Teen Pregnancy: An Alabama Tragedy

For a week, from September 29 to October 3, 1986, the Alabama Journal examined the causes, results, remedies and costs of Alabama's high rate of teen-age pregnancy — the fourth highest in the nation. A teenager gives birth in the state every 49 minutes. The 20-article series, written by Rose Wojnar, Emily Bentley, Dwayne Hood, and Peggy Roberts, examined sex education, analyzed programs for teen-age mothers, and offered vivid portraits of the teens whose futures — and whose babies — are jeopardized by poverty and early pregnancy. The newspaper sent a tabloid reprint of the series to 4,000 legislators, educators, health officials, and other policy makers. 

 

Opelika — Pamela is 15. She spends a lot of time thinking about school, rock 'n' roll, being with friends. In these carefree days of adolescence, Pamela should be celebrating the best years of her life. Still a child in many ways, Pamela — not her real name — has been thrust into the sober realities of adulthood. 

Just a few years after putting aside her dolls, Pamela must now care for a very real 12-week-old boy — her own. The Opelika girl discovered she was pregnant when she was 14, just a few months after she began menstruating. Neither she nor her 19-year-old boyfriend used birth control. 

Pamela's mother says her daughter is irresponsible about taking care of the child. She leaves the baby unattended, isn't concerned with the baby's medical care and takes little responsibility for his welfare. 

The baby's father is unemployed. He provides no care or financial support for the child. 

Pamela's case may seem unusual. But she is far from alone. Alabama had the fourth highest teen birth rate in the nation in 1984. Last year, 10,689 babies were born to women under age 20. That number is larger than the populations of Wetumpka, Millbrook or Tallassee — and another 389 of Alabama's 435 cities. 

During a two-month investigation, the Alabama Journal has learned: 

♦ Somewhere, an Alabama teen gives birth every 49 minutes. 

♦ Statistics indicate Alabama consistently ranks among the states with the highest teen birth rates. One in five births here in 1984 was to a teen mother. 

♦ Experts say there may be twice as many teen pregnancies as births. 

♦ Alabama has the fifth highest infant mortality rate in the nation. 

♦ Teens are getting pregnant at a younger age and more teenagers are having two or three babies before they reach 20. 

♦ Pregnant teens cost Alabama taxpayers at least $97 million last year. 

♦ Some $71 million a year in state Aid to Dependent Children goes to women who gave birth to children while in their teens. 

♦ Despite a long history of high teen-birth rates in Alabama, officials have not devised any statewide solutions to the problem. 

♦ Unlike many other states, Alabama has no state-mandated sex education program for public schools. And although studies show that sex education and school-based clinics that distribute contraceptives can help reduce the incidence of teen pregnancy, Alabama officials have no immediate plans for similar programs. 

♦ The percentage of births to black teen-agers in Alabama is higher than the rate of births to white teens. But the number of white teen-agers having babies exceeds the number for black teens. 

♦ The percentage of out-of-wedlock births to teen-agers is growing. In 1984, they accounted for more than half of the births to teen-age girls. 

♦ The teen birth rate is higher among Alabama's low-income counties. 

 

Alabama officials don't keep track of the number of teen pregnancies or abortions. But some experts say there may have been as many as 20,530 teen pregnancies in Alabama in 1981. 

The figure is based on a formula from the New York-based Alan Guttmacher Institute, which estimated 114 teen pregnancies per 1,000 teen-agers in Alabama that year. That's more than one pregnancy for every 10 teen-age girls. Faye Baggiano, Alabama's Medicaid Agency commissioner, said she believes that for every live birth to a teen, there is one abortion. In that case, there could have been as many as 21,378 pregnant teen-agers in Alabama in 1985, or more than six pregnancies for every 100 teen-age girls. 

Although experts can't agree on the numbers, they do agree that teen-age pregnancy is a tragedy — in the cost to the girls, their babies, and society. 

An estimate by the Alabama Journal, based on figures supplied by state officials, indicates teen-age births cost Alabama taxpayers at least $97.7 million last year. That figure includes welfare benefits to women who had children during adolescence, food stamp costs, and Medicaid expenses for delivery and health care for the baby for one year. But it doesn't include costs for subsidized housing, some prenatal care for pregnant teens, and federal food supplements for children and mothers — which could add millions of dollars a year to the bill. 

