For years, Baltimore has struggled with epidemic levels of teenage pregnancy that rob young women of a chance to continue their educations or pursue careers. And it's not just the mothers who pay a price. The costs to society of teen pregnancies are enormous. Children born to girls who are barely out of childhood themselves are more likely to grow up in poverty, develop health problems, experience failure in school or come into contact with the criminal justice system. Addressing the cumulative effects of all these poor outcomes can cost cities and states millions of dollars a year.
That's why we are heartened by recent evidence that Baltimore is making progress toward reducing teen births. As The Sun's Meredith Cohn reported earlier this week, teenage birth rates in Baltimore have fallen by more than a third over the last five years, a decline that mirrors a similar drop in teen births nationally. Though the city still faces enormous challenges in sustaining that progress, the trend lines appear to be moving in the right direction.
Health officials say falling teen birth rates stem from several factors, including more robust sex education in middle and high school and better access to health care and counseling services for adolescent girls. But the biggest driver in the decline has been teens' increasing use of long-acting, reversible contraceptives, particularly IUDs. The nation's gynecologists recently updated their clinical recommendations to enable teens and young women to access birth control pills and IUDs more easily, and because the IUD is far more effective than either the pill or condoms, in their typical use, the results have been dramatic.
Baltimore is home to six federally qualified health centers that serve a large part of the city's Medicaid and low-income population. Until three years ago, however, none of them offered long-acting reversible contraceptives. Since then the city has ramped up capacity at three of the centers and brought in contractors to help train service providers and work with clinicians to make the full range of contraceptive methods available to teens.
In addition, the city has mounted a major public information campaign to educate teens about the choices they have and how to access contraceptives. Health officials are working with the school system, Planned Parenthood and health clinics to implement an evidence-based sex education curriculum that will be standardized across the city. They're also encouraging young people to spread the word through social media to get their peers to visit school-based health centers or neighborhood clinics for more information.
Despite evidence of progress, however, there is still much to be done. Teen birth rates for African-American and Hispanic girls, for example, are still two to three times higher than those for their white counterparts, even though they are declining at a much steeper rate. And the data suggest that the hardest to reach teens are also the most vulnerable: Those living in unstable, violent neighborhoods who have already dropped out of school to take care of a child. It's vital that health officials identify them and address their needs as quickly as possible so they can avoid a second unplanned pregnancy.
Over the long term, Baltimore's goal should be to forge ahead of the curve by achieving a teen birth rate that is actually lower than the national average. That will require expanding the current effort to make the full range of counseling and contraception services available at all six of the city's federally qualified health centers. The city also needs to make sure the services it offers are "culturally competent" to engage the young people it is trying to reach, be it through social media or more traditional public information campaigns. That's particularly important for fast-growing demographics such as Hispanic teens.
Young people need to understand and take responsibility for their actions, know where to go to get accurate information about effective contraceptive methods and what the stakes are for them and their partners if they don't. The city must reach out to them in a way that builds up demand for the services it is offering, which are useless if nobody knows or cares about them. That's the challenge Baltimore faces if it is to succeed in reducing teen births by making free, effective contraception available to the young people who need it.