Fewer babies on board

Tracy Weeber remembers when her children reached the point of adolescence that some parents dread, when they might come home and tell her that she’d be becoming a young grandmother.

That didn’t happen, however. Her four kids—now between 20 and 24 years old—avoided teen parenthood, as have a growing number of 15- to 19-year-olds statewide, particularly in Butte County.

Weeber is a clinical nurse specialist at Enloe Medical Center, where she’s worked extensively in the maternity ward. She credits the health class her children took in high school as having had a significant impact in her household. In a unit on sex education, Weeber explained, upperclass students calculate the cost of raising a child from birth to age 18. For extra credit, they can carry a simulated baby, which cries when it needs something.

“I know that was a deterrent for my children, once they figured out how much it would cost and what it meant,” Weeber said.

Fewer teens in California are facing the challenges of parenthood. According to the California Department of Public Health, the state’s birth rate for adolescent mothers has dropped to record-low levels. Data recently released by CDPH show a 2014 rate of 20.8 births per 1,000 females ages 15-19, a drop of 10 percent since 2013 and 55 percent since 2000.

Butte County falls below the state rate. For the three-year period of 2012-14, the rate for California was 23.4 births per 1,000; the county’s was 20.2. Marin County has the lowest (7), and Kern the highest (45.1).

“It’s interesting because overall for health outcomes, Butte County is really poor,” Weeber said, referring to medically tracked conditions such as addiction, obesity, smoking and chronic disease. “So it seems to fly in the face of those statistics that our teen birth rate is down.”

It’s hard to pinpoint exact causes for the trend, though. Ann Dickman of Butte County Public Health offered some possible explanations.

First, the fertility rate in general has decreased, in the county as well as the state, “so that’s just part of that same trend,” said Dickman, director of maternal, child and adolescent health. The state birth rate for all women, not just teens, fell to 13.1 per 1,000 in 2013, versus 15.6 in 2000 and 20.6 in 1990.

Particularly for young women, Family PACT may be having an impact.

The Legislature established the Family Planning, Access, Care and Treatment program through the Office of Family Planning in 1997 to provide confidential services to low-income residents. This state-funded support helps teens and adults obtain birth control and educational counseling, including from clinics such as Planned Parenthood and Women’s Health Specialists.

Whether eligible for Family PACT or not, teens know about such resources.

“I know [for] Planned Parenthood, the word is out,” Weeber said.

Beyond pills and condoms, providers offer longer-lasting contraceptives such as Depo-Provera injections and Nexplanon implants.

With these newer choices, or the IUD (intrauterine device), “a woman doesn’t have to remember to take something every day,” Dickman said. “She’s covered regardless—and there’s a belief in our [public health] system that if we can get teens on something like that, they’re going to get more effective birth control.”

Holly Kralj, a local certified nurse midwife on the faculty at Chico State, sees a shift in attitude along with medical changes.

“A lot more teens are comfortable using birth control and probably it’s more socially acceptable,” said Kralj, who has teenagers among her patients. “It used to be more of a taboo for women to be on birth control—it implied they were promiscuous—and I don’t think that’s the case anymore.”

This, in turn, has yielded an increased sense of openness. Kralj (pronounced “cry”) notices the difference in speaking with teen girls at Enloe Women’s Services.

“In general I’d say they are more comfortable with their sexuality,” Kralj said, “and I see a lot of teens coming in with moms to talk about birth control…. I would imagine that young women who are able to talk to parents about birth control have an easier time not getting pregnant.”

Beyond what they might learn in health class, adolescents have greater access to education.

“With the Internet, I think teens are more savvy,” Kralj said. “If you wanted information on something, that’s easy to get, you don’t have to feel embarrassed—you can Google it…. And there’s probably more peer pressure in using birth control, in a positive way.”

If so, that could be due in part to ongoing outreach efforts Dickman’s department undertakes. For instance, Health Education Specialist Tou Chanh makes presentations at high schools and health fairs as part of Public Health’s Family PACT services.

Whatever the reasons, Dickman sees the decline as “good news” from a public health perspective. Not having a baby in adolescence means “teens being able to finish their schooling, set goals and accomplish them,” she said.

“We know there are many teen moms who do great,” Dickman added. “But we know for some moms, this does tend to be the end of the road for them; they end up being caught in a cycle of poverty and hopelessness.

“Obviously, fewer women being in that position is great.”