Air Date: Week of August 18, 1995

After a decade of being officially unconcerned by global population growth, the US has taken new initiatives to help cut high fertility rates in developing countries. But here at home, we have some very high fertility rates of our own, particularly among teenagers — 6 percent of women and girls in the US between the ages of 15 and 19 give birth each year, a higher rate than in Asia and triple the teen fertility rate in Europe. Jennifer Ludden of member station WBUR in Boston explores the reasons for this, and what makes the difference in communities with low teen birth rates. *This piece originally aired August 1994.

Transcript

NUNLEY: This is Living on Earth. I'm Jan Nunley, in for Steve Curwood. Ten billion people by the year 2050, nearly double today's global population. Along with this common projection by population experts come dire predictions about the environmental impact of such growth. For over a decade, the US was officially untroubled by world population growth. Now the Clinton Administration wants to cut high fertility rates in developing countries. But the US has some very high fertility rates of its own, particularly among teenagers. Six percent of US women and girls between the ages of 15 and 19 give birth each year. That's the same rate as Ecuador and Rwanda, higher than in Asia, and triple the teen fertility rate in Europe. We asked Jennifer Ludden of WBUR in Boston to explore the reasons for this, and what makes the difference in communities with low teen birth rates.

(Baby: "Mm, ba ba." Babbles, with a young woman answering.)

ELLIS: My name is Betsy Ellis, and I'm 21. I have 3 children. My daughter's 5, and I have twin boys that are 2.

(Children playing; one begins to cry. Ellis: "You're fightin' with me, huh? I love you. I love you." Baby: "Ba ba." Ellis: "Kissy, kissy.")

LUDDEN: Betsy Ellis laughs nervously, her large, brown eyes look directly at you when she speaks. She says growing up in Haverhill, Massachusetts, no one in her family talked about sex. Except to tell her not to do it.

ELLIS: I got on the Pill at age 14, but my father told me that that gave me permission to have sex and that I shouldn't be on the Pill and took them away from me. But that didn't stop me, 'cause I was young and I was, you know, I just wanted to be loved like most teenagers.

LUDDEN: Of her first pregnancy, Ellis says she didn't understand, didn't comprehend the details of sex or its consequences. She gave birth and continued in a rocky relationship with her daughter's father. Then, almost on schedule, according to the statistics on teen mothers, Ellis became pregnant again.

ELLIS: I wanted a baby. I wanted another baby. My daughter was 3 and she was out of the baby stage, and I guess like, well, I thought that it would bring our relationship closer together if I had another baby.

LUDDEN: Has it?

ELLIS: No.

LUDDEN: What's happened?

ELLIS: I just came out of a battered women's shelter. And our relationship's basically ended.

LUDDEN: Betsy Ellis's story is typical, a by-the-book profile of a teenage mother in the United States: a country with the highest adolescent pregnancy, birth, and abortion rates of any developed country. It's estimated a teenager has a baby in the US every 67 seconds. What's more, analyst Jeanie Rosoff of the Ellen Gutmacher Institute says half of all US pregnancies are unplanned.

ROSOFF: In a country in which well over 90% of people are practicing contraception, it's kind of unusual. Clearly, we think we should be practicing contraception and we are, but we're not doing it very well. We do, I think we do it sporadically.

LUDDEN: Rosoff blames this in part on US health care plans, which often don't pay for contraceptives. And what she calls an inexplicable low tolerance here for birth control. Yet much of the cause is the same that plagues Third World countries with exploding populations. Young American women, say experts, are more likely to have babies when they have less education, few economic opportunities, and little hope for the future.

(Traffic sounds; a church bell rings)

LUDDEN: This church bell tolls every hour in Haverhill, a largely white, working class community north of Boston, where about half the residents are Catholic. Here, unemployment runs above the state average, while incomes lag behind. Fewer than one third of residents complete college. And every year, 80 of every 1,000 women in the area have a baby, a rate close to that in some developing countries where population growth is considered dangerously high.

(Office sounds; a telephone rings. A conversation between 2 women: "That's about the IUDs, okay?" "Okay." "So, kind of look at all that, and...")

LUDDEN: Lorraine Christenson sends another patient home with information on contraceptives. The women's center here at Haverhill's Hale Hospital was strictly OB/GYN. But 2 years ago it added family planning because, Christenson says, many women were returning with repeat pregnancies, citing the same reasons as teens.

CHRISTENSON: It's that need to be accepted. It's that changing of partners, oh maybe this guy will come in, and he told me he wants me to have a baby. I don't really want to have a baby but he told me he'll be here for me. Well, often even before the pregnancy is even done with, this guy's gone out the door. Or maybe, I'll see the same father's name pop up on two or three different women.

LUDDEN: Christenson talks of a culture of increasing acceptance of teen mothers, in which young motherhood is repeated generation after generation; and pregnant students, even in middle schools, are revered by peers. She sees women routinely ignore the economic dependence that comes with teen motherhood, and instead glorify the independence and control over their lives they believe they will gain.

CHRISTENSON: It's a way of getting their own apartments. It's cool to have a boyfriend come and visit you at your apartment, you know, and things like that. They look past all the taking care of the baby and all that responsibility and everything, and they look at let's see, now, what will this bring me that's different and bring attention to me.

(Traffic sounds)

LUDDEN: The city of Newton, Massachusetts, is an hour south of Haverhill by car, and a world away in attitude. Full of upwardly mobile, white-collar families, it boasts the lowest birth rate in the state despite having no public family planning center and little sex education in the schools. At Newton-Wellesley Hospital, the largest OB/GYN provider here, Department Chief James Beresford says typically, the women he sees put off having children until their careers are established. Those seeking contraceptives, he says, are well informed.

BERESFORD: I think in Newton population, they probably researched it, and they come in and say well, I think this is the one for me. And you usually agree with them because they're usually right.

LUDDEN: What Newton also has that Haverhill lacks are teenagers with a solid sense of control over their future. Nineteen-year-old Alexandra Zane takes the Pill faithfully and says she's not ready to be a mother.

ZANE: My goals are basically just to, for school, really, to be educated. Part of me wants to go to med school, so, I mean, my long-term goals are just to be successful. I mean I want to do everything, you know? So...

LUDDEN: If it's cool to have a baby in Haverhill, it's definitely not in Newton, according to Zane. She and a friend recently baby-sat another friend's 3-year-old daughter.

ZANE: My friend and I took the little girl to Dunkin Donuts. We ran into a girl whom we knew at school, and the girl thought that it was one of ours. And the attitude that we got was unbelievable. The looks, you know, the staring, the "Oh " so, is this yours?"

LUDDEN: The kind of attitudes that prevail in Newton may be more the exception than the rule. The average teen birth rate in the US is closer to that of Haverhill. For many organizers of the Cairo conference on population and development, the key to bringing birth rates down in the developing world is to give women better opportunities for education and economic development. In the US, much of the focus is more narrow: increasing access to contraception, and forcing men to take responsibility for their sexual behavior and for out of wedlock children. Yet increasingly, here as in the Third World, experts say the key to fewer unplanned pregnancies is what they call empowerment: expanding opportunities for women. For Living on Earth, I'm Jennifer Ludden in Boston.