Everyone knows the rules--when you ride the bus, you have to ignore everyone else. If someone walks by, don't look at them. If someone farts, don't laugh. If they sit down next to you, just stare out the window. Above all, don't do anything to interfere with everyone else's ignoring. Don't bump into people, don't talk on your phone if you don't have to, and absolutely DO NOT talk to the person sitting next to you. Today I was riding the 54C from where I live to the Southside. I watched as a young woman struggled to board her stroller onto my bus, all the while trying to catch hold of the wrists of two toddlers that were with her. The process took over a minute, which, as you must know, is a severe breach of bus etiquette. I noticed the man in front of me check his watch. I also noticed the crowd of lunchtime hospital employees, students, and other Oakland regulars milling about outside, at the bus stop.
Fifth and Atwood is probably one of the most diverse stops in town, socioeconomically. Medical residents and homeless people share the bench, while middle class nurses and career dishwashers smoke their after- and before- work cigarettes. And there they all were this morning, chatting on their cell phones or staring lifelessly ahead, watching this young woman struggling.
Why did no one, out of all of us looking on, step up to give her a hand? Clearly, she could have used the help. We all either watched her shoving the stroller or we looked back down to the news we were reading, ignoring the situation entirely. Every one of us were either afraid to break the status quo (those sacred city rules of staring straight ahead) or else were far too wrapped up in our own issues to take much notice.
This is the kind of attention, the mix of hesitation and indifference, that is paid to teen pregnancy. Although the situation could easily be considered a crisis (billions of dollars lost to it, hundreds of thousands of girls being shortchanged and children being brought into disadvantaged homes), in the eyes of most people it's just an everyday problem. Any efforts to prevent teen pregnancy will require communicating the problem to an audience that can make a change. Effective communication dictates speaking to the audience from their perspective. When communicating the risks of teen pregnancy, "Crisis Communication" (as defined in Risk Communication) would be over-the-top dramatic. Because it's an everyday problem to most people, the authority of the communicator would be compromised--he or she would likely be laughed at! Teen pregnancy prevention communication falls most squarely into the "Care" and "Consensus" realms of risk communication. It's a subject that has been studied thoroughly, with volumes of information (just look here for an idea of just how much). Unfortunately, there is currently no clear-cut ensured method of prevention. For example, there are strong arguments both for and against abstinence-only sex education as well as for and against handing out contraceptives to teens. This kind of disagreement necessitates "Consensus Communication."
25 September 2007
Teen Pregnancy: Defining the Problem
With three-quarters of a million cases each year in the United States alone, teenage pregnancy is truly an epidemic. That’s 750,000 girls between the ages of 15 and 19, girls largely without any sufficient means of supporting themselves, let alone an infant. Teenage pregnancy not only leaves young girls and their children utterly hopeless, it also is a tremendous drain on local economies. Special health care, housing, and many other needs add up to an estimated $30,000 required of taxpayers for each baby born to a teenager. And, with an average of 15,000 teenage births each year in Pennsylvania, the burden is tremendous—$450 million per year!
Like an aging population or an occasional flooding, teenage pregnancy is an expected expense. It’s considered inevitable: as long as there are teenagers, there will be pregnant teenagers too. Despite the fact that Pennsylvania youth are well-educated on the consequences of sex—every student in public schools is required to attend a sex-education course—pregnancy rates have remained high over the last two decades. The fact is, the detriment is not so much a lack of knowledge as it is a lack of positive influences. Without role models to show them that pregnant teenagers are not the norm, the disadvantaged youth will never reach a higher standard.
Although we can’t change what these teens are exposed to everyday in their neighborhoods and on television, or what they hear from their cynical parents (anything from “You’ll never amount to anything” to “You’ll end up just like I did, pregnant at 17”) we can help them by exposing them to different viewpoints. Some kind of mentoring program—offered through school, community foundations (like Big Brother, Big Sister), or religious organizations—that infiltrates the lives of teenagers with positive role models and good influences is an option. Only by shooting for the roots of the problem, lack of knowledge and poor influences, can any effective change be made.
Like an aging population or an occasional flooding, teenage pregnancy is an expected expense. It’s considered inevitable: as long as there are teenagers, there will be pregnant teenagers too. Despite the fact that Pennsylvania youth are well-educated on the consequences of sex—every student in public schools is required to attend a sex-education course—pregnancy rates have remained high over the last two decades. The fact is, the detriment is not so much a lack of knowledge as it is a lack of positive influences. Without role models to show them that pregnant teenagers are not the norm, the disadvantaged youth will never reach a higher standard.
Although we can’t change what these teens are exposed to everyday in their neighborhoods and on television, or what they hear from their cynical parents (anything from “You’ll never amount to anything” to “You’ll end up just like I did, pregnant at 17”) we can help them by exposing them to different viewpoints. Some kind of mentoring program—offered through school, community foundations (like Big Brother, Big Sister), or religious organizations—that infiltrates the lives of teenagers with positive role models and good influences is an option. Only by shooting for the roots of the problem, lack of knowledge and poor influences, can any effective change be made.
tossing around ideas
Some problems are just going to be around forever. So long as there are new shoes, there will always be freshly discarded gum waiting in the parking lot. Difficult in-laws, teenage pregnancy, even bad hair the morning of class pictures (and don’t forget death and taxes)—they’re all inevitable, just part and parcel of life. Too often the inevitable is just given up as impossible; some problems are just too big, too inescapable to bother.
