Teen pregnancy visionary steps down

Teen pregnancy dropped to historic lows under Sarah Brown's leadership

One advantage to being a reporter is, people generally feel obliged to return your phone calls. Not always, but often enough that you can learn interesting and important things.

Sarah Brown always returned my phone calls.

The head of the National Campaign to Prevent Teen and Unplanned Pregnancy is stepping down after 20 years. That alone tells you how long she has been at the other end of the phone for me: We pretty much raised our kids together, holding hands in the dark tunnel that adolescence can be for parents. She helped me keep my kids safe.

And plenty of other kids, too.

Since peaking in 1990, the teen pregnancy rate has declined by 51 percent and is at a historic low. There has been progress in all 50 states and in all racial and ethnic groups and even in the most disadvantaged communities.

What was once considered an intractable problem has become, under Sarah's leadership, possibly the most successful social welfare campaign in history. The pace of progress in reducing teen pregnancy is actually accelerating.

"This organization under her leadership has gone from nothing to being one of the preeminent organizations in the field," said Isabel Sawhill, who hired Sarah two decades ago after reading a report she wrote for the Institute of Medicine on the consequences of teen pregnancy.

"I thought she had it just right," said Ms. Sawhill, who was working at the Office of Budget and Management when President Bill Clinton said in his State of the Union address that teen pregnancy was the nation's most pressing social problem and asked her to find a solution.

"It started with just the two of us and an assistant in an office somewhere," said Ms. Sawhill. Now at the Brookings Institution, she is president of the campaign's board. "She had a keen sense of what was likely to work."

What Sarah envisioned was an evidence-based program, long on data and short on dogma.

"It wasn't advocacy," said Sarah. "It wasn't fueled by emotion. This is not a partisan problem, and we wanted to find ways to reach across a whole bunch of divides."

She and her team saw teen pregnancy not as a moral issue but a child welfare issue. The evidence was showing how difficult it made life for the children but that it also interrupted the education of the mother, putting her forever at an economic disadvantage.

Why has the program been so successful? Sarah points to a list of reasons, from the recession to MTV shows like "16 and Pregnant." From IUDs and implants to a change in social norms.

"We don't entirely understand what drives these rates up and down. I think there is a little bit of magic in all of this," she said. But if she had to choose one indispensable tool, it would be the campaign's decision not to demonize the media, but to embrace it. Both entertainment and digital.

"When we began, the Internet really didn't exist for us. Now it is the dominant force in the lives of teens. We understood that this was a big country and this was a big problem and you couldn't solve it by going door to door with pamphlets."

That, and the campaign stayed close to its target audience — teens. Only by understanding how they think and how they live could there be any hope of influencing their behavior.

What does Sarah see in the future? Why not just declare victory and go home?

"We may have reached the tipping point, but what if we haven't? This could be a self-sustaining decline, but what if it isn't? Complacency is very risky," she said.

Despite the campaign's success, unplanned pregnancy rates remain high among older teens, among black and Hispanic teens and in high poverty areas. In addition, some 20-somethings and 30-somethings appear to be mysteriously uninformed about how to prevent a pregnancy, and unwed births among older women are climbing.

One answer, she believes, is long-term birth control. The medical community has now endorsed IUDs and implants for teen-agers, as well as older women.

"That changes the default for these young people," she said. "Now you don't have to do something every day or every time to not get pregnant. You actually have to make a decision and do something to get pregnant."

Sarah's three daughters and my two kids followed the sequence we believed would help them succeed in life: education, career formation, marriage and then kids. We crossed that magic finish line.

I feel like we did it holding hands.

Susan Reimer's column appears on Mondays and Thursdays. She can be reached at sreimer@baltsun.com or @SusanReimer on Twitter.com.

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