Youth Violence Interventions

Prevention of Unintended Pregnancy

Babies born to teenage parents are at increased risk for a variety of health-threatening events, including physical, sexual and mental abuse, economic and educational deprivation, and neglect (Zabin 1995). The constellation of young parenthood, poverty, inconsistent parenting styles and erratic supervision by a single parent/family challenged to make ends meet will put the child at increased risk in these areas, all of which have been linked to an increase in violent behavior (Widom 1992, Zabin 1995). The United States has the highest unintended teenage pregnancy rate of any western, industrialized nation. It has been estimated that 80% of all teen pregnancies and 57% of all pregnancies are unintended (Brown 1995). Many adolescents become pregnant as a result of nonconsensual intercourse, itself a violent act (Dickerson 1995).

Teen pregnancy prevention programs were recently reviewed by the Institute of Medicine’s Committee on Unintended Pregnancy (Brown 1995). Although there are literally hundreds of programs operating in the United States, only 23 were judged by the Committee to have been properly evaluated using methodologically sound designs. These programs targeted a number of groups (middle to high school age, female and male, non-sexually active, sexually active, never been pregnant, currently pregnant and parenting) and were carried out in school, community and media settings. Eleven of the 23 evaluations demonstrated at least some positive outcomes (delay of first intercourse, increased use of contraceptives, delay of second pregnancy, increased education and employment). The goals and objectives of the rest of the programs do not appear to have been met, and the overall impact of the 23 programs was not clear. One project that demonstrated positive outcomes is the Elmira Nurse Home Visiting Program, discussed later in this paper.

Few programs have addressed the role of the male in unintended pregnancy, birth and parenting, although surveys suggest that males (even adolescent males) regard contraception as a shared responsibility (Brown 1995). Enforcement of child support requirements appears to be a particularly promising avenue of policymaking. Boys and men who are expected and required to provide for at least the economic needs of any jointly-produced children appear to be more willing to actively and consistently employ contraceptive methods than those who are not required to do so (Brown 1995).