There’s no great mystery about why teen births have been declining steadily in Shelby County for 15 years.
“Education and contraception work,” said Ashley Coffield, CEO of Memphis Planned Parenthood.
But leaders of local organizations that have worked successfully to reduce teen birth rates and improve teen birth outcomes are concerned.
Federal and state funding for local prevention efforts, including comprehensive sexual and reproductive health education in schools, began drying up before the pandemic.
Providers of safe, effective and affordable (often free) methods of birth control are worried that conservative state legislators, emboldened by the end of federal abortion protections, will seek more restrictions.
“And due to COVID-19, sexual and reproductive education has become practically nonexistent over the last two years,” said Cherisse Scott, founding CEO of SisterReach. “What we fear is that we will see a spike in pregnancies, youth dating violence, and STI transmission as early as next year. Add to that the overturning of Roe v. Wade. That option will no longer be available to young people.”
The number of teenagers who give birth in Shelby County has declined by more than half in the past 15 years, from more than 2,000 a year to fewer than 1,000.
“Teen births have been declining, but so have abortions, and that’s important. Many women who get an abortion had a contraceptive failure,” said Claudia Haltom, a retired juvenile court judge, and founder of A Step Ahead Foundation.
Since 2011, the organization has provided more than 7,000 women with long-acting reversible contraceptives that are more than 99% effective.
“Contraception works, but only if it’s widely accessible and affordable,” Haltom said. “Now that abortion has been banned in so many states, I’m very concerned that legislators will go after contraceptives next.”
Pregnant teenagers face higher risks of eclampsia, systemic infections and other life-threatening complications.
But Tennessee law now prohibits all abortions with no exceptions. A physician who provides an abortion can be charged with a felony. If charged, the physician must prove the procedure was necessary to save the mother from death or serious risk.
Most Tennessee schools, meanwhile, are not required to teach sex education. Districts with higher teen pregnancy rates (including Memphis-Shelby County Schools) must teach a family-life curriculum that stresses abstinence. A state law allows parents or guardians to “opt-out” of sex education classes, as well as any LGBTQ-related instruction.
Funding for Be Proud! Be Responsible!, reproductive and sexual health and safety classes offered in MSCS schools, ended in 2020.
“Legislators are making it more difficult to have honest conversations about safe and healthy sexuality, and the consequences of that could be huge,” said Lisa Moore, president and CEO of Girls Inc. in Memphis.
Moore notes that 40% of LGBTQ teenagers report they have attempted suicide. So have 12% of high school girls in general.
She also notes that teenagers who give birth are many times more likely to be poor and undereducated and stay that way.
“Girls have a right to understand how their bodies work and to have autonomy over their bodies,” Moore said. “Having a child as a teenager can be emotionally and financially devastating. But the laws are tying our hands.”
Frayser highs and lows
Teen births put Memphis in an international spotlight a decade ago.
A local TV station reported that 90 students who attended Frayser High School were pregnant or had recently given birth.
“The stunning number means nearly 11 percent of the school’s approximately 800 students are already experiencing the trials of parenthood,” WMC-TV reported in January 2011.
The “stunning” report was repeated in national news broadcasts, British newspapers, and on NBC’s “Today Show.” It was even referenced in an episode of “Glee.”
The report was misleading.
There were dozens of students at Frayser High who were pregnant or had recently given birth, but all were part of a districtwide alternative school to help those students stay in school.
Local school officials, citing privacy concerns, never confirmed the exact number of pregnant students in the district at the time.
Given that 1,802 teenagers gave birth that year in Shelby County, there likely were more than 90 pregnant students at any given time.
But the sensationalized 2011 news reports never mentioned that the county’s teen birth rate actually had been declining since 2008.
“It’s important to remember — regardless of the # of pregnant teens — this started because our community was working to address it,” then-Memphis Mayor A C Wharton tweeted in 2011.
That work continues.
