Preventing Teen-Age Pregnancies : Planned Parenthood Examines Underlying Problems

NEW ORLEANS â€”  Three days of discussion had focused on teen pregnancy prevention--indeed, this was the theme for Planned Parenthood’s annual meeting. But statistics and horror stories aside (such as that of an 8-year-old who gave birth this year in Los Angeles), a consensus seemed to be evolving that it’s time to move beyond debate over abortion and morality, time to start building coalitions to address underlying problems such as poverty and school dropouts.

“Forty-five thousand teens are going to get pregnant this year in Los Angeles,” Dr. J. Hugh Anwyl, executive director of Planned Parenthood of Los Angeles, said in an interview, “a horrendous figure to even try to contemplate.” And, he added, while the numbers may be starting to level off among older teens, they are increasing among those under 15.

There is as yet little cause for optimism in the statistics. But, Anywl said, “For me, the encouraging sign is we’re beginning to move beyond the whole business of focusing on teen pregnancy as though by some magic you can deal with one aspect of their lives and think you’ve got it.”

‘First Line of Defense’

Anne Saunier, who was elected chairperson of the board of the Planned Parenthood Federation of America at the meeting concluding here Sunday, concurred: “I don’t think we’ve ever believed that access to contraceptive services and to abortion would solve the teen-age pregnancy problem. But that’s been our first line of defense. I think that line of defense is pretty well assured.”

Now, Saunier said in an interview, it is essential to “look at the root causes of why teen-age pregnancy is such a phenomenon in this country, as compared to other industrialized countries, and try to attack some of those root causes.”

Among root causes, she mentioned the “enormous mixed messages” society gives teens about sexuality and “the problem parents have dealing with issues related to teen-age sexuality. . . . Parents don’t want their teens to be sexually active and, since they don’t want it, they find it very difficult to talk with them about birth control. That confusion and ambivalence is contributing directly to teen-age pregnancy.”

She is not advocating a radical change of direction for the organization and its 187 affiliates nationwide, Saunier said. Rather, she sees it as “an extension. The right to control one’s own fertility is a basic human right. It’s just that the problem of teen-age pregnancy is more intractable than we had hoped.”

Joyce Ladner, a professor of sociology at Howard University’s School of Social Work who has been involved in research on teen pregnancy for almost two decades, said in an address here that it is time to “rethink” solutions, to begin to treat teen pregnancy as part and parcel of a whole set of problems including juvenile delinquency, teen homicides, drug and alcohol abuse and sexual abuse of children.

Victims of Upward Mobility

As a society, Ladner said, “We’ve become the victims of our upward mobility,” with families headed by single parents and families with mothers in the work force (54% of all white women, 47% of all black women). Today, for the first time, she said, “Children are the primary caretakers for (their) infants and children,” where in earlier times their babies would have been raised by grandparents nearby or members of the extended family.

Ladner said she has seen quite enough of “black girls paraded across the (TV) screen” in documentaries examining the teen pregnancy problem. “Teen pregnancy is not a black problem. It is not a white problem,” although proportionately more black girls become pregnant. The problem, she said, is “more closely entwined with poverty than with any other factor”--and blacks are less likely to either have abortions or place their babies for adoption. (Since 1960, Ladner said, teen pregnancy among whites is up 100%, among blacks, up 10%.)

Birth control alone is not the answer, she emphasized: “We need to listen to the kids,” to build coalitions “with community groups who disagree with us on every other issue except that our kids are our greatest asset. We’ve got to deal with changing values.”

For starters, Ladner said, “We should have mandatory family life education starting in kindergarten.”

Legal issues, funding issues and media issues were also explored during the conference. At a session on “TV and Teen Sex: How to Change Network Policies,” Marcy Kelly of the Los Angeles office of the Carnegie Corporation-funded Center for Population Options, a nonprofit organization that works to promote sexuality responsibility in the media, offered good news and bad.

There have been prime-time inroads, Kelly said, an increasing awareness by the networks that “they can no longer present sex in a vacuum.” She singled out entertainment programs that have dealt realistically with abortion, birth control, AIDS and teen-age choices about being sexually active. But Kelly, suggesting that adolescents learn a great deal about values and relationships in today’s society from television, said she finds it disturbing that, on TV, “couples are increasingly being portrayed as having less verbal communication,” they know each other a shorter time before sexual intimacy and most of the sex is outside of marriage.

The Center for Population Options has compiled a list of guidelines for television, films and music. These include: “Consequences of unprotected sex should be discussed or shown.” “Use of contraceptives should be indicated as a normal part of a sexual relationship.” “Avoid associating violence with sex or love.”

‘Dramatic Convenience’

Another guideline: “Miscarriage should not be used as a dramatic convenience for resolving an unwanted pregnancy.” On television, Kelly said, this device is widely abused.

The global view was the concern of Dr. Daniel R. Weintraub, PPFA’s vice president for international affairs, who said that his objective in his address to delegates was “to get them upset, get them angry.”

He is upset and angry about threats to PPFA’s Family Planning International Assistance program, which is endangered by a Reagan Administration directive that government funding will be withdrawn from any overseas agency that, even with its private funds, engages in abortion counseling, referral or services--even in countries where abortion is legal.

