies, seen billboards, and watched after-school specials that warned me of its perils. Girls who look like me were routinely warned against what would happen to us and to our kids if we became parents too soon. From low birth-weight babies to high drop-out rates, our kids were likely to be on the losing end of every childhood measure."
Barboa is describing an ironic source of the stigma young moms face: the web of campaigns that have been created to prevent teen pregnancy. Teen pregnancy prevention initiatives are often based on the premise that teen parenting is an indisputably bad thing and should be avoided at all costs. And as a consequence, teen moms are constantly presented as failures and victims. "I love my life. I'm not gonna mess it up with a pregnancy," says a teenager at the end of a video on the National Campaign to Prevent Teen and Unwanted Pregnancy's website, Stayteen.org.
Prevention advocates point to the fact that teen parents have higher incidence of the range of problems public health works so hard to end. In a document targeting parents of teens, the National Campaign explains:
"Compared to women who delay childbearing, teen mothers are less likely to complete high school and more likely to end up on welfare. The children of teen mothers are at significantly increased risk of low birth-weight and prematurity, mental retardation, poverty, growing up without a father, welfare dependency, poor school performance, insufficient health care, inadequate parenting, and abuse and neglect."
It's a compelling formula--simply stop teen girls from having kids, and these disparities disappear. But the question that remains is what's really behind these negative outcomes? Is young pregnancy and parenting the cause, or it a correlation with other risk factors, like socio-economic status and race, that recur at all ages? That's what Verónica Bayetti Flores of the National Latina Institute for Reproductive Health (with which I have worked) believes.
"That data can be picked apart pretty easily," she says. "If you look at those negative outcomes in terms of socioeconomic indicators, I think you'd see similar trends. It's trying to place the blame on something that is more a symptom than a cause."
Advocates like Bayetti Flores think that focusing narrowly on preventing pregnancy doesn't address the root cause of these disparities, many of which exist among communities of similar socioeconomic status regardless of age of parenting. Instead, she argues, it turns a societal issue into an individual problem, where the blame for negative outcomes gets transferred onto the individual girls themselves--most frequently girls of color. Despite the fact that there are more white teen parents than teen parents of color overall, Latinas and African Americans are often the target of prevention programs because of the higher incidence of teen pregnancy and parenting within the communities.
A controversial ad series that the National Campaign ran in 2001 is an apt example. The group published print advertisements with photos of young people with one word across their chests. The most shocking of the series were the two with young women of color, one with the word "DIRTY" and the other with the word "CHEAP." The words were part of sentences that ran along the spine of the ad in smaller words, which upon closer inspection focused on changing dirty diapers and the cost of condoms, respectively. But the main message was clear: being teen parents meant something about who these girls were, something decidedly negative. The National Campaign has moderated its tactics significantly in recent years, but these types of messages still underlie many of the country's major prevention efforts.
Stigma is not an uncommon tool in public health prevention programs--think of how we've worked to reduce smoking--and it can often be very successful. But the stigma-based pregnancy prevention efforts also exists alongside the fact that, according to the CDC, one in every 10 new mothers is a teen. One can only imagine what a young mom who ran across the ads mentioned above in an issue of Seventeen magazine might have felt. "There is always a tension between what it means to prevent pregnancy and then providing support to teen [parents] who are vulnerable," explains Heather Boonstra of the Guttmacher Institute.
Teen pregnancy prevention initiatives seem to be a favorite of the Obama administration, which is currently funding them to the tune of about $150 million. Much of this funding was diverted from former President Bush's own favorite sex-ed program: abstinence-only until marriage. This shift may be in response to 2006 data, which showed a 3 percent increase in teen pregnancy rates, the first rise after decades of decline.
"[The Obama administration] is acknowledging the reality and the failed policies of the previous administration with abstinence-only until marriage programs, which have proven to be ineffective," says Monica Rodriguez, CEO of the Sexuality and Education Information Council of the United States. "These [new] programs have sound scientific evidence of their effectiveness in reducing the risk behaviors that result in unintended pregnancy."
But not everyone is happy with this new emphasis, and like Gaby Rodriguez, they want to highlight the stigma that comes along with it.
