By Lindsay Street, Statehouse correspondent | Advocates working to curb teenage pregnancies are celebrating the steepest decline in teen births on record while holding their breaths on federal and state legislation that could threaten progress.
The Trump administration budget and new health care bill proposed to cut a federal grant program that has helped to push down births to teenagers. In South Carolina, the Personhood Act of South Carolina (S. 217, H. 3530) would make contraceptive access more difficult as it effectively would abortions in the state.
Since 1991, the state’s teen birth rate has declined by 64 percent, according to the S.C. Campaign to Prevent Teen Pregnancy. From 2014 to 2015, the state’s teen birth rate had its sharpest one-year decline of 8 percent.
A lot has gone into that decline, including federal and state programs, better education, and community involvement, said the organization’s CEO Beth De Santis.
“Teen pregnancy is seen as a key issue in South Carolina. Not only has communities recognized teen pregnancy as a problem, but communities are also taking action — from comprehensive sex education classes, to after-school programs, to mentors in the faith setting, to teen-friendly health centers across the state,” she said in a statement to Statehouse Report. “Teen pregnancy is a complex problem and it takes a complex solution – one that involves all facets of a community.”
Despite the good news, the state is still has the 16th highest rate of teen birth in the country, according to the campaign.
‘Amazing’ downward trend
South Carolina appears to be following the national decline in teen births.
The Centers for Disease Control published a report June 30 that said the national rate of teen pregnancy dropped 9 percent in 2016. The birth rate for teenagers aged 15 to 19 declined to 20.3 births per 1,000 women.
It’s a decrease that the report’s lead author and National Center for Health Statistics statistician demographer Brady Hamilton called “amazing.” Hamilton said the decline in teen pregnancies has been a trend nationwide since 1991.
Hamilton also said the CDC report showed an increase in women over the age of 30 having children, with a decline in women under the age of 30 having children. Additionally, there’s been a decrease in the Cesarean surgery rate, but it’s been the drop in births by teenagers that has caught headlines.
“There’s certainly a public interest and concern about teen pregnancy and teen births,” Hamilton said. “It has a high impact in terms of the future prospect of these teen mothers and teen fathers. They’re trying to finish their educations … and laying the groundwork for their entrance into the workforce. Having a child is no easy task. They require a great deal of time and resources in their care.”
A rural success story
The S.C. Campaign to Prevent Teen Pregnancy has kept tabs on where the state needs work.
Impoverished and rural counties usually have the highest rates of teen pregnancy in the state. The counties with the highest rates of teen pregnancy include Oconee, Cherokee, Union, Lancaster, Chesterfield, Lee, Marlboro, Dillon, Marion, Allendale, Colleton and Jasper. Marlboro ranks No. 1 in the state for most teen births at 75.1 per 1,000 females aged 15 to 19 years old. That means for every 100 girls in that age group, at least seven gave birth in 2015.
But rural Bamberg County bucks the trend. It has the lowest birth rates for teenagers in the state, even beating out Charleston and Richland counties. Those three counties had fewer than two teen births each per 1,000 females aged 15 to 19 years old in 2015.
According to the campaign, the difference in Bamberg is that it has a strong, community-led teen pregnancy prevention programming that started in the 1980s and continues today.
“Compared to 20 years ago, more schools have implemented evidence-based curricula,” De Santis said. “More health centers have become teen-friendly. More health centers are promoting long acting reversible contraceptives as the most effective form of birth control. More efforts are in place for 18-19 year olds, who account for the majority of teen births.”
And who deserves the credit? Teenagers, De Santis said.
“The bulk of the praise must be given to teens, who ultimately have the power to make healthy decisions,” she said. “Teens today are delaying initiation or, if they do have sex, are using contraception more than they did 20 years ago.”
Legislation contributed to downturn
Federal and state legislation has contributed to the state and national downturn in teen births.
A 2016 CDC report showed a positive impact from the federal Affordable Care Act’s Medicaid expansion in decreasing teen pregnancies nationwide. According to that report, one of the key policies shown to reduce teen pregnancies was increasing access to contraceptive counseling and services.
Two ACA provisions that helped, according to CDC, were expanding full Medicaid services based on income eligibility and making family planning services available at a slightly higher income level.
Although South Carolina did not expand Medicaid coverage under the ACA, De Santis said that inaction did not negatively impact the state’s teen birth rate.
“In our opinion, that decision has not affected the teen birth rate in any significant way,” she said. “In South Carolina, we enjoy a wonderful relationship with DHHS (S.C. Department of Health and Human Services), whom happens to lead the state’s Medicaid program. DHEC (S.C. Department of Health and Environmenal Control) has been a wonderful partner in teen pregnancy prevention and pregnancy care throughout our state.”
Since 2010, DHEC has implemented its Personal Responsibility and Education Program via community-based teen pregnancy prevention and intervention programs across the state. DHEC also oversees state abstinence education efforts, which are designed to support children and adolescents by promoting abstaining from sex to prevent teen pregnancy.
Possible federal trouble ahead
De Santis said other portions of the federal health care act contributed to prevention of teen pregnancy. The act created the Office of Adolescent Health (OAH) which provides competitive grant awards to states toward implementing pregnancy prevention in teenagers.
But the Office of Adolescent Health is on the chopping block for the September federal budget.
The National Campaign to Prevent Teen Pregnancy spoke out against President Donald Trump’s January proposal to end funding to the Office of Adolescent Health’s Teen Pregnancy Prevention Program before the close of the 2016-17 fiscal year, something that hasn’t happened. The Trump administration has also proposed a $51 million cut to the program in the coming fiscal year. The New York Daily News reported this finding in the proposed budget in June. Lawmakers are expected to pass the federal 2017-18 budget by end of September.
“Federal investments in teen pregnancy prevention programs through the OAH have benefited South Carolina and this country tremendously as we have seen through the declines in teen birth rates. We are uncertain about the new administration’s potential impact overall; but it is an area of interest for us to keep a watchful eye on,” De Santis wrote.
A look ahead at next year’s state issues
The federal health care bill and budget aren’t the only items S.C. advocates are watching. In South Carolina, the campaign is looking at four bills that could shape the future trend — only one that could possibly cause a backslide in the drop in teen pregnancies.
The positive proposals in the General Assembly include H.3809, which would make it possible for doctors to prescribe a 12-month refill on contraceptives, and H.3064, which would allow pharmacists to administer contraceptive patches and oral contraceptives.
“These bills in essence (S.217 is the exception) would potentially enhance or improve the educational baseline (S.461/H.3663) and create some efficiencies related to access to medical care (in this case contraceptives) that could impact (and perhaps reduce) teen pregnancies,” De Santis said in a statement.
S.217, the so-called Personhood Act, could “negatively affect” contraceptive access in the state, she said.
“More attention and education (should be) given to the most effective forms of birth control – long acting reversible contraception. The most effective forms of birth control are the IUD and the implant; both have less than a 1 percent failure rate,” De Santis said.
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We Can Do Better, South Carolina!
This is a fascinating, though disturbing, article. Those differing teen pregnancy figures really do tell the story. For the sake of these young girls, let’s hope good political sense prevails over moralising. Well written and timely article by Lindsay Street and Statehouse Report.