- May 23, 2023
- Jennifer Salerno
It’s been nearly a year since the U.S. Supreme Court overturned Roe v. Wade in the hallmark Dobbs vs. Jackson Women’s Health Organization case. Last June, the landscape of pregnancy care and reproductive health in America changed significantly.
In honor of National Teen Pregnancy Prevention Month, we’re revisiting the topic of youth sexual health with a renewed focus on development, including prevention efforts for both professionals and parents. (Spoiler alert: you’ll notice a theme of “early and often” for both!)
Updates About Teen Pregnancy
Teen pregnancy in the U.S. has been declining for the past 3 decades, due in part to fewer teens being sexually active and more teens using one or more forms of birth control. Still, there is work to be done in reducing teen pregnancy rates in all communities. Disproportionate rates of teen pregnancy exist among youth in foster care, homeless youth, and LGBTQ+ youth, and for any adolescent who becomes a parent, the social and economic costs in the near- and long-term are high.
Teen mothers are more likely to:
- Have lower school achievement and/or drop out of school
- Have more health problems
- Be incarcerated during adolescence
- Face unemployment as a young adult
So, when health professionals meet with youth with unplanned pregnancies, they have many questions. What risks do I face and how can I stay safe? What resources can help me care for this baby? What if I’m not ready to be a parent? What if I am? These questions are deeply personal and impact the rest of one’s life.
But –
What if we allow ourselves a moment to ask other questions in this post-Roe era? Questions that might help us understand better how to decrease the number of unplanned pregnancies from occurring in the first place? Questions that move us from reaction to prevention?
Many professionals and parents of youth grapple with what they can really do to prevent teen pregnancy and encourage safer sexual behavior. It can be hard to know which tools to use and which questions to ask to prevent risk behaviors from occurring and resulting in adverse outcomes, like sexually transmitted infections (STIs).
Sexual Health in Youth Starts with Education About Development
Prevention starts with education.
In the graphic above, we see the interdisciplinary nature of sexual health – there aren’t just icons for birth control pills, though that’s one important piece. Sexual health is about the physical, mental, and emotional development of a person as they progress through puberty and beyond. That’s why we see icons representing healthy foods, exercise/weight training, meditation, medical checkups, screeners (checklists), and more.
Sexual health is far more than educating youth about sexual intercourse and the risks associated with having unprotected sex, engaging in sexual activity at an early age, and having multiple sexual partners. It includes education about development.
For example, parents are typically the first ones to educate their daughters about their first menstrual period (menarche). Often, boys learn about this major milestone much later from school-based health professionals, or perhaps from an older sister.
Sexual health should include age-appropriate conversations about sexual development in both girls and boys and come from both parents and professionals. In most developed countries, menarche occurs between the ages of 10 and 16. Imagine the difference between a 10-year-old girl who has never had a single conversation about periods and one who has had multiple conversations over time with both her parents and healthcare professionals. The former may feel fearful of the sudden change in her body and experience emotional distress related to what has just occurred and what this means for her. The latter may still feel unsettled at the big change (because getting one’s period is a big deal), but she will be equipped with the knowledge and support to deal with it.
Educating youth about menstrual cycles is just one component of encouraging healthy sexual development. It is also important to have conversations about physical exercise, healthy eating, the risks associated with social media use, the relationship between teen pregnancy and alcohol, making informed medical decisions, understanding and honoring consent, intimate partner violence, and more.
Sexual Health Screening: Early and Often
In October 2022, the U.S. Preventive Services Task Force published new anxiety screening recommendations for clinicians:
| The USPSTF recommends screening for anxiety in children and adolescents aged 8 to 18 years. |
While there is not currently a parallel USPSTF recommendation for youth sexual health screening, clinicians agree it is best practice to have conversations about sexual health and development early and often. One of the most effective tools for engaging in conversations about sexual health is to use standardized screening tools that target specific age groups and risk areas.
Healthcare Professionals: Ask Youth About Sexual Health During Routine Appointments
Studies show healthcare professionals are missing a key opportunity in teen pregnancy prevention efforts during routine appointments by not talking about it. While it may seem obvious to begin conversations about sexual health and reproductive services in checkups with the pediatrician or family physician, multiple studies show this isn’t usually happening, and when it is, conversations are very brief.
A recent (2021) study published in the Journal of the American Academy of Pediatrics found that
a majority of adolescents and their parents considered conversations about puberty, sexually transmitted infections, HIV, and birth control important, yet less than one-third of youth reported actually discussing these topics at their most recent preventative visit.
These conversations are a critical part of teen pregnancy prevention, increasing sexual health knowledge, and encouraging safer sexual behavior.
If you’re a youth healthcare professional reading this and feel like you don’t know where to start when talking with teens, consider utilizing a standardized screening tool and brief intervention system that youth can interact with from their own devices. Imagine the improved outcomes for the youth you serve. The Adolescent Counseling Technologies for Sexual Health (ACT-SH), shown in the graphic below, helps professionals engage youth with a set of questions that identify risk factors and then participate in interactive, tailored, evidence-based counseling for safer sexual behaviors.
Equipping Parents
Parents, there are age-appropriate ways to talk about sexual health with your younger children, older children, and tweens. We’re not asking you to teach your 8-year-old how to use a condom!
However, discussing puberty and body changes, private parts, consent (“no means no”), personal hygiene, and more are all important components of creating a safe environment where questions are welcome and children learn to appreciate and respect their bodies and others’ bodies.
TeenSpeak is an excellent resource to help parents confidently connect with their teens about common risks, including sexual health. It offers a variety of educational and interactive materials and training options to improve parent-teen relationships. Teens who feel connected to their family have less drug use, delay sex, and have less depressive feelings leading to suicide.
Learn More
The CDC identifies teen pregnancy prevention as one of its top 7 priorities or ‘winnable battles’ in public health. Prevention efforts include continuing education and increasing awareness. It also includes utilizing targeted risk screeners to identify youth who are engaging in risky sexual health behaviors so professionals can intervene effectively with evidence-based brief interventions.
We are proud to be part of the solution. Adolescent Counseling Technologies for Sexual Health (ACT-SH) identifies sexual health risk behaviors resulting in high incidence of sexually transmitted infections (STIs) and unintended pregnancy, in addition to risk factors contributing to unsafe sexual decision making. Youth receive a greater understanding of their own sexual risk behaviors, potential outcomes, and an opening for discussing their sexual behaviors and experiences. ACT-SH works with professionals to quickly meet sexual health screening requirements by providing standardized, evidence-based screening and risk counseling in just 7 minutes.
Curious how ACT-SH can help your team? Get in touch today.