The United States has the highest rate of teen pregnancy in the developed world,[1] and Texas is fifth highest in the 50 states,[2] with the highest rate of repeat teen pregnancies![3] That’s not surprising, given that 25% of Texas school districts don’t teach sex education and almost 60% teach abstinence-only.[4]
The figure below shows the 2012 birth rates in teens by state.[5] As you can see, Texas sits right in the middle of a hotbed of teen pregnancy and births, along with New Mexico, Mississippi, Arkansas, Louisiana, Oklahoma, Kentucky and West Virginia.
[6]
It’s not just teens having accidental pregnancies either. In Texas, more than half of all pregnancies (54%) are accidental.[7]
The situation has worsened recently in Texas counties that used to be served by Planned Parenthood. In 2011, Texas defunded Planned Parenthood, leaving many counties without any services.[8] A new study reports that those counties had an increase in Medicaid-covered births in the 18 months following funding removal, whereas counties with services showed a decrease in Medicaid-covered births.[9]
Teenage pregnancy has social consequences. Compared with women who have babies later in life, teenagers who have babies are:
Less likely to finish high school;
More likely to rely on public assistance;
More likely to be poor as adults; and
More likely to have children who have poorer educational, behavioral, and health outcomes over the course of their lives than do kids born to older parents.[10]
Accidental pregnancies cost the taxpayer too. In 2010, more than 57%[11] of all births in Texas were publicly funded at a cost of nearly $3 billion—almost a third of which was paid by Texas.[12] That is our tax dollars that could be invested in education or health, paying for a preventable situation.
Our country as a whole loses out too, as each student dropping out of school represents about $260,000 in lost earnings, taxes, and productivity.[13]
Pregnancy is not the only unintended consequence of sex—disease is another consequence and a potentially fatal one. Texas ranked third among the 50 states in the number of HIV[14] diagnoses in 2015. Texas also ranks 16th in syphilis, 13th in chlamydia, and 11th gonorrhea.[15] In fact, Austin has more sexually transmitted disease cases than 50 other cities surveyed, and Dallas is ninth![16]
The disease risk is higher for young people too. Of the 20 million new sexually transmitted infection or “STI” cases every year, about half in 2000 occurred among individuals aged 15 to 24.[17]
This book aims to improve these statistics, providing marital education in an easy-to-read, nonjudgmental fashion. Why “marital” education instead of “sex” education? We chose this name in hope of reaching parents who support abstinence-only education.
Abstinence-only education may have a positive benefit in delaying the onset of sexual activity[18]—but it can lead to marriage at an earlier age. Without marital education, those young couples may not know how to plan their family. Thus, even if they are married, young parents are still at risk for dropping out of school with all of the negative consequences mentioned above.
Further, although pregnancy is an important focus, the information presented here is also relevant for marriages in which children are not an option. We believe that whether you have children or not, reproductive health care and education is important to your well-being, and that your well-being is important to everyone’s well-being.
This book thus provides a basic education in the types of family planning and disease prevention methods available and discusses their failure rates and the common reasons for failure. It makes suggestions for doubling or trebling up (using two or three different methods) to improve the chances of avoiding accidental pregnancy and disease.
Our purpose here is not to scare young people but to provide essential information in a balanced and nonjudgmental way. Hopefully, this book will also be able to connect with parents who have been pro–abstinence-only and encourage them to consider marital education in their communities. In Texas, and other states with high HIV rates, it may mean the difference between a happy healthy life, and a shortened one fighting HIV.
A copy of this book for personal use can be downloaded at www.Treble-Up.com. A $1 donation is suggested per copy for school use. Read it, pass it on, and if you get the opportunity, vote for abstinence-plus–marital education to be taught in your local schools.
Kearney M. S. & Levine P. B., Why is the teen birth rate in the United States so high and why does it matter? J. Econ. Perspect. 26(2):141–66 (2012). Abstract available online at https://www.ncbi.nlm.nih.gov/pubmed/22792555. (Kearney and Levine write: “Teens in the United States are far more likely to give birth than in any other industrialized country in the world. U.S. teens are two and a half times as likely to give birth as compared to teens in Canada, around four times as likely as teens in Germany or Norway, and almost 10 times as likely as teens in Switzerland. Among more developed countries, Russia has the next highest teen birth rate after the United States, but an American teenage girl is still around 25 percent more likely to give birth than her counterpart in Russia.”)
