Thirty years ago, the small town of Denmark, S.C., had one of the state's highest teen pregnancy rates.
"We had very young grandparents, grandparents were maybe [in their] 30s," says Michelle Nimmons, who has worked for the past 30 years on the issue of teen pregnancy. "Great-grandmamas were in their 40s, and parents were in their teens, so a lot of education had to happen."
Efforts like hers have paid off in Denmark and around the country in the past couple of decades. Since the 1990s, teen pregnancies have decreased by more than 50 percent, as a recent policy brief from The Brookings Institution reports. In 2011, the CDC reports, "329,797 babies were born to women aged 15–19 years," a number the CDC calls a "record low."
Despite those declines in the United States, the U.S. still has one of the highest teen birth rates in the industrialized world, says Forrest Alton, chief executive officer of the South Carolina Campaign to Prevent Teen Pregnancy.
"Frankly, it's not even close," Alton says. "We certainly can pause for a moment to celebrate the progress that we've made, but by no means should we wash our hands of this issue and think we have it solved."
Denmark now has one of the lowest teen pregnancy rates in South Carolina, and now every student there gets comprehensive sex education starting in middle school. But those changes were hard-fought over many years.
Nimmons tells NPR's Rachel Martin that the biggest challenge to reducing teen pregnancies has been getting people to acknowledge that there's a problem in the first place.
"Remember, South Carolina is the Bible Belt ... [and] churches are the central focus of the community," Nimmons says. "We had to convince parents that we were really just wanting to reinforce the values that they were teaching in their homes. Because we truly believe that abstinence is the best option for young people, and that's what parents want for their children."
Teen pregnancy is not only about young women, and Nimmons says they recognized this and focused their program on the boys in the community as well. She says the boys also needed to understand the consequences of having unprotected sex, both emotional and financial.
"We have sessions where young men and young ladies are there talking together and learning the curriculum together, because it's important for them to have those conversations," she says.
Though Nimmons isn't afraid to meet teenagers where they are when it comes to talking about sex, not all adults are comfortable in those conversations. So, some former students help by acting as mentors for current students.
The program relies on local businesses — some owned by those former students — to help carry its sex education message, too. For example, while part of the program is promoting the use of condoms, distributing condoms in South Carolina's schools is not permitted. That's where local businesses can step in, to help make condoms available.
Despite the Denmark program's success, Alton says, "there's still a tremendous amount of work left to be done."
Alton wants more funding for teen pregnancy prevention programs to send a clear social message to kids that abstinence is best, but that safe sex is a must. And, he says, parents still need to get better at having honest and early conversations with kids about sex, and about the risks and responsibilities that come with it.
RACHEL MARTIN, HOST:
We're going to talk now about a positive public health story here in the United States. This is how things used to be in Denmark, South Carolina.
MICHELLE NIMMONS: We had very young grandparents, grandparents who were maybe 30's. Great-grand mamas were in their 40's and parents were in their teens, so a lot of education had to happen.
MARTIN: That's Michelle Nimmons with the Bamberg School District. And she's worked for the past 30 years on the issue of teen pregnancy in South Carolina. And efforts like hers that paid off around the country in the last couple decades.
Since the 1990s, teen pregnancies have decreased by more than 50 percent. Today in her town of Denmark, South Carolina, every student in public school gets comprehensive sex education starting in middle school. But that change and others were hard-fought over many years. Michelle Nimmons says one of the biggest challenges to reducing teen pregnancies has been getting people to acknowledge there is a problem in the first place.
NIMMONS: Now, remember South Carolina is the Bible Belt and we have a small rural community that is isolated. Churches are the central focus of the community. We had to convince parents that we were really just wanting to reinforce the values that they were teaching in their homes because we truly believe that abstinence is the best option for young people, and that's what parents wanted for their children. That's what churches say is best.
MARTIN: And this is not just about young women. I mean we think of teen pregnancy, we think of girls because they're the ones who inevitably end up bearing the burden. But your program, you made an effort to focus on boys, as well. Why was that a priority and what did that end up looking like?
NIMMONS: It was a priority because we understood that it involved both genders. Young ladies weren't getting pregnant by themselves. And we felt it was important for the young men to understand what the consequences were when they engaged in sexual behaviors and did not contraceptive effectively. They don't get to walk away from a pregnancy and not have emotional scars or financial responsibilities. So, we have sessions where young men and young ladies are there talking together and learning the curriculum together because it's important for them to have those conversations. Role playing is a large part of that because they need to become comfortable with whatever their refusal message is going to be. They need to have an opportunity to practice that so that when they find themselves in that real-life situation - hey, this is what I said I was going to say to get myself out of this, to communicate my message to my partner that this isn't what I want or to negotiate condom usage.
MARTIN: I understand condoms cannot be legally distributed in South Carolina schools. Where are young men getting access to condoms now? Are you engaging local businesses? What kind of businesses are helping?
NIMMONS: We have a barber shop that's owned by two former students of ours. And they have been open and welcoming to us in that they allow us to put the condoms in their barber shop and they notify us when the supply is running low. They've gone through the program. They're now in their early 40s. They remember the conversations we had with them. They have been positive role models for the young people in our community in that they both have volunteered to be recreational coaches in the community. So, the young men feel comfortable with them. We have a beauty parlor that does the same thing - another former student owns that. And we have a Laundromat that is a couple of hundred feet away from the high school. And we just drop them. And kids know on the way home walking, they can go in there and pick them up too.
MARTIN: And lastly, I wonder if you have noticed after all these years the level of sophistication change, how kids talk about sex. Has it become more open? Are kids more comfortable talking about it to the point where it's pushing you and your colleagues perhaps out of your comfort zones?
NIMMONS: Well, Rachel, times have definitely changed. But one thing I have always said to my staff, never let them see you flinch. And they say things to see if this old lady is going to flinch. And I find it hilarious because that's just my cup of tea.
NIMMONS: You want to go there, we can go there, kind of thing. But you got to know what the proper terms are also. And we have to stay current because they come up with different terms for everything all the time. It's just definitely a different world now.
MARTIN: And even though Michelle Nimmons isn't afraid to meet teenagers where they are when it comes to talking about sex, not all adults are that comfortable in those conversations.
FORREST ALTON: Sometimes, despite the progress that we've made, we still get a little tongue tied on these issues.
MARTIN: This is Forrest Alton. He's chief executive officer of the South Carolina Campaign to Prevent Teen Pregnancy. He says despite the declines we've seen in the United States, we still have one of the highest teen birth rates in the industrialized world.
ALTON: Frankly, it's not even close. So, we certainly can pause for a moment to celebrate the progress that we've made but by no means should we wash our hands of this issue and think we have it solved. There's still a tremendous amount of work left to be done.
MARTIN: Alton wants more funding for teen pregnancy prevention programs, a clear social message to kids that abstinence is best, but safe sex is a must. And, yes, he says parents still need to get better about having honest and early conversations with our kids about sex, the risks and the responsibilities that come with it.
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MARTIN: You're listening to WEEKEND EDITION from NPR News. Transcript provided by NPR, Copyright NPR.