State officials and other leaders attribute the rate to Alabama's low per capita income, a lack of communication between parents and children about sex and values, and the absence of sex education programs in Alabama's schools. 

 

For years, Alabama has had one of the nation's highest teen birth rates. In 1984, the percentage of births to Alabama teens was 18.2 percent. Alabama followed Mississippi, Arkansas and Kentucky in the rate of babies born to teens. 

The number of out-of-wedlock births to teens continues to increase. Fifty-five percent of the infants born to teen-agers in 1985 were illegitimate. That compares with 51 percent in 1982 and 46 percent in 1977. 

The picture is even bleaker in Montgomery County. In 1985, Montgomery County teen-agers had 529 babies. Seventy-six percent of those babies were born to unmarried girls. 

Illegitimate teen births occur more often among blacks than whites, state records show. In 1984, for example, nearly nine out of 10 teen births to "nonwhites" occurred outside of marriage. 

Even more striking, it appears that many teens are having more than one baby before they reach 20. In 1985, nearly 20 percent of pregnant teens were having their second child. Another 3.4 percent were pregnant for the third time, while 0.6 percent had their fourth child. 

In Montgomery County, the figures were similar — except here, 1.1 percent of pregnant teens were on their fourth pregnancy. 

The babies face a more disturbing possibility — death. Alabama had the nation's fifth highest infant mortality rate in 1985. For every 1,000 live births, more than 12 did not survive their first year. That means every 12 hours, an infant less than a year old dies in Alabama. 

The cost for this is enormous. Alabama spends about $9.7 million a year to take care of low birth weight infants born to teens and requiring treatment in a neo-natal intensive care unit. 

The figures alone are alarming. But fill in the pieces and the scene becomes even grimmer. It becomes a landscape of wasted human potential. 

Statistics indicate that 90 percent of a teen-age mother's "life script" is written from the moment she has her baby. She won't finish high school. She'll join the welfare rolls. What's more, she'll probably stay on welfare the rest of her life. And her child — if he lives — probably will repeat the cycle. 

State officials and educators offer varying reasons why the teen birth rate here is so high. They say poverty is one reason. In 1984, Alabama's per-capita income was 46th in the nation, state records show. Research indicates poor teen-agers are more likely to get pregnant and have babies. 

In Perry County, the poorest county in the state in 1983, 23.4 percent of the births were to teen-age girls. But in Madison County — the richest county in 1983 — only 15.7 percent of births were to teens. 

 

Rose Sanders, a Selma lawyer, offers a number of reasons why poor teens tend to have more babies. She wrote "Babycakes," a musical that explores the problems of teen pregnancy and teenagers' attitude about sex. 

Sanders said when "the frustrations and the hopelessness [caused by poverty] intensify . . . you see, more kids find relief in a partner." 

Also, she speculated, poor teens may be drawn to have a child out of a longing for material goods. A poor girl may see a baby as richer girls see a stereo or automobile — something they can call their own. 

In addition, poor teen-agers — because they have little hope of going to college or getting a job — "need ways to save their self-esteem," Sanders explained. "Having a baby is a miraculous thing." 

Ralph Spiga, an assistant professor of psychology at Auburn University at Montgomery, said Alabama has many "risk factors" associated with sexual activity. 

For example, the increasing number of single-parent households and working mothers means teen-agers are more likely to encounter adult situations — including opportunities for sex. Also, single parents may not be with their children, leaving questions that may have to be answered solely by a teen's peers, Spiga theorized. 

Larry Rodick, executive director of Planned Parenthood of Alabama Inc., said he thinks the birth rate to teens is high here due to a "lack of access to sex education and a lack of access to birth control" as well as to poverty. He points to studies that show sex-education classes in school have led to a decrease in teen pregnancies and sexual activity. A recent study by Johns Hopkins University in Baltimore found inner-city black girls who took part in a sex-education program had fewer pregnancies than girls who didn't participate. 

While officials tend to agree that sex education and information about birth control can help lower the incidence of teen pregnancy, most of the state's schools lack those programs. Some officials say Alabama's traditionally conservative climate and the strong influence of the church have stifled efforts to teach children about birth control, as well as hampered government efforts to address teen pregnancy. 

