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Mississippi tops the national rate for teen births in 2020

Mississippi again leads the nation in teen births despite declining rates both in the state and across the country.

Mississippi’s rate has dropped significantly in the past two decades, but it still lags behind the rest of the country. In 2020, the most recent year for which data is available, Mississippi teens gave birth at a rate nearly double the national average, according to data from the Centers for Disease Control and Prevention.

Advocates and a former state senator point to Mississippi’s unchanging and, in their view, lackluster sex education law.

Although curricula for core subjects like math and science are reviewed and updated every five years, the Mississippi Department of Education has not approved any new sex education curricula in more than a decade.

Josh McCawley, deputy director of Teen Health Mississippi, a policy and advocacy group focused on adolescent sexual and reproductive health, said this inaction means Mississippi’s sex education content is seriously out of date, with issues like consent and Violence in relationships largely absent.

“It’s really hard to do really good sex education in 2022 when you’re working with curricula that were written in the 1990s,” McCawley said.

Even if the state department of education approves more curricula, there is no guarantee that schools will switch to a new one.

“Once a school picks a curriculum, they tend to stick with it,” said Scott Clements, state director of MDE’s School Health Programs.

Many of Mississippi’s teen mothers are 18 or 19 years old and out of reach of the elementary education system. The birth rate among that age group is three times higher than that of 15-17 year olds.

While reforming Mississippi’s sex education policy is an important piece of the puzzle, McCawley said the need to address major issues like intergenerational poverty means it’s not the endgame for addressing the state’s high teen birth rate.

“It would be great if there was a solution, but unfortunately, there are many contributing factors that create an environment where Mississippi has the highest teen birth rate in the country,” McCawley said. “It will take a lot of people from a lot of different sectors: education, health, social services, housing. It’s going to take a lot of factors to address what we’re seeing.”

The national teen birth rate has dropped 75% since its 1991 peak, a trend attributable to lower rates of sexual activity among youth and increased use of contraception.

The birth rate for teens ages 15 to 19 decreased in 31 states, but increased in Mississippi in 2020. Between-state rates ranged from a low of 6.1 per 1,000 births in Massachusetts to a high of 27.9 in Mississippi.

However, Mississippians are less likely to use highly effective birth control methods, such as intrauterine devices (IUDs) and implants. As of 2018, the number of patients at publicly funded Title X clinics who used such birth control was only 7%, compared to 18% nationally. In recent years, people have sometimes had trouble reaching clinics by phone, waiting months for an appointment or being told it’s up to the doctor on staff to determine what type of birth control they receive.

Lawmakers passed the state’s sex education law in 2011, which required each school district to choose between “abstinence-only” or “abstinence-plus” curricula. Everyone must emphasize that abstaining from sexual intercourse is the only method that offers foolproof protection against pregnancies outside of marriage and sexually transmitted infections.

Attempts to change the law to require curricula to be medically accurate or evidence-based have failed. One such attempt was by former Sen. Sally Doty, a Republican from Brookhaven and one of the few Republicans who supported changing the law.

Doty introduced the “Personal Responsibility Act” in 2016, which passed the Senate Education Committee but never came to a vote. The bill would have required sex education curricula to be evidence-based and would also have required sex education to be taught twice in elementary school, once in middle school, and once in high school. The 2011 law did not establish specific age requirements.

Doty, who is now the executive director of the Mississippi Utilities Staff, is still supportive of the changes being made. It also advocates changing to a policy of exclusion rather than acceptance, ending gender segregation for sex education instruction, and removing curriculum requirements in state law that prevent evidence-based curricula that are used in other states are used in Mississippi.

“I don’t think teen sex is any different in Mississippi than it is in any other state,” Doty said.

Doty said the absence of comprehensive sex education in schools, or parents providing it at home, is detrimental to a teenager’s development and means many young people only get their sex education from Internet porn. Doty said the Legislature’s inaction doesn’t help either.

