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Premarital Abstinence Pledges Ineffective, Study Finds
Teenagers Who Make Such Promises Are Just as Likely to Have Sex, and Less Likely to Use Protection, the Data Indicate
By Rob Stein
Washington Post Staff Writer
Monday, December 29, 2008; A02
 Teenagers who pledge to remain virgins until marriage are just as likely to have premarital sex as those who do not promise abstinence and are significantly less likely to use condoms and other forms of birth control when they do, according to a study released today.

The new analysis of data from a large federal survey found that more than half of youths became sexually active before marriage regardless of whether they had taken a "virginity pledge," but that the percentage who took precautions against pregnancy or sexually transmitted diseases was 10 points lower for pledgers than for non-pledgers.

"Taking a pledge doesn't seem to make any difference at all in any sexual behavior," said Janet E. Rosenbaum of the Johns Hopkins Bloomberg School of Public Health, whose report appears in the January issue of the journal Pediatrics. "But it does seem to make a difference in condom use and other forms of birth control that is quite striking."

The study is the latest in a series that have raised questions about programs that focus on encouraging abstinence until marriage, including those that specifically ask students to publicly declare their intention to remain virgins. The new analysis, however, goes beyond earlier analyses by focusing on teens who had similar values about sex and other issues before they took a virginity pledge.

"Previous studies would compare a mixture of apples and oranges," Rosenbaum said. "I tried to pull out the apples and compare only the apples to other apples."

The findings are reigniting the debate about the effectiveness of abstinence-focused sexual education just as Congress and the new Obama administration are about to reconsider the more than $176 million in annual funding for such programs.

"This study again raises the issue of why the federal government is continuing to invest in abstinence-only programs," said Sarah Brown of the National Campaign to Prevent Teen and Unplanned Pregnancy. "What have we gained if we only encourage young people to delay sex until they are older, but then when they do become sexually active -- and most do well before marriage -- they don't protect themselves or their partners?"

James Wagoner of the advocacy group Advocates for Youth agreed: "The Democratic Congress needs to get its head out of the sand and get real about sex education in America."

Proponents of such programs, however, dismissed the study as flawed and argued that programs that focus on abstinence go much further than simply asking youths to make a one-time promise to remain virgins.

"It is remarkable that an author who employs rigorous research methodology would then compromise those standards by making wild, ideologically tainted and inaccurate analysis regarding the content of abstinence education programs," said Valerie Huber of the National Abstinence Education Association.

Rosenbaum analyzed data collected by the federal government's National Longitudinal Study of Adolescent Health, which gathered detailed information from a representative sample of about 11,000 students in grades seven through 12 in 1995, 1996 and 2001.

Although researchers have analyzed data from that survey before to examine abstinence education programs, the new study is the first to use a more stringent method to account for other factors that could influence the teens' behavior, such as their attitudes about sex before they took the pledge.

Rosenbaum focused on about 3,400 students who had not had sex or taken a virginity pledge in 1995. She compared 289 students who were 17 years old on average in 1996, when they took a virginity pledge, with 645 who did not take a pledge but were otherwise similar. She based that judgment on about 100 variables, including their attitudes and their parents' attitudes about sex and their perception of their friends' attitudes about sex and birth control.

"This study came about because somebody who decides to take a virginity pledge tends to be different from the average American teenager. The pledgers tend to be more religious. They tend to be more conservative. They tend to be less positive about sex. There are some striking differences," Rosenbaum said. "So comparing pledgers to all non-pledgers doesn't make a lot of sense."

By 2001, Rosenbaum found, 82 percent of those who had taken a pledge had retracted their promises, and there was no significant difference in the proportion of students in both groups who had engaged in any type of sexual activity, including giving or receiving oral sex, vaginal intercourse, the age at which they first had sex, or their number of sexual partners. More than half of both groups had engaged in various types of sexual activity, had an average of about three sexual partners and had had sex for the first time by age 21 even if they were unmarried.

"It seems that pledgers aren't really internalizing the pledge," Rosenbaum said. "Participating in a program doesn't appear to be motivating them to change their behavior. It seems like abstinence has to come from an individual conviction rather than participating in a program."

While there was no difference in the rate of sexually transmitted diseases in the two groups, the percentage of students who reported condom use was about 10 points lower for those who had taken the pledge, and they were about 6 percentage points less likely to use any form of contraception. For example, about 24 percent of those who had taken a pledge said they always used a condom, compared with about 34 percent of those who had not.

Rosenbaum attributed the difference to what youths learn about condoms in abstinence-focused programs.

"There's been a lot of work that has found that teenagers who take part in abstinence-only education have more negative views about condoms," she said. "They tend not to give accurate information about condoms and birth control."

But Huber disputed that charge.

"Abstinence education programs provide accurate information on the level of protection offered through the typical use of condoms and contraception," she said. "Students understand that while condoms may reduce the risk of infection and/or pregnancy, they do not remove the risk."

