美国国家公共电台 NPR In Texas, Abstinence-Only Programs May Contribute To Teen Pregnancies（在线收听）

RACHEL MARTIN, HOST:

Today in Your Health, we're going to look at teen pregnancy because nationwide the rates of teen pregnancy have been on the decline. Reporter Lauren Silverman from member station KERA in Dallas has been looking into this, and she joins me now. Hi, Lauren.

LAUREN SILVERMAN, BYLINE: Hey, Rachel.

MARTIN: So this is good news, right?

SILVERMAN: Yeah. So across the country, the number of teenagers who are having babies has hit a record low. It's down to about 1 out of 45 young women, and that's everywhere. But recently, researchers have found there are still these pockets where the teen birth rate is much higher than the national average. And some of these hot spots are in Texas, and to understand why this is happening, I wanted to tell the story of Jessica Chester.

MARTIN: OK. Jessica's story. Let's listen.

SILVERMAN: When Jessica Chester was in high school in north Texas, she wanted to become a doctor.

JESSICA CHESTER: I was that student. I was top of the class - full tuition scholarship to UTD. I was not the stereotypical girl someone would look at and say, oh, she's going to get pregnant and drop out of school, you know, I just wasn't.

SILVERMAN: But right before her senior year, Chester missed her period. She bought a pregnancy test and told her mom to wait outside the bathroom door.

CHESTER: Both lines came up, and I didn't say a word. I just slid the test under the door. I had tears. And I remember just opening the door. She was standing there with her arms, out and she just wrapped me up and hugged me. And I just cried and, you know, she told me it's going to be OK.

SILVERMAN: Chester's mother had also been a teen mom and so had her grandmother. Every year in Texas about 35,000 young women have babies before their 20th birthdays. Teen birth rates are typically highest where education levels are low and poverty is high. But a new study co-authored by Dr. Julie Caesar shows there's more at play.

JULIE DECESARE: We removed poverty as a variable, and we did the same thing for education. And we found these 10 centers where their teen birth rates were much higher than would be predicted.

SILVERMAN: In the clusters that you found, a few were in Texas.

DECESARE: Lots of them were in Texas.

SILVERMAN: The Dallas and San Antonio areas, for example, had teen pregnancy rates 50 and 40 percent above the national average. Here's the thing - teens everywhere are having sex. Gwen Daverth CEO of Texas Campaign to Prevent Teen Pregnancy says the high numbers in Texas reflect policy, not promiscuity.

GWEN DAVERTH: What I mean by that is we're not connecting high-risk youth with contraception services. Our state is the most restrictive state when it comes to accessing health care.

SILVERMAN: For instance, if you're a 17-year-old mom and want prescription birth control, in most cases you need your parents' permission.

SKYLAR: Mommy, do you know the people that talk?

SILVERMAN: Twelve years ago after Skylar was born - that's him playing video games - Chester wasn't given contraception counseling and still wasn't sure where to go for help. She continued dating Skylar's father and three months later was pregnant again. She and her boyfriend hadn't realized, she could get pregnant so soon after having a baby. She was a full-time student at UT, Dallas double majoring in molecular biology and business administration. The education Chester never got, she says, was sex ed.

CHESTER: In hindsight it's like dude, like, what were you all thinking? I was an 18 year old. I came in 17 pregnant, had my baby at 18. Why weren't you all, you know, lining up the chart and showing me these are your options?

SILVERMAN: Chester's high school, like the majority of schools in Texas, teaches abstinence only or doesn't offer sexual education at all. Nicole Hudgens with the socially conservative Texas Values Public Policy Group supports abstinence-only education and says there are plenty of options for young moms who become pregnant.

NICOLE HUDGENS: There are so many places like crisis pregnancy centers that are able to help these girls that are in need.

SILVERMAN: That help generally does not include education about contraception. Most teen parents don't finish high school and just 2 percent go on to graduate from college. Jessica Chester falls into that 2 percent. She graduated and works in community outreach. She admits it's tough.

CHESTER: A lot of my sorority sisters, they've gone through medical school. They're doctors now, and I'm so happy for them. But I can't lie. Sometimes it's hard. You know, every graduation that comes around, I know that that's something I always wanted to do. And it's hard because sometimes I do feel like a failure like I gave up on my goals and dreams or I missed them up. But when I look at my children, I don't regret a thing.

SILVERMAN: Chester hears her boys laughing upstairs, wipes her tears and goes to cheer them on.

MARTIN: And we've got Lauren Silverman back to talk about this. She's a reporter from member station KERA who's been looking into teen pregnancy rates. So, Lauren, it's hard to imagine that in this day and age, teens have so much information online. But there is still such an information gap, it seems, in some communities when it comes to preventing pregnancy.

SILVERMAN: Yeah. And talking about sex can be uncomfortable and even with information, teens sometimes make rash decisions as I'm sure you remember.

MARTIN: Yeah.

SILVERMAN: But the information gap is real in Texas. Here nearly 85 percent of high schools teach abstinence only or don't have any sexual education at all. And there are some districts that seem to be adopting this sort of third-way approach called abstinence plus which still encourages abstinence, but it also includes information on pregnancy, prevention and STDs. But still in Texas, abstinence-only education is king.

MARTIN: What did you find out about school districts, states where things are working well?

SILVERMAN: So in addition to providing sexual education, a lot of these places are focusing on access, making access to contraception easier and literally meeting teen moms in hospitals or doctors offices. In South Carolina, for example, young women who have babies and are on Medicaid, which is health insurance for lower income people, they're offered the opportunity to get a long-acting form of birth control right after they give birth. Colorado also is subsidizing the cost of long-acting birth control. They're both abortions and teen birth rates are dropping faster than the national average.

MARTIN: Finally, Lauren, do we know anything more about Jessica's future plans? She said she wanted to go to med school. Is that still in the cards for her?

SILVERMAN: She is still thinking about it. Right now she's actually working doing some family planning counseling as well, and she's still thinking about medical school.

MARTIN: Lauren Silverman from member station KERA. Her story was part of our reporting partnership with Kaiser Health News. Lauren, thanks so much.

SILVERMAN: Thanks, Rachel.