Peer leaders at UCSF's New Generation Health Clinic at a recent Brava Theater event.
While acceptance of teen pregnancy in middle-class communities has increased in recent years, this is not the case in many underserved African American and Hispanic communities.
The decline in stigma can be attributed in part to the media. There are a number of teen blogs that encourage the idea of becoming pregnant, and last year’s hit film Juno, which was released in theaters, shows a teen going back to life as usual after having a baby. Unintended pregnancy often plays out differently for young women from underserved groups.
Recently, young women from an ensemble group called Glass Diamonds — a collaborative project of the New Generation Health Center (NGHC), UCSF’s National Center of Excellence in Women’s Health (COE) and Brava! for Women in the Arts — used media to showcase their stories in a holiday production called Girltropolis, a multimedia work highlighting issues of access for young women to reproductive health.
The ensemble is made up of urban underserved youths who present the issues they face, including depression, violence, peer pressure, career planning, sexism, self-esteem and educational barriers, in a performance. The teens were brought together through their visits to New Generation Health Center.
Founded in 1974 as a one-day-a-week teen clinic at San Francisco General Hospital, New Generation Health Center provides confidential, youth-friendly reproductive health services. The center also seeks to educate community youths about the risks of teen pregnancy and sexually transmitted infections and support research studies that focus on adolescent reproductive health issues.
The majority of NGHC’s clients are from underserved San Francisco neighborhoods, which include the Mission District and Bayview-Hunters Point. These are also areas of the city that report the highest rates of teen pregnancy and sexually transmitted disease.
The center reaches out to underserved urban youths ages 12 to 24. It serves more than 5,000 clinical reproductive health patients annually. Roughly 10 percent of their patients are male, and about 12 percent of their patients have limited English proficiency.
One of the organization’s goals is to allow teens to make informed decisions about their reproductive health. According to the US Bureau of Labor Statistics, teen pregnancy is a major contributing factor in child poverty rates. A child has a 27 percent chance of growing up in poverty if the mother was a teen parent. Teen mothers are less likely to graduate from high school or college, compared with women who postpone childbearing until later in their lives.
Addressing Health Disparities UCSF has singled out serving the community as one of seven major directions in the UCSF Strategic Plan. Its vision is to work at the local, regional and global level to eliminate health disparities.
In this case, the economic disparity faced by a teen mother correlates with health disparity. UCSF is taking a lead in conducting health disparities research, which includes examining the correlation between teen pregnancy and poverty within a culturally appropriate context.
At the recent Health Disparities Research Symposium at UCSF, findings from a study on unintended pregnancy were presented.
Several studies show that African American and Hispanic women thought of unintended pregnancy as a problem for the advancement of their communities and neighborhoods.
“Based on studies, unintended pregnancy in the African American and Latino communities is considered to be problematic,” said Allison Bryant, MD, assistant adjunct professor, UCSF Department of Obstetrics, Gynecology and Reproductive Sciences. “Low-income African American postpartum women in our focus groups talked about the issues of lack of education and a breakdown of the family paradigm. Some women described a link between this breakdown and the lingering legacy of slavery that they felt continues to impact the family dynamic in their communities.”
While the NGHC understands that a pregnancy impacts a teen mother’s life the most, it also acknowledges that reproductive health is deeply tied to culture and that views about it are community-specific. Often, underserved teens are not able to take advantage of the resources afforded to more affluent communities.
“If you take a movie like Juno, it demonstrated the impact of adolescent pregnancy in some settings, but the depiction of some features of that teen’s circumstances, including excellent social and financial support and the ability to continue one’s education uninterrupted, is probably not entirely reflective of the social situation that many urban and low-income teens find themselves in if and when they have an unplanned pregnancy,” said Bryant.
According to national statistics, more than 40 percent of teenage mothers report living in poverty at age 27. The rates are especially high among African American and Hispanic adolescent mothers, more than half of whom end up in poverty and two-thirds of whom find themselves on welfare.
“All research indicates that our targeted group — low-income young women of color from the ages of 14 to 24 — are systematically denied access to the information and support that would help them make healthy choices in many aspects of their lives,” said Anita Lopez, education and outreach manager of New Generation Health Center. “These teenagers and young women often do not have high expectations and, most importantly, the means to achieve them. These factors lead to greater risk of unintended pregnancies or infection by HIV or STIs.”
UCSF is addressing risk factors by providing expertise and health outreach to these teens. Whether through performance outlets, counseling or medical care, the idea is to allow the teens to make informed decisions.
This spring, NGHC, in conjunction with COE, will present the Young Women’s Health Conference. The free conference is open to all young women, who can choose to attend workshops on positive sexuality, issues of violence and career decisionmaking, among others.
“We want people to know that we are really in the community and are identified as really being part of the community,” said Lopez. “UCSF allows us to provide quality resources like great doctors and interns, and we provide the connection with the community.”