Others say religion has nothing to do with it, pointing instead to a lack of leadership and the attitude — until recently — that teen-age pregnancy was a "black problem." 

But that perception is changing. The state Department of Public Health has initiated a task force that is examining the problems of teen-age pregnancy and infant mortality. By April, the task force is to have recommendations for the legislature. 

Meanwhile, officials with Alabama's Medicaid agency are launching a multipronged effort to educate teen-agers and the public about the problems and consequences of being a teen mother. 

The Alabama Council on Adolescent Pregnancy unites state officials, academics, religious organizations, professional and parent groups into an organization that will explore the economic problems associated with teen pregnancy. 

Why the sudden concern? 

 

Kay Johnson, a health program associate with the Washington-based Children's Defense Fund, said officials are looking more seriously at the problem because "the consequences of birth are more serious." With the number of pregnant, unmarried teens increasing and the high divorce rate, "the ability [for pregnant teens] to earn a living and become self-sufficient has been changing," she said. 

During the 1960's, if a teen-ager had a baby, she probably dropped out of school, got married, and her husband got a minimum-wage job. Today, a pregnant teen is "10 years out of sync with her peers," Johnson explained. 

Not only is it harder for teen-agers to deal with pregnancy, officials said, it's harder for society to foot the bill. Fox said he believes there's been increasing awareness of the "unnecessary health care cost" of pregnant teens and teen mothers. For example, the average stay in the hospital for a low birth weight baby is almost 20 days, at a cost of between $12,000 and $13,000. 

But there's another reason teen pregnancy has become a hot issue, officials acknowledge. It is no longer a problem plaguing only low-income groups. Teen pregnancy now cuts across all lines of race and income. 

Sanders said she believes leaders are being spurred to action because more white girls are becoming pregnant Before, she said, they were less concerned because it was considered a problem affecting only blacks. 

Baggiano points to a lack of leadership. She said many people are just beginning to realize the extent of the problem. The only previous instance of state officials taking action, she said, was in 1980 when the state Department of Pensions and Security, now the Department of Human Resources, held a conference on the issue. "No one has ever done anything. You have to have someone take a leadership role." 

 

SIDEBAR 

A Teen Mom Tells Her Story 

I went into labor in school. 

I was walking to class when I went . . . when my water broke. I didn't know I was in labor; I thought I was freaking out. 

Somebody told me . . . my friend told me I was fixin' to have my baby. I told her my clothes were wet and she told me my water had broke. 

I said, "No, it didn't." I thought I had peed on myself. 

She said, "It's your water," and I said, "No, it isn't," and she said, "Yes, it is," and I said, "No, it isn't" 

She said, "Yes, it is." Then she dragged me to the bathroom 'cause she didn't want anything to happen to me. 

This was in the hallway. And people were in the bathroom and so were a couple of people I knew. So a girl came in that was going to class, and I told her I was fixin' to have my baby, and she went and told the teacher. 

And so the whole school found out. The whole school knew I was having my baby . . . the whole school by first period. 

My water broke at 8 o'clock — 8 o'clock on the head. My baby knows how to tell time. I had my first contraction at 8:20 a.m. — in the school building. 

I was on the pill for about six months, and I had gotten off it because this guy I got pregnant by, he was a new guy. I had just started seeing him, and I didn't think I was going to go to bed with him. And when I did, I said, "Well, I guess I better get back on the pill" 

But I didn't get a chance. I got pregnant. . . . 

At first I was very embarrassed for people to know I was pregnant. 

And I gained weight. That's the most I ever weighed, 140 pounds. 

I had a good idea when I did it that I was pregnant. I didn't know, I mean I wasn't absolutely, positive sure . . . but I kinda knew it, and I believe he did too, because after that I didn't see him no more. 

Oh, I've seen him a couple of times, but he's not being a good daddy. 

You know, he's not being a father. I would want him to take care of my baby. But he's still in high school, and all he wants to do is play football. 

At first I wanted us to get back together — my baby's father and me — real bad because I always thought families are supposed to be together. 

I wanted my boy to be his only baby. 

But he and I didn't have a real good relationship. That baby came from fooling around. That's the honest truth, I'm telling you. 