Thomson-DeVeaux A., How defunding Planned Parenthood could affect health care, FiveThirtyEight (2017). Available online at https://fivethirtyeight.com/features/how-defunding-planned-parenthood-could-affect-health-care/. (Thomson-DeVeaux wrote: “Texas . . . embarked on a series of efforts to divert funding away from Planned Parenthood in 2011. First, the legislature instituted broad cuts to family planning services, spurring the closure of 82 clinics, one-third of which were affiliated with Planned Parenthood.”) For more information on Texas efforts to defund reproductive health care, see Department of Health Policy, School of Public Health and Health Services, George Washington University, Deteriorating Access to Women’s Health Services in Texas: Potential Effects of the Women’s Health Program Affiliate Rule (2012). Available online at http://s3.amazonaws.com/static.texastribune.org/media/documents/GWU_WHP_study.pdf. See also Lee J., Charts: This is what happens when you defund Planned Parenthood, MotherJones (2013). Available online at http://www.motherjones.com/politics/2013/03/what-happens-when-you-defund-planned-parenthood.
Endnote 9
Stevenson A. J., et al., Effect of removal of Planned Parenthood from the Texas Women’s Health Program, N. Engl. J. Med. 374:853–860 (2016). Available online at http://www.nejm.org/doi/full/10.1056/NEJMsa1511902. (Stevenson et al. wrote: “The percentage of women who underwent childbirth covered by Medicaid within 18 months increased from 7.0% to 8.4% in the counties with [now closed] Planned Parenthood affiliates and decreased from 6.4% to 5.9% in the counties without Planned Parenthood affiliates [estimated difference in differences, 1.9 percentage points; P = 0.01].”)
Selby W. G., Democratic legislators say more than half of Texas births funded by Medicaid, PolitiFact Texas (2012). Available online at http://www.politifact.com/texas/statements/2012/mar/24/elliott-naishtat/democratic-legislators-say-more-half-texas-births-/. (Selby wrote: “[Texas Health and Human Services Commission] spokesman Geoffrey Wool . . . add[ed] that in 2010, 56.9 percent of Texas births—or 220,899 out of 388,447 total births—were covered by Medicaid, at an average cost of $11,600.”)
Shuger L., Teen Pregnancy and High School Dropout: What Communities Can Do to Address These Issues (Washington, DC: The National Campaign to Prevent Teen and Unplanned Pregnancy and America’s Promise Alliance, 2012), available online at https://powertodecide.org/what-we-do/information/resource-library/teen-pregnancy-and-high-school-dropout. (Shuger wrote that “fully 30 percent of teen girls who have dropped out of high school cite pregnancy or parenthood as a key reason. . . . According to the Alliance for Excellent Education [The High Cost of High School Dropouts: What the Nation Pays for Inadequate High Schools (2008)], it is estimated that over the course of his or her lifetime, a single high school dropout costs the nation approximately $260,000 in lost earnings, taxes, and productivity. Put another way, if students who dropped out of the Class of 2011 had graduated from high school, the nation’s economy would likely benefit from nearly $154 billion in additional income over the course of their lifetimes.”)
Endnote 14
HIV is human immunodeficiency virus, which will eventually cause AIDS—acquired immunodeficiency syndrome—and death if left untreated.
Corlis N., Ten U.S. Cities with Most Positive STD [Sexually Transmitted Disease] Tests (2015). Available online at https://www.stdcheck.com/blog/top-10-us-cities-positive-std-tests/. Cf. Different surveys include different diseases, and thus STD statistics are highly variable. This particular survey did not include herpes simplex virus 1 (HSV1) or hepatitis A, but did include chlamydia, gonorrhea, HSV-2, hepatitis B and C, HIV-1 and -2, and syphilis.
Endnote 17
American Sexual Health Association, Statistics (2020). Available online at http://www.ashasexualhealth.org/stdsstis/statistics/. (The American Sexual Health Association writes that the CDC “estimates that nearly 20 million new STIs occur every year [in the United States], half of those among young people aged 15–24.”)
Endnote 18
Jemmott JB III, et al., Efficacy of a theory-based abstinence-only intervention over 24 months, Arch. Pediatr. Adolesc. Med. 164(2):152–9 (2010). Available online at http://nationalabstinenceclearinghouse.com/pdf/contentmgmt/abstinence.pdf. (Jemmott et al. wrote: “The abstinence-only intervention compared with the health-promotion control intervention reduced by about 33% the percentage of students who ever reported having sexual intercourse by the time of the 24-month follow-up, controlling for grade, age, and intervention-maintenance condition.”) Most studies report, however, that overall teen pregnancies are higher with abstinence-only education. See Stanger-Hall K. F. & Hall D. W., Abstinence-only education and teen pregnancy rates: Why we need comprehensive sex education in the U.S, PLoS One 6(10):e24658 (2011). Available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3194801/. (Stranger-Hall et al. wrote: “Using the most recent national data (2005) from all U.S. states with information on sex education laws or policies (N = 48), we show that increasing emphasis on abstinence education is positively correlated with teenage pregnancy and birth rates. This trend remains significant after accounting for socioeconomic status, teen educational attainment, ethnic composition of the teen population, and availability of Medicaid waivers for family planning services in each state. These data show clearly that abstinence-only education as a state policy is ineffective in preventing teenage pregnancy and may actually be contributing to the high teenage pregnancy rates in the U.S.”)
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