"The current discourse surrounding young motherhood is both stigmatizing and insensitive, and presents young motherhood as a problem in itself as opposed to the real problems that often surround it," National Latina Institute for Reproductive Health argues in a new campaign. Instead of focusing on stigma as a way to discourage teen parenting, the Institute pushes for more attention to challenges that too many moms face--things like poverty, lack of access to health care and closed off educational opportunities, all of which the group says are to blame for the negative outcomes associated with teen parenting.
The Strong Families Initiative, a project of Asian Communities for Reproductive Justice, (another group with which I work) has a similar desire to draw attention away from stigma. The initiative is spearheading Mama's Day, an effort to provide love and support to the mothers who often get demonized in today's political climate, including teen moms. This week they'll be encouraging people to share this message: Babies need love, Moms do too. Tell a young mom, I stand with you.
Even advocates who are in favor of the new emphasis on teen pregnancy prevention agree that stigma is a concern. "We frame [teen pregnancy] as something that is problematic or undesirable," says Rodriguez of SIECUS. "A lot of teen pregnancy prevention programs use stigma and shame. It might not be their intended message, but that might be what comes across."
Bill Albert, chief program officer at the National Campaign to Prevent Teen and Unwanted Pregnancy, acknowledges that teen pregnancy prevention programs are not well tailored toward teens who are already pregnant or parenting. But he says that's not their point. "We are focused on primary prevention, helping teens avoid pregnancy in the first place," he explains. "Most teen pregnancy prevention programs have not really been successful in helping young women avoid subsequent pregnancies."
The reality is that most of these programs don't know what to do with teens who are already parents, and usually choose to exclude them completely. Meanwhile, the programs created specifically for supporting teen parents, like Detroit's Catherine Ferguson Academy, are facing extinction. A similar school in New York City was shut down two years ago.
Benita Miller ends up working with many of the young moms who have nowhere to go for support. She founded the Brooklyn Young Mother's Collective after trying to connect teen mothers to existing programming geared toward helping girls succeed. She was constantly turned away because the programs weren't designed for parents and didn't provide things like childcare. Miller talked about the challenge of fundraising for her program: "When you look at girls funding in general, teen mothers are the boogeyman. [Girls programs] always want to make connections between lack of self-esteem and young mothers. Their argument is that if these young women are successful, they won't become teen mothers."
Delsie Ann Bailey, a college student in North Carolina, has experienced firsthand these attitudes toward young mothers. At 17 and as a junior in high school she gave birth to her daughter and has since become active in statewide teen pregnancy prevention efforts. While at a training in Washington, D.C., the young people present were asked to move to opposite sides of the room depending on whether they agreed or disagreed with the statement "Teen parents can be good parents." Delsie was shocked by the responses.
"One young woman really supported her idea that teen parents couldn't be a good parent, even though I was sitting right there," she explains. When I asked Bailey where she thought these attitudes toward young parents came from, she said, "I would assume just by looking at the teen population, [they think] teenagers aren't the wisest sometimes and don't make the wisest decisions. A lot of people carry that over because it's the word 'teen' before the word 'parent.' "
Bailey stresses that her experience as a young mother hasn't been easy, and so she understands all too well why prevention campaigns focus on stopping teens from getting pregnant in the first place. "Being a teen parent and dealing with everything that it entails, missing out on things that my friends do because I have a little girl at home, I had to grow up a lot quicker than I really wanted to," she explains.
Like many, Bailey's trying to strike a balance between efforts to delay parenting for teens while also providing support to young people who do parent.
The Obama administration has also shown signs of trying to strike this balance. New funding last year, the Pregnancy Assistance Fund, directed $24 million toward programs that support teen parents. It was a compromise between the interests of pro-life Pennsylvania Sen. Robert Casey and adolescent health advocates. Of course, if the political circus around the current budget debate is any indication, all of the money for these programs may be on the chopping block for 2012. The original House GOP budget proposed eliminating teen pregnancy prevention funds entirely.
A response to teen pregnancy that focuses narrowly on shaming and scaring young women ignores the fact that poverty, lack of access to health care (including contraception and abortion) and other socioeconomic factors may have a bigger influence on whether they are successful parents than the age of their first birth. Looking at what keeps a young mom from having a second child as a teen might be a better indicator of what teen pregnancy prevention could look like, without the focus on stigma.
"When we do connect [teen moms] with opportunities, we don't have a repeat pregnancy rate the way that attitudinal programs do," Miller explains. "We have less than 2 percent repeat births, because when we give them the opportunity these young women thrive."