Clinton's Double-Sided Push to End Teen Birth

Combining abstinence and contraceptives stirs debate

HARDLY anyone thinks it's a good idea for unmarried teens to be having babies. But figuring out how best to prevent teen pregnancy is an area fraught with controversy.

Should teens be taught only about abstinence from sex? Should contraceptives be made easily available to them? Or can teens sort their way through a mixture of the two messages - that abstinence is the best approach, but if one does have sex, contraception is crucial?

A new, privately funded campaign to reduce teen pregnancy, announced by President Clinton this week at the White House, is for now seeking to avoid that conflict. But as the group's moves into an eventual strategy of getting an anti-teen-pregnancy message into the media - both news and entertainment - it may find itself taking sides.

The Clinton administration has already made clear where it stands: Discussing both abstinence and birth control is the best approach, say administration officials.

But the new National Campaign to Reduce Teenage Pregnancy wants for now to serve as an umbrella organization helping groups around the country that take varying approaches.

''Our view is that we want to stimulate a wide variety of solutions,'' says Sarah Brown, a researcher at the Institute of Medicine and co-coordinator of the new national campaign. ''Solutions will depend on the communities themselves. A conservative rural community might handle it very differently from an inner-city community.''

Added to the mix is Henry Foster's new position, also announced this week, as an unpaid adviser to the Clinton administration on teen pregnancy. Dr. Foster failed to gain confirmation last year as surgeon general because of his record of performing abortions.

He has become a lightning rod for conservative groups, who complain that his ''I Have a Future'' program in Nashville promoted the use of contraceptives - and therefore sexual activity - among young people. He will also be the administration's liaison to the new National Campaign to Reduce Teenage Pregnancy.

Representatives of some abstinence-only groups appeared at the White House for the announcement of the new campaign. One such group is called Best Friends - an organization founded by Elayne Bennett, wife of former Republican official William Bennett - which teaches young girls about love and dating without mentioning contraception.

Other activists in the abstinence-only camp, such as the Family Research Council, would have nothing to do with the Clinton-administration-organized campaign if asked. Kristi Hamrick, spokeswoman at the Family Research Council, says the root of the problem is not teen pregnancy but teen sex.

''Early sexual activity makes it harder for people to form committed relationships later in life,'' says Ms. Hamrick. And naturally, if teens aren't having sex in the first place, they won't be getting pregnant. She says the teen birth rate has been declining because more teens are choosing to abstain from sex.

Groups that favor teaching teens about birth control say they are acknowledging a fact of life: that growing numbers of teens are sexually active, whether adults tell them to abstain or not, and that these teens should at least protect themselves physically.

Kris Moore, a specialist on teen pregnancy at the research organization Child Trends Inc., says the early indication is that a combined approach - teaching both abstinence and birth control - has the greatest success.

But, Ms. Moore adds, ''there is no silver-bullet solution'' to teen motherhood. ''There's a lot of energy going into solving this problem,'' she says, ''but most programs lack a definitive study to evaluate effectiveness.''

THE teen birthrate went up by one-fourth between 1986 and 1991, then declined slightly in 1992 and again in 1993, the last years for which data are available. It is not known yet whether those declines represent fluctuations in the rate or if they show the beginning of a downward trend, says Moore.

What hasn't changed is the upward trend in childbearing among unmarried teens. And overall, the United States still has by far the highest rate of teen motherhood in the Western world.

The new campaign seeks to provide some national leadership in the face of a national crisis.

''Groups are telling us it's very hard to get started completely on their own,'' says Isabel Sawhill, a researcher at the Urban Institute and the other co-coordinator of the new campaign. ''They need help and encouragement, ideally money, and a sense of national leadership and involvement.''

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