 
 

They're Having Babies. Are We Helping?
 By Patrick Welsh
Sunday, December 14, 2008; B01
 The girls gather in small groups outside Alexandria's T.C. Williams High School most mornings, standing with their babies on their hips, talking and giggling like sorority sisters. Sometimes their mothers drop the kids (and their kids) off with a carefree smile and a wave. As I watch the girls carry their children into the Tiny Titans day-care center in our new $100 million building, I can't help wondering what Sister Mary Avelina, my 11th-grade English teacher, would have thought.

Okay, I'm an old guy from the 1950s, an era light-years from today. But even in these less censorious times, I'm amazed -- and concerned -- by the apparently nonchalant attitude both these girls and their mothers exhibit in front of teachers, administrators and hundreds of students each day. Last I heard, teen pregnancy is still a major concern in this country -- teenage mothers are less likely to finish school and more likely to live in poverty; their children are more likely to have difficulties in school and with the law; and on and on.

But none of that seems to register with these young women. In fact, "some girls seem to be really into it," says T.C. senior Mary Ball. "They are embracing their pregnancies." Nor is the sight of a pregnant classmate much of a surprise to the students at T.C. anymore. "When I was in middle school, I'd be shocked to see a pregnant eighth-grader," says Ball. "Now it seems so ordinary that we don't even talk about it."

Teenage pregnancy has been bright on American radar screens for the past year: TV teen starlet Jamie Lynn Spears's pregnancy caused a minor media storm last December. The pregnant-teen movie "Juno" won Oscar nods. And there was Bristol Palin, daughter of Alaska Gov. Sarah Palin, bringing the issue front and center during the recent presidential campaign. But I've been observing the phenomenon up close for a couple of years now, and the picture I see is more troubling than any of those high-profile pregnancies make it seem.

The somber statistics about teen motherhood are the reason the day-care center, run by the local nonprofit Campagna Center, was opened in T.C. Williams two years ago. The idea is to keep the girls in school, let them get their diplomas and help them avoid the kind of fate described earlier. I've been a teacher for more than 30 years, and I want the best for my students and to help them succeed in every way possible. I know that these girls need support. But I can't help thinking we're going at this all wrong.

On the surface, Alexandria seems to be striving to stem teen pregnancy. Every high school student is required to take a "family life" course that teaches about birth control, sexually transmitted disease and teen pregnancy. The Adolescent Health Center, a clinic providing birth control, was built a few blocks from the school. The city-run Campaign on Adolescent Pregnancy sponsors workshops for parents and teens. But none of this coalesces to hit the teens with the message that getting pregnant is a disaster. And within the school, apart from the family life class, the attitude is laissez-faire, as if teachers and administrators are afraid to address the issue for fear of offending the students who have children.

Once a girl gets pregnant, though, the school leaps in to do everything for her. But I wonder: Is it possible that all this assistance -- with little or no comment about the kids' actions -- has the unintended effect of actually encouraging them to get pregnant? Are we making it easier for girls to make a bad choice and helping them avoid the truth about the consequences?

And for many, it does seem to be a choice. "There's a myth that these pregnancies are accidental," says school nurse Nancy Runton. "But many of them aren't. I've known girls who've made 'I'll get pregnant if you get pregnant' pacts. It's a status thing. These girls go around school telling each other how beautiful they look pregnant, how cute their tummies look."

Pregnancy pacts, too, were in the news earlier this year when a group of girls in a Massachusetts high school reportedly made one (though some denied it). But that's only one way the situation at T.C. reflects what's happening across the country. The birth rate among teens, after falling 36 percent since 1990, went up 3 percent in 2006, the first increase in 15 years. And most of the rise is due to pregnancies among Hispanic girls.

Lots of white teens nationally have babies, but that's not really the case at T.C. Teen motherhood here is mostly a class issue -- and given Alexandria's demographics, that means the teen mothers are virtually all lower-income blacks and Hispanics with few financial or other resources. Moreover, the number of Hispanic girls with babies is double the number of black girls, which also reflects a national trend. According to Sarah Brown, director of the National Campaign to Prevent Teen and Unplanned Pregnancy, Hispanics now have the highest rate of teen pregnancy and births of any racial or ethnic group in the country.

In our school of 2,211 students, we now have at least 70 girls who are soon-to-be or already mothers. Many T.C. teachers and administrators have decidedly mixed emotions about the situation. Social worker Terri Wright says that for many girls, getting pregnant before they turn 18 is a rite of passage. "They don't wear sweatshirts or baggy dresses to conceal their pregnancies," says Wright. "I get invitations to baby showers. Girls bring me pictures of their kids dressed up like little dolls."

"There is zero shame," agrees school nurse Runton. One girl walked into a colleague's class last month, announced that she was pregnant and began showing her sonogram around. Another 16-year-old proudly proclaimed that she was "going on maternity leave." The teacher tried to explain that maternity leave is a job benefit that doesn't apply to high school students.

