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Teen Pregnancy, Birth Rates Plummet across D.C. Region

Teen pregnancy and birth rates have gone down sharply across the Washington region in the past decade, with the District slashing its numbers by more than half to historic lows.

Arlington and Prince George's counties also have recorded striking reductions in both rates, which are among the most significant indicators of children's well-being. In addition, in virtually each jurisdiction, the trajectories have been chiefly marked among African American teens, closing much of a once-intractable gap with white rates.

The reversals reflect national trends that have public health experts expectant that programs and messages intended at adolescents have hit their mark at last.

Donald Shell, health officer for Prince George's, where the birthrate for females age 15 to 19 fell by nearly a third between 1996 and 2005 said, "We think kids are making better choices. Our efforts finally are bringing forth some fruit."

The District has accomplished dramatic development. In 1996, its pregnancy rate for the same age group was 164.5 per 1,000. Appalled by the triple digits, a coalition of nonprofit groups and city agencies start reaching out to a variety of communities, holding public discussions and trying to educate parents how to talk to their children about love, sex and relationships.

Brenda Rhodes Miller, executive director of the D.C. Campaign to Prevent Teen Pregnancy, recalled, "The city was remarkably unified." Advocates vowed to reduce the rate to the mid-70s by 2005. Instead, as statistics released this month show, it plunged to 64.4. The reduction in the birthrate paralleled that.

Rhodes Miller's new goal as she said, "to cut that 64 in half. A double-digit teen pregnancy rate for the nation's capital is just not acceptable."

Yet within the region's optimistic news are troubling details that could undermine the progress. Several jurisdictions still have what one health worker explained as "extraordinarily high" rates. In others, figures are ticking up again as of more Latina pregnancies.

Darhyl Jasper, a public health nursing supervisor who heads Alexandria's teen pregnancy prevention program said, "I can look at the numbers and be very concerned."

Alexandria, which started tackling the issue "way back in the '70s," was the only jurisdiction to have its teen birthrate raise over the most recent decade and managed a minimal decline in its pregnancy rate. Jasper said, "I cannot say why."

In a country with the worst rates in the industrialized world, officials have focused on teen pregnancies and births for the reason of their distressing, lifelong ramifications.

Adolescent mothers frequently compromise not only their health but also their future, dropping out of school and struggling monetarily. Their babies are at higher risk for a host of problems, with low birth weight and abuse, neglect and poor academic performance.

The Annie E. Casey Foundation has noted, "Teen childbearing affects young people at both ends of childhood."

The achievements since the mid-1990s are attributed in part to a holdup in teenagers' start of sexual activity. Causes for that are not easy to tease out, and the politicized push for abstinence-only curriculum in schools has made the discussion more volatile.

Most studies give more recognition to teens' greater use of condoms and other protection and the wider collection of options obtainable to them, together with such long-acting choices as the birth control patch.

Calvert County makes contraception available to girls at its family planning clinics for no charge and, except in rare cases, no questions. The approach may elucidate why the teen birthrate there fell 46 percent by 2005.

Health officer David Rogers said, "Our underlying message is they should not be sexually active." Any counsel, like the contraception itself, is delivered in "a nonjudgmental way. Certainly our success is based on that."

The work that remains is daunting.

In the District, nearly one in fourteen births is not a young mother's first. Midwife Loral Patchen works with several of those adolescents through a program she directs at Washington Hospital Center. Their average age is 16 years, and their lives often are in tumult. Patchen hears about HIV-infected parents, abusive boyfriends and fears of homelessness.

Staff members dispense education, contraception and encompassing support. Their intention is to assist the teens avert subsequent pregnancies.

She said, "So many of them are so ambivalent. It is not that they want to have a child. It's just that they did not want to have a child enough to do something about it."

Maria Cruz enrolled when she became pregnant at 13. She stuck with the program through her daughter's birth and said it has kept her from repeating the mistakes of her much unfocused youth. She returned to class and graduated from Cardozo Senior High School in June.

Cruz, who juggles a part-time bank teller's job and college preparation as she takes care of 4-year-old Katie explained, "I have matured a lot." She talks of having another child - after college, when she is married.

She said, "When I am ready, not now."

However, even stable development can suddenly slip. This summer, Montgomery County officials were surprised to learn that their teen birthrate had jumped to 20.1 in 2005 from 17.9 the previous year. It was the third successive increase, powered completely by births in the Latino community.

Judy Covich, the county's school health director said, "The cultural component is one piece of a very complex story."

Given the Washington region's changing demographics, as well as the countries, several communities soon could be facing the same challenge. Most family planning services lag in providing for language requirements and cultural sensitivities, said David Landry of the Guttmacher Institute, which studies sexual and reproductive health.

Landry celebrates the undeniable headway that has been made with teen pregnancy and birthrates across the United States. He is uncertain what lies further on, though.

He said, "It's a very unclear future we are moving into."



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