Planned Parenthood’s international division supports programs in developing countries that increase access to contraception, train family planning personnel and educate both men and women about sexuality and contraception.

‘It’s Poor Ethics’

“Our policy,” Weintraub said in an interview, “is that we shouldn’t accept the Administration’s policy.” He added, “It’s poor medicine and it’s poor ethics” and, he said, it makes a travesty of America’s obligation to protect basic freedoms in countries to which it gives aid through U.S.A.I.D.

Funding for PPFA’s international effort, about $20 million for programs in 40 developing countries and for shipment of contraceptives, ends in January, 1988. There is no way, Weintraub insists, that Planned Parenthood will agree to the new policy and, he said, the board has authorized “legislative and legal action” to fight it.

Weintraub, a dentist who formerly served in the Peace Corps and with AID, has traveled extensively in the Third World and said he has encountered little opposition to family planning in target countries, even among Catholics. There are cultural hurdles, he acknowledged, but said these can be overcome through semantics. (In Africa, for example, family planning becomes “desirable births”). Basically, Weintraub said, “The opposition is in this country, not overseas.”

“Keeping Cool When the Heat is On” was the topic of a workshop to teach emotional survival skills to those who deal with harassment and violence from forces opposed to abortion.

“I’d like you to get a nice clear picture of one of your enemies,” instructed the facilitator, and then ask God to “do to them just what they deserve.” A woman in the audience shouted out, “Convert ‘em!”

A “how to” workshop focused on grass-roots organizing around the issue of sexuality education. During the question-and-answer period, a woman said, “In D.C. we see more and more a push for chastity. . . .” This brought a response from panelist Jim LeFevre, executive director of Planned Parenthood of Northern New England: “I’d like to see a brochure, ‘It’s OK to say yes--if you say yes responsibly.’ This zeal for chastity doesn’t square with the data. . . . It simply is romantic fiction.”

One of the presenters at a panel discussion on approaches to delivery of sexuality education was Peggy Brick, director of education for Planned Parenthood of Bergen County in Hackensack, N.J. She is co-developer of a 16-lesson teaching manual on contraception, “Positive Images,” and of a 10-minute video, “Swept Away Is Not OK.”

Thinking About Contraception

“Our philosophy,” she said in an interview, “is that you have to empower kids, get kids to see that thinking about sex means thinking about contraception. There’s a great reluctance to do that. Everybody wants to teach them to say no.”

In “Swept Away Is Not OK,” the message, Brick says, is “Protect yourself. You owe it to yourself, to your partner, to your future.

“The (popular) vision of romance has absolutely nothing to do with birth control. We’re trying to get kids to combine them, so the whole thing becomes less awesome.”

Susan Newcomer, director of education for the PPFA, views knowledge of and access to contraceptives for teens as “a necessary, but not a sufficient, answer.” To avoid unwanted pregnancies, she said, teens need both the ability and the motivation--and that motivation is linked to their having “a sense of the future--in fact, jobs. In fact, good education, in fact decision-making skills, not just self-esteem.”

She recognizes, however, that this takes money and “a real sense of social commitment” whereas the reality today is that “there’s a lot of resentment about teen-agers in this country.” In Newcomer’s perception, those who oppose the objectives of Planned Parenthood are “real angry about teen-agers having sex and not getting caught.”

They need to know, Newcomer said in an interview, “that babies having babies costs $16 billion a year and maybe that money is better spent.”

‘Spotty, Erratic’ Efforts

Whereas few of the nation’s 10,500 school districts have categorically banned family life education, she said, “nobody knows what’s really going on” in some of the programs (Anwyl labels LAUSD efforts “very spotty and erratic”) and Newcomer suspects sex education in some schools consists of handing out work sheets.

While some have been advocating a return to a morality of earlier times, PPFA chairperson Anne Saunier dismisses the idea that moral standards have changed significantly--”I think that’s a myth. Teen-agers have always been sexually active. It’s just that our society in previous generations had ways of handling pregnancy that weren’t so obvious,” such as sending the pregnant girl to live with relatives and placing the child for adoption.

“Another thing that’s different today is biology,” Saunier said. A century ago, she pointed out, “the average age of onset of menses was much higher and the average age of first marriage was lower. There were fewer years between sexuality and marriage. . . . Today, you’re talking about 10 to 12 years of being biologically mature before you are in a setting that the entire society embraces as appropriate for sexuality.”

Hugh Anwyl of L.A. Planned Parenthood, by profession a minister in the United Church of Christ, said: “I think, if we want to get our national priorities straight, it’s high time that we, from a religious point of view, developed a prototype of what a responsible human being is like.”

Three pilot school-based clinics offering birth control counseling together with general health services are scheduled to open in the Los Angeles Unified School District early next year and, Anwyl said, “They have a lot to do to coalesce community support.”

Anwyl is not beyond suggesting that it might make sense that all women, whether sexually active or not, routinely take contraceptives “as soon as it’s possible for them to start reproducing. If you’re doing that, the abortion issue will disappear. Then we’d move off this debate. Otherwise, we’ll be talking like this another 100 years.”

Meanwhile, he said, the infighting between the two sides--Planned Parenthood and those who oppose right to abortion and other tenets of the organization--”will go on until both sides recognize that nobody has the whole truth” but they have in common a problem of massive scope.