Loss of federal prevention funds will lead to more unintended teen pregnancies

If we want to make sure every Oklahoman has the chance to become a productive, healthy adult, then preventing teen pregnancies is one of the most important things we can do. While some teen mothers and their children manage to beat the odds, giving birth before completing one’s education and being prepared to parent greatly increases the likelihood of being trapped in a cycle of misfortune.

Research finds that only about 50 percent of women who become teenage mothers earn a high school diploma by age 22 and only around 10 percent will graduate from college. Two in five mothers who give birth before age 20 are living in poverty within the first year of their child’s birth. The children of teen parents have a higher risk for low birth weight and infant mortality, have lower school achievement and more behavioral problems, and are more likely  to be incarcerated at some time during adolescence.

The good news is that great progress has been made in recent years in reducing teen pregnancies. Since the early 1990s, the national teen pregnancy rate is down by 55 percent and the teen birth rate has fallen by 64 percent, according to the National Campaign to Prevent Teen and Unplanned Pregnancy. But there is still much more work to be done, especially in Oklahoma. Between 1991 and 2015, the teen birth rate in Oklahoma fell by 52 percent overall and by 71 percent for black teens. Still, in 2015, Oklahoma’s teen birth rate — 34.8 births per 1,000 females ages 15-19 — remained the second highest among the states and was more than 50 percent higher than the national rate of 22.3 births per 1,000 female teenagers. There were 4,802 births to teenage Oklahoma mothers in 2014. Public spending on teen pregnancies tops $150 million per year in Oklahoma.

This is why the recent announcement that the Trump Administration plans to abruptly terminate the national Teen Pregnancy Prevention Program (TPP) is so concerning. The $213 million program funds 84 initiatives nationally, most of which work to implement evidence-based prevention programs in areas with high teen pregnancy rates. The five-year program was expected to run through 2020; however, in July, all the grantees received letters from the U.S. Department of Health and Human Services informing them that they would not be funded past June 2018. The Administration’s decision was based on the President’s budget, which recommended eliminating the Teen Pregnancy Prevention Program. However, Congress has yet to complete its work on the FY 2018 budget.  The House Appropriations Commitee removed pregnancy prevention funding from its proposed FY 2018 budget, and the Senate Appropriations Committee will begin deliberations when Congress reconvenes this month.

The elimination of federal teen pregnancy prevention funding would be felt especially strongly in Oklahoma. TPP funds three large programs in the state: one in Tulsa, led by Youth Services of Tulsa, one in Oklahoma City, led by the Oklahoma City-County Health Department, and one in Choctaw, McCurtain and Pushmataha counties led by the Choctaw Nation. The two metro area programs involve broad-based community partnerships pursuing a range of evidence-based teen pregnancy prevention efforts. The Choctaw Nation’s program is geared specifically to Native American middle school and high school students. Together, the programs serve some 15,000 teens annually. Their combined annual federal funding is $3.9 million.

The Department of Health and Human Services’ Office of Adolescent Health has justified eliminating the Teen Pregnancy Prevention Program by stating that the “very weak evidence of positive impact of these programs stands in stark contrast to the promised results, jeopardizing the youth who were served.” However, the success seen in reducing teen pregnancy rates belies the claim that the programs are not working and may be somehow jeopardizing the youth they serve. In addition, extensive evaluations from the first round of TPP grants (2010-14) helped to build a body of knowledge about what works to prevent teen pregnancy that is being used to strengthen current projects.

In reality, it’s widely believed that the decision to cut teen pregnancy prevention funding reflects the influence of Trump Administration appointees who are outspoken advocates of abstinence-only education and opponents of more comprehensive approaches. Yet, extensive research over the past 15 years has established that an abstinence-only approach to teen pregnancy prevention is ineffective, often medically inaccurate, and even harmful. By contrast, comprehensive teen pregnancy prevention programs that include abstinence and contraception information lead to reductions in “sexual activity, the number of sex partners, the frequency of unprotected sexual activity, and sexually transmitted infections”, according to a 2012 meta-analysis by the Centers for Disease Control. The programs being eliminated all include abstinence education, along with information on contraception, healthy relationships, and sexual decision-making.

The complete elimination of Oklahoma’s main teen pregnancy prevention initiatives will  affect the lives of thousands of teens. As the head of Youth Services of Tulsa said in a recent interview with the Tulsa World: