What Actually Works?

Shirley Bogard was an impressive teenager in the Kentucky Baptist church where I was pastor. The church awarded her its scholarship for the most deserving teenager so she could train as a nurse. She was a devoted Christian, and she became a super-competent nurse.

Shirley, now Shirley Martin, became the nurse in Louisville and Jefferson County’s Teenage Parent Program (TAPP)—a middle school and high school for pregnant students. She hired my wife, Dot, who is also a nurse, to work with her, teaching the teenagers prenatal nutrition, healthy child-raising, and how not to get pregnant again. They worked in the ob/gyn clinic held in the school two days a week: The girls got regular medical examinations, without having to leave school and their studies.

A University of Louisville School of Medicine study reported that, surprisingly, unlike typical teenage mothers, TAPP’s teenagers produced healthy babies averaging normal birth weight. Premature babies are highly expensive when they require intensive care and are more likely to have learning problems and medical problems later in life. TAPP prevented that. It was enormously cost-effective.

And 99 percent of these girls chose not to have an abortion. By contrast, the official Centers for Disease Control and Prevention report for 1998—the year of the Louisville study—concludes that 75 percent of pregnant teenagers younger than 15 years old, and 39.1 percent of teenagers 15 to 19 years old, terminated their pregnancies with abortions. The abortion ratio in TAPP, with girls 12 years old and up, was a remarkably low 1 percent. TAPP gave pregnant teenagers a way to continue school while taking care of their babies, and while building an economically viable future. The clear result was that they chose not to have abortions.

The school had a nursery, so the girls could attend school regularly without having to worry about who would care for their babies. They each worked one class period a day in the nursery, thus receiving expert instruction in care for babies. Two trusted social workers counseled the girls, helping them plan their futures, stay in school, and complete their diplomas. The girls had much lower dropout rates and much lower drug addiction and suicides than typical teenagers.

While the preferred goal, especially among teenagers, is prevention of unintended pregnancy, the Teenage Parent Program provides a striking example of how to reduce abortion rates:

• 80 percent of women who have abortions say they did not intend to get pregnant. TAPP had remarkable success in preventing almost all of its girls from getting pregnant a second time while still in school.

• Most who have abortions say they could not afford to raise a child. The Guttmacher Institute reports that “poor and low-income women account for more than half of U.S. abortions.” TAPP’s social workers helped its girls plan a viable future.

• Many worry about how to afford health care for themselves and their babies; TAPP provided ob/gyn care and nurses to counsel them about medical needs.

But the catch is how to pay for a school like TAPP. The public school system paid for the usual education—English, math, history, etc. Medicaid and the State Maternal Health Division, supported by federal funding, paid for most of the ob/gyn clinic. Ominously, in 2002 federal funding for the ob/gyn services was canceled, and the state could not afford it alone. The ob/gyn program is no longer available to students without insurance or Medicaid, and no nurses are teaching any more.

The support that was provided by TAPP, in many ways, is echoed when the nation adequately provides programs such as SCHIP (health insurance for children), health insurance for all ages, child care assistance, as well as food stamps and WIC (Women, Infants, and Children).

IN ADDITION TO DOT’S experience with TAPP, our family has another reason to know personally how crucial support for pregnant women and children is in preventing abortions. In the eighth week of Dot’s third pregnancy, she got rubella (German measles). Rubella in the first trimester of pregnancy is likely to be devastating for the baby’s heart, brain, sight, and hearing. But we did not have an abortion because we had hope we could cope.

Our son David was born with a heart that failed in his first month; odds were against his survival. He has had a dozen operations, two on his heart. He did not speak, mumble, or chew until he was 4 and a half years old. He has brain damage. He is legally blind. But we had enormous support from church members, medical personnel, the Kentucky School for the Blind, and caring teachers, and we had medical insurance and a job. Now David translates theological books from German to English for leading publishers and for researchers.

That is why I worried enormously when the Bush administration cut back crucial supports for mothers and babies. I suspected it would increase abortions among those who did not have the kind of resources our family had. The government’s official reports for 2002—the first full year of the Bush administration—had not yet been published, but I found 16 states that had reported. Based on these states, I published two articles predicting that although the number of annual abortions had declined significantly in the previous decade, the reductions would stall and abortions would actually increase in 2002. Some people attacked my findings harshly, claiming that when the complete data for 2002 was released, I would be proven wrong.

But the official government CDC report is now published. As I had predicted, the number of abortions did increase in 2002. And though the abortion rates for teenagers declined from the mid-1980s through 2000, they actually increased from 2001 through 2005. Though the abortion rate for all women was going down dramatically through 2000, it stalled at 15 per 1,000 from 2000 through 2005. And though the infant mortality rate had been steadily decreasing for six decades, it actually increased in 2002, for the first time ever. Furthermore, the economy is so devastated now in 2009 that more pregnant women may conclude they cannot afford a baby and thus choose to have an abortion.

The Obama administration is expanding health care insurance for children and is developing plans to provide access to health insurance for all of us, is working to get the economy revived, and is supporting programs to curb unintended pregnancy. If abortions reduced significantly during the Clinton years, stayed flat during the Bush years, and reduce significantly during the Obama years, what is a consistent pro-life person like me to conclude about which approach actually works to reduce abortion rates?

Glen Stassen is the Lewis B. Smedes Pro­fessor of Christian Ethics at Fuller Theo­logical Seminary in Pasadena, California, and author of Living the Sermon on the Mount: A Practical Hope for Grace and Deliverance.

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