- The Washington Times - Sunday, June 7, 2015

Sarah S. Brown, who has spent the past two decades battling the “intractable” social problem of teen pregnancy, is retiring in an unusual place: on top.

Unwanted teen pregnancies and births have not been eliminated in the U.S., of course, but Ms. Brown, the longtime chief executive of the National Campaign to Prevent Teen and Unplanned Pregnancy, has witnessed — and contributed greatly to — one of the best turnaround stories in public health today. Both teen pregnancy and birthrates are at historically low levels, having fallen by half over the past 20 years.

The “intractable” problem, Ms. Brown said in an interview, turned out to be treatable with smart public policy and the adroit use of media to change attitudes and influence behavior.

The use of media to address teen pregnancy has turned out especially well, Ms. Brown said in a recent interview.

“Millions and millions of teen girls and boys” have watched programs such as MTV’s reality show “16 and Pregnant,” she said.

Far from getting a glamorized or scripted view of teen parenthood, they got an unvarnished — and sobering — look at the strains of everyday life with a baby, she said. A 2010 study of 1,000 teens showed that almost half of the girls “agreed strongly” that watching such shows would cause them to “think harder” about avoiding pregnancy.

This and myriad other pregnancy-prevention messages in Hollywood productions, magazines, newspapers, TV shows and online media properties have helped sell the national campaign’s simple message that adolescence is not the time to become a parent, Ms. Brown said.

The mission

The National Campaign to Prevent Teen Pregnancy — its mission of addressing unplanned pregnancy was added later — was created in response to the alarming rise in teen pregnancy and birthrates in the late 1980s, when many thought the problem may have no solution.

“The epidemic of teen pregnancies and births where there is no marriage” is “our most serious social problem,” President Clinton said in his 1995 State of the Union address.

Indeed, data from the Guttmacher Institute, the nonprofit that promotes reproductive health, said the pregnancy rate reached almost 117 per 1,000 women ages 15 to 19 in 1990, a 10 percent climb from just four years earlier.

When Ms. Brown and academic Isabelle V. Sawhill sat down with like-minded allies, the problem looked intractable. But by the spring of 1996, they were ready to announce a national campaign that was nonpartisan, independent of government and privately funded.

The campaign also had a specific, ambitious goal: to reduce the teen pregnancy rate by a third by 2005.

Critics of the national campaign thought its board skewed too heavily toward birth-control advocates and would end up dismissing the benefits of sexual abstinence during adolescence. It would be sad if the campaign pursued only “a knee-jerk condom-distribution plan,” a spokeswoman for the conservative Family Research Council said in 1996.

But the national campaign forged ahead with former New Jersey Gov. Thomas H. Kean, a Republican, as chairman of the board, a mixture of right-leaning, centrist and left-leaning board members and Ms. Brown as one of its most public faces.

“We are not perfect, but we strive to include a variety of views” and be “big-tent and bipartisan,” Ms. Brown said.

The issues the council addressed — sex, pregnancy, relationships, birth control and babies — are “the core of human life,” she said. “I just don’t think any single group or person has all the answers” to all the questions.

The results

The steady decline in America’s teen pregnancy and birthrates has been viewed as a huge public health success story.

In 2009, the teen pregnancy rate fell to 65.3 pregnancies per 1,000 for ages 15 to 19, the lowest since the numbers were first tracked in 1976, the National Center for Health Statistics said in April 2014. Moreover, the pregnancy rate dropped by more than half in high-school-age teens, from 77.1 pregnancies per 1,000 ages 15-17 in 1990 to 36.4 pregnancies per 1,000 teens in 2009.

Guttmacher Institute data for 2010 found that the rates fell again, to 57.4 pregnancies per 1,000 for all teens and 30.1 pregnancies for high-school-age teens.

Teen birthrates plummeted, too, by 57 percent overall, with the result that there were “an estimated 4 million fewer births to teenagers from 1992 to 2012,” the federal government said in an August report.

Moreover, data from a May 2014 Guttmacher Institute report showed that the teen abortion rate fell too, from 37.4 abortions per 1,000 teens ages 15-19 in 1991 to 14.7 abortions per 1,000 teens in 2010.

Reasons for these declines include more teens choosing to delay sexual activity until after high school, the greater use contraceptives for the sexually active, the use more effective birth-control methods, and teens deciding to limit the number of sex partners.

In addition, Ms. Brown said, the national message campaign enlisted parents, teens, clergy, communities, schools, the media and public health officials to all deliver a consistent message: Adolescence is not the time to become a parent but a time to invest oneself in education, vocational and career development, and prepare to become part of a stable, two-parent family later in life.

New leader, new goal

Ms. Brown’s successor, Ginny Ehrlich, a former Clinton Foundation executive and current director of childhood obesity prevention efforts at the Robert Wood Johnson Foundation, will start as chief executive in August. She will take the reins of an organization that has dozens of funders, net assets of $39 million, according to its 2014 Form 990, and a top four-star rating from the Charity Navigator, which rates the effectiveness of philanthropic organizations.

Ms. Brown “is a hard act to follow,” Ruth Levine, director of the global development and population program at the William and Flora Hewlett Foundation, a longtime supporter of the national campaign, wrote this year.

The national campaign’s goal for 2020 is another 20 percent reduction in the teen pregnancy rate as well as a 20 percent reduction in the proportion of pregnancies of women under 30 that are “unplanned.”

Ms. Brown is optimistic about the goals because “fewer teen mothers beget fewer teen mothers.”

“One of the most powerful predictors of being a teen mother is if your own mother was a teen when she had you,” she said. “If you don’t see [teen pregnancy] as much, it doesn’t seem as normal a thing to do as expected.”

Ms. Brown said she will miss the people with whom she has worked over the years, especially during the heady days of the organization’s growth and the clear progress their work was making.

“This is not Pollyannish,” she said, “but I don’t think we’ve had any headaches here. I really mean that. This has been Brigadoon.”

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