SEABROOK SAYS: Most Gaston County folks do not know the writer, Sally Swanson. She was the leader of our very effective five-year teen pregnancy reduction effort. Does reading this encourage you to help continue to reduce teen pregnancy? I hope so.
Roughly half of all pregnancies in our state – and in our country are unplanned. That doesn’t mean that the children born from these pregnancies are unwanted or unloved or doomed from the get go. But it means that these families might not be prepared – ready for the cost of diapers and child care; in a safe, stable home and relationship; with basic supportive benefits, like the ability to take time from work or school to even give birth. Teenagers approach pregnancy, birth, and parenting with added challenges: they may not have finished high school and haven’t finished college, they likely don’t have a resume or savings or a credit history, and, as they approach the task of parenting a child – which is hard for anyone – they are deeply stigmatized in their families, communities, and society. When we talk about addressing teen pregnancy, we don’t do it to cast aspersions on young people or young parents. In fact, let me be very clear: Young parents can be great parents when they have the support they need, and health departments have been key players in that support system. We talk about teen pregnancy to encourage communities to do what they can to make sure that the children in their communities – in their classrooms, on their playgrounds, as their future workers and leaders – are surrounded by families who are emotionally and financially ready to parent. We do it to protect the ability of each community’s young people to build a strong future for themselves. We do it because we know that the skills it takes for a 17 year old to avoid an unplanned pregnancy carry forward to 27 and 37. We do it because teen pregnancy is almost entirely preventable when our education systems, our health systems, and our community norms align to support young people and to support prevention.
Five years ago, across sectors of the community, Gaston County scaled up pregnancy prevention efforts by working on four major components: mobilizing the community, implementing evidence-based programs, improving health care services for adolescents, and linking young people to both health care and programmatic services. In addition, there was special focus on the most high-risk populations, most notably, older teens.
Community leaders came together to serve on a series of leadership teams, including one for youth, to take on planning and implementing the initiative. These teams spent the better part of a year surveying the community, assessing needs, and planning. In the process of surveying the community, we found that 96% of county residents thought the community should do more to prevent teen pregnancy, that 87% of parents thought it was important for teens to have a place to get birth control, and that 80% thought their own child should have information on birth control even though they hoped their child would stay abstinent.
To implement programs, we helped build the capacity of organizations and youth-serving professionals across the community to provide evidence-based programs. More than 6,500 young people have since participated in an evidence-based program, and most of these participants came from the county’s teen birth hot spots.
In 2012, Gaston County Health Department opened the Teen Wellness Center, a clinic that provides a full complement of health care services, including sexual and reproductive health care. Young people provided input to redesign a section of the main health department clinic to serve teens and young adults. The walls are bright blue and green, the magazine racks are stocked with Teen Vogue and Sports Illustrated, instead of Woman’s Day. The posters and pamphlets are designed for teens. More importantly, though, the staff is trained to provide adolescent-friendly health care. How do I know this is the more important part? Because we’ve worked with the community’s private providers, as well, to make the same changes in practice, and they’re making progress even without redesigning a space. When we look at the combined reach of the private providers and the health department, providers who have committed to adolescent-friendly sexual and reproductive health care served 36% of the county’s 15-19 year old female population in 2013.
The Gaston Youth Connected also worked to connect teens to the health care they need. “If you build it, they will come,” does not work – even if you have a gorgeous space just for teens. They have to know where to go, they have to know about their right to get care, and they have to feel welcome. Youth-serving professionals and school personnel were trained on how to make a good referral for teens. We introduced a social marketing campaign to try to reach older teens who are less attached to systems like the school system and who are too old for most youth programs. And, program partners incorporated a lesson on how to seek health care.
So, all of these activities are great, but what about the results? Since the project started, teen pregnancies in Gaston County have dropped 43% – that’s compared to around 37% statewide. At the start of the project, Gaston County’s teen pregnancy rate was 17% higher than the state rate; now it’s only 6% higher. And, there is more, the racial gap between white and black rates closed, indicating significant strides in addressing a long standing disparity.
My hope for the community is that everyone can continue to educate, provide needed services and work in concert to prevent unplanned, too early pregnancies. Onward!
Sally Swanson, Chief Program Officer