"I don't personally accept it, but once a girl is pregnant, I have to be all open arms," Wright says.

The pregnant teens' classmates don't necessarily applaud the phenomenon, either. "These girls having babies are living in a dream world," says Lauren Heming, a senior in my AP English class. "They think that because the school is giving them all this help now, things will be easy for them when they graduate."

Kayla Tall, another senior, sees lots of girls as under "great pressure to grow up fast by having sex." And, she says, "A lot of girls think that if they have the baby, they can keep hanging on to the boyfriend. In fact, these guys are little boys who have used the girls to prove themselves to each other."

I'd be less than honest if I didn't admit that I'm torn about T.C's teen moms and the Tiny Titans center. As upset as I get at the recklessness I see in some of the girls and their boyfriends, I can't begrudge someone like Cynthia Quinteros the help she needs to raise her one-year-old son. "If it wasn't for the day-care center, I would have to quit school to take care of Angel," says the 16-year-old. "My mother is a single mom, and my brother is 11. My mom has to work."

Cynthia's days are grueling. She gets up at 6 a.m., feeds and dresses Angel and is at school by 7:50. She drops Angel off at the center, eats breakfast in the cafeteria and heads for class. Her mom picks her and the baby up at 3:15 p.m. At home, Cynthia eats, plays with Angel, starts homework and then leaves at 4:50 for her supermarket cashier's job. She gets home at 10:10, does a little homework and goes to bed.

Cynthia says that lots of her friends actively tried to get pregnant, but she didn't. Like many girls she knows, she was getting a shot of the contraceptive DMPA/Depo-Provera every three months at the teen health clinic starting when she was 13. (Which evokes further conflicting emotions on my part and surely must do the same to health-care providers called upon to provide birth-control shots to 13-year-old girls.)

Cynthia would tell her mom that she had to stay after school and then go to the clinic, but when her mother insisted that she come home right away, she missed her shots and got pregnant at 15 by an 18-year-old guy. She says that all her friends who have babies wish they had waited. "They've learned the hard way," she says. "None of them want to have another baby now. Most of them are getting their Depo shots regularly."

Angel's father isn't involved with the baby, but not all the guys who father children by teenage girls are AWOL. Every morning, 19-year-old Gustavo Martinez drives 16-year-old Karla Becerra to school and carries their 3-month-old son into day care before going to work for a local contractor. He's at school by 4 every day to pick them up. "My father was never around, and I don't want to have that happen to my son," Gustavo told me. He says he's saving money so that he and Karla can have their own place and get married.

But they are very much the exception. The fact is, says Robert Wolverton, medical director of the teen health clinic, most of these girls and their families see no problem with being unmarried and having a child at 16 or 17.

According to the Virginia Department of Health, there were 204 pregnancies among Alexandria teens in 2006, resulting in 102 births and 99 abortions. Pregnancy rates among Latinas were the highest of any group.

The Tiny Titans center is at maximum capacity and has a long waiting list. It currently cares for eight babies ranging from 6 weeks to 24 months, eight toddlers from 24 months to 36 months and 18 children from 3 to 5 years of age.

Most of the mothers are in free and reduced school-lunch programs, and few have insurance. So when they get pregnant, a whole tax-supported industry kicks into action: The Health Department assigns a nurse to the girl, a group called Resource Mothers is notified to pick girls up at school or home and drive them to doctor's appointments, and the Campagna Center plans day care for the child. The school dietitian plans nutritious meals for the mothers. The federally funded WIC program provides free formula, milk, cheese, peanut butter and the like to the teens and their babies. In Virginia, girls from 13 on up are eligible for free reproductive services -- prenatal care, hospital visits and delivery.

According to a study by the National Campaign to Prevent Teen and Unplanned Pregnancy, teen childbearing nationwide cost taxpayers $9.1 billion in 2004. Teens 17 and under -- the ages of most of the girls at T.C. -- account for $8.6 billion of that total, or an average of $4,080 per teen mother annually.

School social worker David Wynne states the obvious: "Whatever we're doing, it's not working." It's hard to say whether other school districts do any better than Alexandria at discouraging teen pregnancy. According to Brown, school sex-ed programs nationwide are a patchwork that includes everything from required HIV/AIDS education to using students as peer counselors to abstinence-only programs. No one really knows what's working where. But at T.C., I know that almost every adult involved in helping our girls seems to be at a loss, especially in the face of the rising birth rate among Hispanics.

Cynthia Quinteros, however, has a theory. "I feel that the community is afraid to talk about all the girls who are getting pregnant," she says. "Once you get pregnant, they do everything for you, but they ought to be doing all they can do to show girls how difficult their lives will be if they have a baby. I love Angel, but if I didn't have him I wouldn't have to work after school, I could study more, I could be a normal teenager."

Out of the mouths of babes.



patrwelsh@gmail.com





Patrick Welsh teaches English at T.C. Williams High School in Alexandria.