“There are some real problems with the law as it stands…it’s a difficult situation to talk about. But I don’t think anyone can look at the numbers in the state and say we don’t need to talk about it,” Doty said.

Some of the restrictions in the state law also place an undue burden on school districts, according to McCawley. Mississippi law requires parents to opt their children into sex education, which creates a logistical barrier that keeps children with parents who support sex education out of the classroom.

“If a student doesn’t opt ​​in, it’s mostly not because of a parental disagreement, but because of inefficiency in getting permissions home and back,” McCawley said.

Keeping boys and girls apart during sex education instruction places another burden on schools that especially hurts understaffed rural school districts, according to McCawley.

The law also prohibits the demonstration of condoms and other contraceptive methods. Teachers can tell students how to use them, but not show them. This has led to creative workarounds by advocates like Sanford Johnson, who went viral in 2012 for a video in which he teaches students “how to put on a sock.”

While Johnson, now executive director of Teach Plus Mississippi, a nonprofit organization that trains teachers in understanding educational policy, believes that more comprehensive, sex-positive services and resources are available to youth now than a decade ago, there is much work to be done. According to the 2015 state health department Youth Risk Behavior Survey, 54% of Mississippi high school students have had sex and 39% did not use a condom the last time they had sex.

Johnson says that the policy that treats young people as if they are not worthy of the truth contributes to these risky behaviors.

“We know what works,” Johnson said. “When you present kids with all the information, they’re going to make better decisions.”

Eleven sex education curricula were approved by the state education department in 2011. Of 142 public school districts in the state, 80 have chosen abstinence-only instruction and 62 have chosen additional abstinence, according to current data from the MDE.

Approved curricula vary in substance and tone. The Game Plan curriculum, currently in use by the Wilkinson County School District, was co-developed with former professional basketball player AC Green and has a sports theme.

The REAL Essentials WAIT curriculum is currently used by 12 school districts and describes proper use of a male condom as a “risk” behavior for HIV/AIDS. The curriculum includes activities such as an STD crossword puzzle and classroom discussion prompts such as: “When it comes to sex, men are like microwaves and women are like slow cookers.”

Ninety school districts teach the Choosing The Best curriculum. Of those, 61 use a withdrawal-only version and 26 use a withdrawal-plus version. Abstinence plus curricula teach students about the risks and failure rates of non-abstinence birth control methods.

The second most popular curriculum is Draw The Line/Respect The Line, an evidence-based abstinence plus curriculum currently in use by 26 school districts statewide.

The content and quality of sex education instruction vary by district. While two districts may be using the same curriculum, there is no guarantee that they will be teaching the same lessons. The state sex education law lists six components of abstinence-only instruction, but does not require that each one be covered.

While organizations like Teen Health Mississippi and Mississippi First have pushed for years for lawmakers to update the state’s sex education law, no action has been taken. The law was reauthorized as written in 2016 and 2021.

“The state Legislature really doesn’t want to touch on something like sex education until it has to,” McCawley said.

Another concern among advocates is that Mississippi’s sex education law, flawed as it is, is not being enforced. McCawley said the sense of urgency and level of oversight that existed after the law was passed is no longer present, and many districts are likely no longer in compliance with the law.

“As time went on, oversight lessened and districts really picked up on that,” McCawley said. “They realized that they can do whatever they want, in any case, and there will be no repercussions for that.”

Clements, whose office oversees sex education compliance, said monitoring is done every three years but hasn’t been done since the start of the COVID-19 pandemic. Monitoring will resume next year and includes reviewing what curriculum is being used and which teachers are providing the instruction.

With all the challenges schools have faced due to COVID-19, sex education hasn’t been a top priority, she said.

“Unfortunately, like a lot of things with COVID, the focus has been on making sure kids can go to school.” Clement said.

Mississippi Today reporter Isabelle Taft contributed to this story.

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