I'm living with my foster parents — have been since I was 13 or 14. 

For me to be 17 years old and living under somebody else's roof — they don't do that much for me. . . . I do everything I can not to have to ask anybody for anything, but my baby doesn't go without, either. 

If I have to swallow my pride and ask for some money, I will, but I've only asked for money one time. 

I only had one more year in school to go. I thought I had made it too, boy. 

I always was worried about getting pregnant, you know. I said, "God, I know I'm not going to get pregnant in 12th grade." A lot of girls in 12th grade got pregnant. 

The timing was just right for me, though. I got a summer job before he started eating cereal. . . . Now I am in OIC (Opportunities Industrialization Center) and I get paid for that, you know. 

When I get through with classes, they'll help me find a job. 

I want to be on my own even though I know I can't be on my own right now. 

It's just that you don't ever think it's going to be you, you always think it's going to be the other person. 

 

SIDEBAR 

The Teen Father's Role 

By Emily Bentley 

 

Frankie, 20, lives in a Montgomery housing project Standing with his friends at an empty storefront across from the project, he is close enough to check in on his four children. 

Two of them he fathered with a 16- year-old girl. The other two he fathered with a 36-year-old. Both partners live in the neighborhood — the younger one with her parents. 

"But I see her a lot, and I help out with the kids," Frankie said. Frankie is proud of his offspring, and his friends seem to admire him and his virility. His buddies say there are plenty of teen-age guys in the project who know how it feels to be a father. 

"Just wait 'til they all get home from school," said one boy. "Some guys won't admit it when someone says their baby is his," he added. 

But Frankie said he cares about his children, although he didn't know all their names. "I don't keep up with all their names," he said. 

Frankie said he met the 16-year-old girl in the housing project. "I care about her," he said, adding that he had sex with the girl because "I wanted to share a part of her." 

"I did want a child; I love her," he added. "I see her a lot. She lives just around the comer over there." 

Frankie is married to a third woman and said he's trying to start a family with her. 

He said his 16-year-old girlfriend is going to school, and her babies stay in a day-care home during the day. He said she doesn't mind having the children. 

"I love my children and I want to have another baby with her before she turns 18." 

 

Meanwhile, 17-year-old Robert says he would rather spend time with his 5- month-old son than hang out with his friends the way he used to before the baby was born. 

Robert, not his real name, doesn't live with the baby's mother, but he cares for the child nearly every weekend and about three days during the week at his mother's Birmingham home. And he saves $60 a week from his job as a restaurant busboy to help support the child. He says he has no immediate plans to marry the baby's 16-yearold mother, but he has gone to court to have the child's name legally changed to match his. 

"Having a baby doesn't make me feel tied down," he said. "I don't hang around with my friends as much anymore, and I have to put money aside, but those are my decisions." 

A high school drop-out, Robert is working to get his general equivalency diploma and plans to enlist in the Army next year. 

Robert dated the baby's mother for a year before she became pregnant. Actually, they had stopped going together when she discovered she was pregnant, and she didn't tell him until she was six months along. 

They hadn't used any birth control, but abortion wasn't even an option. "I wouldn't have let her get one," he said. 

Robert wasn't at the hospital when his son was born, something he regrets now. But his attitude toward the baby's mother and just about everything else in his life changed after the birth. 

Although he still dates other girls, he said the baby has brought them closer. The baby's mother, still in high school, would like to think they will one day get married, said Robert. 

"She says, 'I hope he won't have to have a stepfather.' But I tell her that won't ever happen — even if we don't get married." 

Robert likes dressing up his son in the same style clothes he wears and glows when people say the baby looks like him. 

He imagines rearing his son to be just like him, minus the mistakes. "I just want him to follow in my footsteps. But I want him to play football in college." 

 

Myths Teens Have About Sex 

These are some of the incorrect beliefs many teen-agers have about pregnancy and sexual activity, according to local health officials. All of these are false. 

♦ You can't get pregnant the first time you have sex. 

♦ You can't get pregnant standing up. 

♦ You can't get pregnant if you have sex in the bathtub. 

♦ You can't get pregnant if you douche, especially with a soft drink, after intercourse. 

♦ The household cleanser "Comet" will kill venereal disease. 

♦ Carrying heavy items will stop a pregnancy.