But before giving up, imagine you were in a terrible accident and you wake up in the hospital unable to feel anything below your waist. Horrified, you listen as the doctor tells you that you’ll likely never walk again. “There’s a small chance that, given some time and a series of operations, we might can help you. But there’s really not much we can do.” Do you think you’d concede: Since the odds are against improvement, why bother? Of course not! You’d rally with that ounce of hope and say You’d sure as hell better do everything you can!
Precisely because there’s something we can do—even if that something is so small it hardly makes an impact—we have to try. It’s true: as long as there are teenagers, there will be teenage pregnancy. Adolescence is an age when we believe we are immune to everything. Even kids in the worst situations harbor some small hope that they’ll be something different than their mom, their older sister, than everyone they know. But patterns are passed down through generations because we learn by imitating what we see. It is critical that young girls (and boys, too) have positive role models and good influences somewhere in their lives, in addition to proper sexual health education.
Although I’ve never been directly affected by this problem, several people in my life have been (and I would bet that several people in your life have been, too, whether you’re aware or not). I feel very strongly about the issue of teenage pregnancy and the heartbreak associated with it.
My interest in women’s health extends beyond preventative measures for teenage pregnancies into a number of other areas in obstetrics (that’s the field of medicine concerned with everything about pregnancy). Recent volunteer experience at the Midwife Center has raised my awareness about the practice of midwifery, and I am concerned that the general public has too little knowledge of this form of obstetrical care. Most people (including myself until recently) think of midwives as archaic, some background character in some old story from the middle ages. The fact is, midwives are very much present in today’s healthcare scene. They offer an alternative to typical hospital obstetrical care—a very welcome alternative. Most often, delivery in hospitals is a very impersonal way to bring your child into the world. Hospital care of obstetric patients centers on a single, ultimate goal—the good health of mother and child. Certainly, this should be expected, and is all many mothers-to-be would (think to) ask for. But what about the experience? The most meaningful moments in the lives of some women is in the birth of their children. (Certainly not to discount the meaning of women’s lives—there is far more to us than having babies. Just note that the experience of giving birth can be incredibly emotional and moving—and meaningful.) Even when they pose absolutely no risk, obstetricians grimace at the thought of giving in to a patient’s wishes if they’re unorthodox or not in line with hospital policy. Midwives, while also primarily concerned with the good health of mother and child, tend to be much more relaxed and open to a patient’s wishes. Experiences with midwives are described as more fulfilling and warmer—yet so few women are aware of their options for pregnancy care.
A third issue is somewhat involved with the previous one. Due to legislation, Certified Nurse-Midwives are still not allowed to write prescriptions for basic medicines. Although they have training equal to that of other practitioners that do write prescriptions, some stigma against midwives as being untrained semi-professionals remains. I think this issue ought to be broached, explored, and ultimately fairly resolved.
But before giving up, imagine you were in a terrible accident and you wake up in the hospital unable to feel anything below your waist. Horrified, you listen as the doctor tells you that you’ll likely never walk again. “There’s a small chance that, given some time and a series of operations, we might can help you. But there’s really not much we can do.” Do you think you’d concede: Since the odds are against improvement, why bother? Of course not! You’d rally with that ounce of hope and say You’d sure as hell better do everything you can!
Precisely because there’s something we can do—even if that something is so small it hardly makes an impact—we have to try. It’s true: as long as there are teenagers, there will be teenage pregnancy. Adolescence is an age when we believe we are immune to everything. Even kids in the worst situations harbor some small hope that they’ll be something different than their mom, their older sister, than everyone they know. But patterns are passed down through generations because we learn by imitating what we see. It is critical that young girls (and boys, too) have positive role models and good influences somewhere in their lives, in addition to proper sexual health education.
Although I’ve never been directly affected by this problem, several people in my life have been (and I would bet that several people in your life have been, too, whether you’re aware or not). I feel very strongly about the issue of teenage pregnancy and the heartbreak associated with it.
My interest in women’s health extends beyond preventative measures for teenage pregnancies into a number of other areas in obstetrics (that’s the field of medicine concerned with everything about pregnancy). Recent volunteer experience at the Midwife Center has raised my awareness about the practice of midwifery, and I am concerned that the general public has too little knowledge of this form of obstetrical care. Most people (including myself until recently) think of midwives as archaic, some background character in some old story from the middle ages. The fact is, midwives are very much present in today’s healthcare scene. They offer an alternative to typical hospital obstetrical care—a very welcome alternative. Most often, delivery in hospitals is a very impersonal way to bring your child into the world. Hospital care of obstetric patients centers on a single, ultimate goal—the good health of mother and child. Certainly, this should be expected, and is all many mothers-to-be would (think to) ask for. But what about the experience? The most meaningful moments in the lives of some women is in the birth of their children. (Certainly not to discount the meaning of women’s lives—there is far more to us than having babies. Just note that the experience of giving birth can be incredibly emotional and moving—and meaningful.) Even when they pose absolutely no risk, obstetricians grimace at the thought of giving in to a patient’s wishes if they’re unorthodox or not in line with hospital policy. Midwives, while also primarily concerned with the good health of mother and child, tend to be much more relaxed and open to a patient’s wishes. Experiences with midwives are described as more fulfilling and warmer—yet so few women are aware of their options for pregnancy care.
A third issue is somewhat involved with the previous one. Due to legislation, Certified Nurse-Midwives are still not allowed to write prescriptions for basic medicines. Although they have training equal to that of other practitioners that do write prescriptions, some stigma against midwives as being untrained semi-professionals remains. I think this issue ought to be broached, explored, and ultimately fairly resolved.
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