Preaching Abstinence Not Enough Researchers Say Only Programs That Include Both Abstinence Education And Birth Control Information Work

As legislatures around the country debate strategies for reducing teenage pregnancy, researchers say there is little evidence that simply promoting abstinence will work.

The new welfare law identifies out-of-wedlock pregnancy, especially among teenagers, as a national crisis. As part of the law, Congress gave states $50 million a year to spend on educational programs that call for abstinence until marriage.

But only programs that include both abstinence education and information about birth control have been shown to work reliably, researchers said at the American Public Welfare Association convention recently.

An Atlanta program, “Postponing Sexual Involvement,” is regarded by many as the most successful effort in the country in reducing teenage pregnancy. Children in the Atlanta middle schools attend five classroom sessions in sexuality and birth control and five sessions conducted by high school students on strategies to use to postpone sexual involvement.

Births were reduced by about one-third by the end of 12th grade, according to Marion Howard, a professor at Emory University, although she said the study was “small and can’t be generalized.” But other cities that have left out the family planning information have not had similar success, she said.

Howard said she did not rule out the possibility that an abstinence-only program eventually might be successful, but so far none that used only the abstinence part of the Atlanta model has succeeded.

A half-dozen of the nation’s leading scholars in the field of teenage pregnancy told a convention of state welfare directors in Washington that the social science landscape is littered with reports of failed efforts to persuade teenagers to avoid pregnancy.

“There are hundreds of programs that have not been effective at all,” said Rebecca Maynard, a professor at the University of Pennsylvania. New Chance, a comprehensive program that cost between $4,400 and $17,000 per person, had significant results at only two of its 16 sites, Maynard reported.

She said two strands of evidence appear in programs with better results: Teenagers get a clear message about values-that having children is “irrational behavior”; and young girls see that their failure to comply with rules has “clear consequences.”

“These kids grow up in homes with no consistency,” Maynard said. “Teens appreciate clarity. They may not like the consequences, but they come to understand them.”

Successful programs need to be more paternalistic than in the past, she said. “The ones that were pretty bossy were the most effective.”

She dismissed voluntary programs as an answer. “Less than 1 in 10 teen mothers come into voluntary programs,” she said.

Kristin A. Moore, president of Child Trends Inc., said many commonly held beliefs about teenage childbearing are myths. These include:

Teenagers who become pregnant want to have babies. She said that only 14 percent of teenagers who get pregnant intend to.

Virtually all teenagers are sexually active. By their 15th birthday, 18 percent of girls and 27 percent of boys have had sex; by 17, the figures rise to 52 percent of girls and 58 percent of boys, she said.

Most births to unmarried mothers are to teenagers. The figure is 31 percent, according to Moore.

Teenage childbearing rates are similar in the United States to those in other comparable “Westernized” democracies. Moore said the birth rate among U.S. teenagers is two to eight times higher than that in other comparable nations.

Moore told the welfare group that the “antecedents” of teenage pregnancy are clear: poverty, early school failure, early behavior problems and family problems.