Teen pregnancy: No easy answer

Published 8:00 am Monday, May 9, 2011

As teen pregnancy numbers fall in the state, officials are still trying to deal with the high numbers in Mower County, which are in the top 10. - Illustration by Eric Johnson

While teen pregnancy rates may be at a 40-year low in Minnesota, Mower County is near the top of the heap.

An alarming number of Mower County teenagers are getting pregnant, but many consider the problem a well kept secret.

“Our rates are significant when compared to other counties and the state,” said Margene Gunderson, director of Mower County Public Health.

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In 2009, teen pregnancy in Minnesota dropped to its lowest rate since 1970, at 24.3 births per 1,000 females age 15 to 19, according to a report released Thursday by Teenwise Minnesota. That was a 10 percent decrease from 2008.

But to Gunderson, that good news is little solace, since Mower ranks seventh-highest in the state.

Despite alarming rates, teen pregnancy is not being addressed as aggressively as many health officials would like. Few community groups are actively addressing it, and few see a problem, according to Gunderson.

“We’ve been in the top 10 for some time,” Gunderson said. In the 20 years she’s worked in public health, Gunderson said teen pregnancy rates have always been high in Mower County. However, she noted the county climbed into the top 10 more recently.

Mower has a pregnancy rate of 1 in 17 for teens ages 15 to 19, compared to the state rate of 1 in 27, according to public health statistics.

That breaks down to 1 in 37 for ages 15 to 17 compared to 1 in 53 statewide. For ages 18 to 19, the rating is 1 in 9 compared to the state’s 1 in 16 rate.

“We do have high teen pregnancy rates, but what I notice is among the 18- to 19-year-olds, it really rises,” Gunderson said.

Carol Holtz, chairwoman of Department of Family and Internal Medicine at Austin Medical Center, said it’s a common misperception that the Hispanic community is driving up the numbers.

“It’s not a race issue at all. It’s just across the board, well balanced,” she said.

Gunderson echoed this, noting rates can’t be traced to one group, race or social class: Teen pregnancies are happening in all demographics in Mower County.

That’s made it difficult to address the high rate, because it’s difficult to target one group.

“There really isn’t one profile that fits the person that’s going to experience teen pregnancy,” Gunderson said.

Young pregnancies may not end with teenage years. Volunteer coordinator Jan Johnson said Rachel’s Hope serves more women in their early 20s. The average age of women serviced at Rachel’s Hope is 23, though the center serves all ages, according to Johnson.

A costly concern

Some may question if teen pregnancy is a serious concern, especially since 18- and 19-year-olds are legal adults. But, it has proven expensive to taxpayers.

In 2004, teen pregnancy cost Minnesota taxpayers $142 million, according a report by the National Campaign to Prevent Teen pregnancy. From 1991 to 2004, more than 75,200 children were born to teen mothers at a cost of more than $2.3 billion.

Teen births cost an estimated $9.1 billion a year nationwide, according to the report.

That doesn’t calculate the effect on the teen mom. Teens who become pregnant are at a disadvantage, Gunderson said.

Statistics back this up, according to public health nurse Janne Barnett.

“The statistics basically say that they’re going to have a harder time,” she said.

Along with a risk of a pregnant teen not graduating high school, there are also concerns about a college education, job training and career aspirations, according to Gunderson.

In fact, Holtz reported four in 10 pregnant teens who worked with former AMC intern Kirsten Schmidt dropped out of school.

Schmidt, a University of Wisconsin-La Crosse graduate, worked to educate and assist pregnant teens during her internship. In almost all cases, she found her help was necessary.

“For the most part, they were not prepared,” Schmidt said. “They didn’t know a lot of the basics of what to expect, and they didn’t feel comfortable going to the prenatal classes by themselves.”

Schmidt tested the teens before and after her efforts, and all showed an increase in knowledge.

The uncertainty affects the baby, too. Health officials consider teen pregnancies high-risk, but another concern is the mother’s nutrition.

Many teens don’t eat a balanced, nutritious diet, and Barnett said that can affect the pregnancy. Calcium intake is a concern for teens and young women, and Gunderson noted a young pregnancy can lead to anemia.

“If pregnant mom isn’t having proper nutrition, that is a risk factor for early delivery and low birth weight delivery, and those are two concerns that we have in the public health world because their nutrition is really bad, some of them,” Gunderson said.

Women trying to get pregnant should be taking prenatal vitamins and folic acid.

“When they’re unintended pregnancies, you’re missing all that pre-care,” Barnett said.

In many cases, teen pregnancy doesn’t end with one child. In fact, Barnett said about 17 percent of teen births in the state are subsequent births.

“That’s not a good thing,” Barnett said.

Barnett and Gunderson noted teen births tend to create a cycle.

“If you are the product of a teen pregnancy, you are likely to have a teen pregnancy,” Gunderson said.

Barnett said some public health employees have worked with two generations of teen mothers. However, Gunderson said there is a silver lining when trying for prevention.

“If we prevent one teen pregnancy, we might prevent the cycle of continuation,” Gunderson said.

Knowledge is the first step

Despite high teen pregnancy rates, few community efforts are underway to address the problem.

“People sort of acknowledge it, but nobody’s working on it,” Gunderson said.

That may be largely due to the nature of the subject. People are largely uncomfortable talking about sex, which is traditionally a touchy subject to address in some families, Gunderson noted.

“People need to see it as an issue that needs some work, and I’m not so sure people believe that teen pregnancy is around,” Gunderson said.

Discussion will be a key. Along with talking about sex, Gunderson said talks must also address life and career goals.

“We’re equipping them with information about how to avoid alcohol and drugs,” Gunderson said. “We need to equip them with how to deal with decisions about their sexuality.”

Gunderson noted the schools have other issues besides teen pregnancy.

From her experience at AMC, Holtz agreed there needs to be more local action.

“I wish there was a little bit more traction for some community action,” she said.

“It needs to be a community effort,” she added.

That may be easier said than done. Along with sexual education in the classroom, schools often partner with agencies like the Parenting Resource Center. However Maryanne Law, executive director, said those efforts aren’t as prevalent as they once were, largely because of funding reductions.

“The funding is just ending for prevention programs,” Law said.

Still, Schmidt said there’s no clear-cut solution.

“There really is no easy answer to this,” Schmidt said.

Look for the final part in this series Monday in the Herald.