The county’s teen birth rate has dropped by more than half from 65.8 (per 1,000 births) in 2005 to 31.7 in 2020 (the most recent statistics available locally).
Teen birth rates have fallen dramatically across the state and country as well. Nationally, the teen birth rate has declined from 61.8 to 15.4 in the past 30 years. Tennessee’s rate has dropped from 62 to 23.7 during that time.
“We’ve made huge strides in Memphis, and that success is the result of many factors, many people and organizations working separately and together to reduce teen births,” said Kellie Spilman, director of the Early Success Coalition.
Staying a step ahead
The “stunning” 2011 story about Frayser High was inaccurate, but it did intensify local efforts to address teen births and outcomes.
A Step Ahead Foundation was established later that year. So was SisterReach, which supports reproductive health and autonomy for women of color, LGBTQ and women in rural areas.
That same year, Tennessee was one of 17 states that received extra federal funding to design programs to improve outcomes for teen mothers and their children.
Shelby County government launched a $4 million program to hire social workers to connect pregnant teens and teen mothers to support services. The program also provided prenatal care in high schools.
But organizations in Shelby County were addressing issues related to teen pregnancy long before “Glee” took notice.
In 1916, members of the Church of the Nazarene opened the Bethany Home to provide food, shelter, and counseling for unwed mothers and their children. The home closed in 2006.
Girls Inc. was founded in 1946 to help girls ages 5-18 become happy and successful adults. It provides after-school and in-school programming, including health education, and pregnancy, drug. and violence prevention, for about 2,000 girls every year.
“Our girls are not getting pregnant; they are graduating from high school baby-free, and they are staying healthy and going on to post-secondary education,” Moore said. “It’s proof that the most effective way to prevent teen pregnancy is through comprehensive sex education and comprehensive programming.”
Planned Parenthood of Memphis has been operating in Memphis since 1938, when it was known as the Memphis Birth Control Association. Last year, 1,297 patient visits were ages 19 and younger.
The organization is the largest provider of comprehensive and LGBTQ-inclusive sex education in the state. Its two health centers offer low-cost emergency contraception, and free, long-acting birth control, including IUDs, implants and birth control shots. Last year the organization also supplied more than 600,000 free condoms.
“Condoms are a very effective way to prevent both STIs and pregnancy, and our goal is to make them widely available through many partners including SisterReach,” Coffield said.
Collective action and concern
Local efforts to reduce teen births and improve teen birth outcomes increased dramatically three years before the Frayser High story.
In 2008, the Urban Child Institute convened the Mid-South Collaborative on Adolescent Pregnancy, Prevention, and Parenting.
The collaborative soon changed its very long name to Memphis Teen Vision (MemTV). Its work was directed by the Center for Research on Women at the University of Memphis.
Their goal: “A future where all teens are taught comprehensive sex education, teens’ onset of sexual intercourse is delayed, teen pregnancies are reduced/eliminated, and teen parents are provided assistance.”
MemTV brought together more than three dozen local organizations from multiple perspectives, including abstinence-only education programs and abortion service providers.
In 2010, Le Bonheur and MemTV launched Be Proud! Be Responsible! Classes on reproductive and sexual health and safety were provided to thousands of local teenagers in schools, churches, and community centers.
“Be Proud” ended when funding ran out in 2020. MemTV has been “on hiatus” ever since. The U of M’s Center for Research on Women ceased operations several years ago.
“Once again, SCS youth are without consistent and dedicated sexual and reproductive health education or staff in the schools,” Scott said.
Shelby County public school districts are required by state law to teach a Family Life Curriculum twice a year to students in grades 4-12.
Local districts use the Michigan Model Family Life Curriculum, also known as the Family Life AIDS/HIV curriculum. The scripted, abstinence-centered course is taught by district teachers, nurses and staff.
This story first appeared at dailymemphian.com under an exclusive use agreement with The Institute.