Two college-age women in jeans and sneakers walk gingerly into the waiting room and plop down in front of the television.
They whispertogether while they wait for the nurse. One of the sophomores at Anne Arundel Community College is here for a gynecological exam. The other tagged along to provide moral support. Both are a little nervous.
Edie Segree sticks her head around the corner and senses the tension. The 51-year-old outreach coordinator of Healthy Teens, a pilot program to reduce adolescent pregnancy and infant mortality in Annapolis, is a pro. She makes a few friendly comments, then eases the firststudent into the examining room.
Segree is used to dealing with nervous girls by now. In the last year, she's counseled hundreds of them -- 12-year-olds who drop by to talk about their periods, 16-year-olds who come for birth control, 19-year-olds who fear they're pregnant.
The small clinic inside the Stanton Center on West Washington Street is filled with comfortable chairs, magazines and posters. One of the pictures tacked on the wall shows a pregnant girl missing graduation. The caption warns: "Clothes won't be the only thing you can't get into."
Girls in the neighborhood stop by to chat with Segree and Nadine Smith, the 40-year-old program director. They ask questionsthat they're afraid to ask at home. Can you get pregnant while on your period? How do you stop a guy from pressuring you into sex? How doyou make your boyfriend wear a condom?
Sometimes boys drop by, too, although they're often more uncomfortable. Smith and Segree directthem to the teen center down the block, where two men from the community dispense condoms and advice.
"There's a lot of misinformation, a lot of wrong ideas out there," said Smith, who took over the Annapolis program last January.
"The difference between this and traditional family planning centers is that we're very involved in the community, and we try to include the men. We try to teach responsibilityand self-esteem, so they make the right choices."
Annapolis was one of three sites chosen for Healthy Teens in July 1989 when the state stepped up its efforts to combat adolescent pregnancy. Similar programs were set up in the Mondawmin Mall in Baltimore and in Cheverly in Prince George's County. The areas were targeted because they had alarmingly high teen pregnancy and infant mortality rates, said Dr. Russell Moy, director of maternal health and family planning for the Maryland Health Department.
In Annapolis' 21401 and 21403 ZIP codes, 12 out of every 1,000 newborns die before age 1. Annapolis is one of four communities in Anne Arundel County that have higher infant deathrates than the rest of Maryland, which has the ninth-highest rate inthe United States.
State health officials have found high infant death rates go hand-in-hand with teen pregnancy. Both are more commonin neighborhoods with large poor and working-class communities.
Even though prenatal care, nutrition counseling and financial assistance are widely available, many women living in poorer neighborhoods fail to get proper health care, Moy said. Without counseling, they're also likely to continue unhealthy habits -- skipping meals, smoking cigarettes, drinking or using drugs -- that can lead to premature and underweight babies.
"The concept of Healthy Teens was preventive care," Moy said. "We wanted to get people involved in the system, to improve their attitudes toward health care, and to actively reduce teenpregnancy."
The state General Assembly awarded three successive $1.6 million grants to Healthy Teens. Health officials hope to continue the program for another three years, but are uncertain of its future until a new state budget is approved.
"I didn't want any more kids, but still, I ended up with another one."
Davonya Parker is 18, unmarried and the mother of two boys.
The first time she visited the clinic at the Stanton Center, she was 15 and had just given birth to her first son, now 3. She wanted to avoid another pregnancy.
"Yeah, I was nervous," the Eastport resident recalled with a shy smile. "But it's a nice place, real relaxed. I felt all right talkingto them."
She received a prescription for birth control pills, but stopped taking them because she started feeling sick. She forgot the nurse's admonishment to use an alternate form of birth control.
At age 16, she became pregnant with her second son.
Determined notto have more children, she now comes in for regular checkups and is using birth control. She wants to return to high school to get her diploma.
Davonya is one of more than 325 girls under 19 who have turned to the clinic for gynecological exams, counseling and birth control since it opened in 1989. An additional estimated 325 women betweenthe ages of 19 and 24 are regular patients.