Hope found in fighting teen-age pregnancy Negative tests signal key time to intervene

January 10, 1996|By Diana K. Sugg | Diana K. Sugg,SUN STAFF

Maybe the teen-age girl has an upset stomach that she believes is morning sickness, or she notices another telltale sign. She's scared, and she goes to a clinic for a pregnancy test.

The girl is like thousands of other high-risk teen-agers who had been regarded as almost impossible to identify, let alone reach with advice and counseling intended to keep them from becoming mothers too soon.

Researchers now say that first pregnancy test, administered at the school or community clinic, presents a key opportunity to intervene. Almost three of five adolescent girls in a nationwide survey had received negative test results at clinics before they became pregnant, according to a study published in today's Journal of the American Medical Association.

The study from the Johns Hopkins School of Public Health looked at more than 2,900 teen-agers under age 17 at 52 clinics. For the first time, researchers were able to show that a surprising number of girls were going to clinics and receiving negative pregnancy tests. Among a subgroup who eventually conceived, one in four had negative tests at clinics site before the pregnancy.

"That's staggering," said Dr. Robert Blum, professor of pediatrics and director of the adolescent health program at University of Minnesota. "There is a huge window of opportunity that we haven't taken advantage of. Clinicians have often viewed a negative pregnancy test as a reprieve and often said, 'Well, kids are just too relieved at that moment in time to do much contraceptive education.' "

In response to the study, Dr. Peter Beilenson, Baltimore health commissioner, said he planned to look into ways to intensify services for teens who have negative pregnancy tests. The city oversees about 20 clinics that serve several thousand adolescents.

For years, experts have tried various methods of combating the increasing problem of teen pregnancy. They have worked to reach teen-agers at schools and in the community, with mixed results. Earlier studies had found that sexually active teens often took as long as a year to get to a clinic.

The new finding emphasizes the importance of the clinic, said Laurie Schwab Zabin, the lead author and a professor in the department of population dynamics at the Hopkins School of Public Health. She said the intervention with teen-agers needed to be significant, including counseling, education and follow-up.

Dr. Zabin is testing which methods are most effective.

In the community, experts say little money is available but that reaching girls as early as elementary school is crucial. "We've got to pull back and begin earlier with them," said Rosetta Stith, ++ director of Baltimore's Paquin School for Expectant and Parenting Adolescents. "They're going to go 90 miles an hour, they're going to go into that wall unless you intervene earlier and talk to them about options, choices and consequences."

Most teen-agers who have children say they don't want to, Dr. Zabin said. It's not that they don't understand the facts of life. Some are in situations where they can't believe they will ever realize their dreams, so they don't go to the trouble of avoiding pregnancy.

Others, like Constance Warren, never thought it would happen to them. The Baltimore woman, 18, said she became sexually active at 13 and pregnant at 15. She used birth control sporadically.

Officials with Planned Parenthood of Maryland, which has seven clinics, say they work to counsel and educate their clients, the majority of whom are females 15 to 28.

"This kind of study does, frankly, underscore exactly the approach that we've been taking for a long time and hopefully should help us in articulating why it's so important that we continue to provide these services," said Sana F. Shtasel, president and chief executive officer.

Meanwhile, Ms. Warren goes to school, works and raises her 2-year-old daughter, Tatiana.

"I try my hardest to deal with it," she said. "As a parent you have your ups and downs. I would not recommend someone to go through it. It's hell. But you have to learn how to deal with that and how to take responsibility for your actions. My action was to have a baby, and now I'm taking responsibility for that."

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