Kansas saw another year of improvement in teen pregnancy rates, which have fallen dramatically since 2008, according to a report released in December.

"We are encouraged by the continued decline in the teen pregnancy rates for several Kansas counties and the state overall," Rachel Sisson, director of the KDHE Bureau of Family Health said in a statement. "KDHE remains committed to working closely with local partners and communities to identify, support and spread strategies and interventions that are making a difference."

While the state's pregnancy rates have dropped more than 50 percent since 2008, national teen pregnancy rates also have improved during that time, keeping Kansas slightly above the national rate. In 2017, pregnancy rates dropped among females ages 10-19, 10-17 and 15-17. But those ages 18-19 saw a 3.2 percent increase in pregnancy rates, according to the 2017 Kansas Adolescent and Teenage Pregnancy Report released in December by the Kansas Department of Health and Environment's Bureau of Epidemiology and Public Health Informatics.

The rate of pregnancies among teens ages 15 to 19 in Kansas, including live births, stillbirths and abortions, was 25.3 per 1,000 female age-group population, down from 25.7 in 2016.

The state recorded a total of 2,446 pregnancies among teens ages 15 to 19 in 2017, and 2,469 counting girls as young as 10. Teen pregnancies in the state have fallen every year since 2008, when there were 5,309 pregnancies among Kansas teens ages 15 to 19, and 5,371 among those 10 to 19.


Pregnancy programs

The Kansas Department of Health and Environment has several programs geared toward supporting pregnant teens and teen parents.

The Teen Pregnancy Targeted Case Management (TPTCM) program serves teens enrolled in Kan-Care with support to increase self-sufficiency and delay subsequent pregnancies until education goals are met.

The Lifting Young Families Towards Excellence (LYFTE) program helps teens and young families develop life skills, with a focus on health, education and employment.

The Abstinence Education Grant Program (AEGP) promotes abstinence, helps teens resist peer pressure and provides education about sexually transmitted diseases.

KDHE also promotes Power to Decide, a national campaign to reduce unplanned pregnancy that provides research-based information on sexual health and contraception.

"I do feel like the teen pregnancy management programs do help," said Lisa Goins, a registered nurse at the Crawford County Health Department, noting efforts to prevent or delay subsequent pregnancies among those who become parents as teens. "There are going to be some people who will get pregnant again, but the majority of them get their life together."

Programs to address teen pregnancy are affected by the controversy surrounding the topic, with political and religious beliefs and family expectations playing a role in how it is addressed.

"I think knowledge is power. It really is. It would be great if parents would share that, but if they don't feel comfortable, then have somebody else do it for them," Goins said.


Delivering change

Pregnancy rates vary throughout the state, with females ages 10 to 19 averaging 12.7 per 1,000 peer group population in Kansas. The highest rates are in Geary County (39.4), Greeley County (34.1) and Morton County (31.7). Several countries reported no teen pregnancies in 2017: Chase, Cheyenne, Gove, Graham, Hodgeman, Jewell, Lane, Lincoln, Ness, Ottawa and Wallace.

In Geary County, the pregnancy rate rose in 2017 from a five-year average of 33.8 per 1,000 peer group population. Jill Nelson, program director for Delivering Change: Healthy Families-Healthy, pointed to demographics as a contributing factor to the county's high rate of teen pregnancies.

"Geary County is actually one of the youngest counties in the state of Kansas because we have the Fort Riley military installation that sits in Geary County," she said. "We have a very young population just in general because of that."

Delivering Change receives about $70,000 a year in grant funding to administer the TPTCM program there, said program director Jill Nelson.

A case manager works with pregnant teens from the time of their first OB-GYN appointment through the first year of their baby's life, assessing their social and emotional needs and pointing them toward resources such as prenatal education and federal funding for food through Women Infants and Children (WIC). A case manager meets with a teen mother at least once a month, offering guidance on goals related to education, housing and work.

Geary County also receives $122,000 in federal funding through the LYFTE program, which supports young adults to age 24 and reaches young men as well as women, Nelson said.

She said the programs have been successful in helping young parents reach their goals and become stable.

"I think that building that relationship between the navigator and the participant helps them to know that somebody's on their side," she said.

Nelson also refers clients to the Konza Prairie Community Health Center for access to contraception and counseling on abstinence and natural family planning.

"Even if you have a pregnancy early on before you had intended, it should not become a stumbling block or something that prevents you from your long-term goals," Nelson said. "Sometimes those are the most motivated individuals because they want to do well."

Delivering Change was established in 2012 in response to high infant mortality rates in the county. During the past five years, the county's infant mortality rate has dropped 50 percent, Nelson said.

"I think everybody would like to see that trend continue going down," she said. "We want to make sure that women are ready and as prepared as you can be to become a parent."


Contributing factors

Christie Appelhanz, executive director of Children's Alliance of Kansas and a board member for Seaman USD 345, said improvements in teen pregnancy rates reflect shifts in sexuality education, which are changing to become more broadly focused on healthy relationships.

"The goal of most sexuality education programs in the U.S. is to decrease negative consequences of sexual activity — to stop the spread of sexually transmitted infections and decrease rates of teen pregnancy," she said. "These are worthy goals, but we don't believe they go far enough."

For the past seven years, the Children's Alliance of Kansas has received federal funding through KDHE for its Healthy Life Choices program, focusing on reducing pregnancy among teens in the welfare system. Funding for that program ended in September.

"It's hard to imagine that we wouldn't have an impact as a result of that," Appelhanz said.

Jason Wesco, executive vice president of Community Health Center of Southeast Kansas, said that while he would like to think improvements in teen pregnancy rates are a result of educational programs, he suspects contraception has played a bigger role in the decrease.

"We’ve done a lot of work to make contraception more easy to access, so I think that has to be a factor in all of this," Wesco said. "I would suspect it's a national factor."

Community Health Center of Southeast Kansas provides comprehensive teen pregnancy services in Crawford, Cherokee and Labette counties, with funding from the LYFTE and TPTCM programs and a Maternal and Child Health grant. In 2017, those counties saw teen birth rates of 12.5, 15 and 17.2 respectively, down from averages of 17.2, 19.9 and 19.1 during the past five years.

The organization has been providing prenatal care since it was founded in 2003. Among the services it provides, CHCSEK has incorporated digital badging, which uses mobile apps to track goals and earn points and incentives like diapers.

"It's gamifying learning," Wesco said.

Along with education and access to contraception, Vanessa Sanburn, executive director of Let's Talk, said social factors also play a role in pregnancy rates.

"Sex among teenagers is declining," she said. "Some people attribute that to kids being more on their phones and texting rather than being in the same room as partners."

Based in Lawrence, Let's Talk provides comprehensive sex education and support to school districts and parents and runs a text message-based support line for questions about sexual health or relationships. The organization tackles difficult topics, helping parents address such issues as consent and pornography with their teens, Sanburn said.

"I think the more comfortable people are talking about sexual health, the more critical thinking goes into decisions," she said. "The amount of critical thought and rational thinking that young people are using to make deliberate decisions about sex and relationships seems to have increased from my perspective."

Jonna Lorenz is a freelance writer. She can be reached at jonnalorenz@gmail.com.