Boulder County clinic served as pilot for teen pregnancy reduction program
In 2007, Susan Buchanan, Executive Director and CEO of Boulder Valley Women’s Health Center, was presented with an opportunity that would gladden the heart of many a nonprofit executive.
“When we initially got involved in the planning, the question from the funder was: ‘If money were no object, what would you do to expand access to marginalized populations?’” Buchanan said. “It was like every executive director’s dream. We got to dream big, think outside the box.”
The private funder wanted to test strategies to change the fact that nearly half of all pregnancies were unplanned. High upfront costs meant access to the most effective methods of contraception – implants and IUDs – stood in the way of women being able to choose these methods.
“… If you can make sure pregnancies are intended and planned for … (a young woman) can complete her education, form a stable relationship, get her feet wet in the job market,” Buchanan said. “In fact, you have healthier babies, too.”
The results have been stunning. The teen fertility rate was cut almost in half in Boulder County and more than cut in half in the state of Colorado. Preventing unplanned pregnancies helped avoid up to $70 million in public assistance costs. Most importantly, more young women are charting their life’s course, rather than having babies too early.
These results would likely have been considered too much to hope for, when Buchanan and others began thinking about how to implement the program. Among the things they worked on: training more providers to place IUDs and contraceptive implants; developing effective ways to educate teens to think about and take action to protect their own health and various steps to ensure that women are satisfied with their contraceptive choices. It also included outreach to let teens know where they could access care and information, including about their best contraceptive options.
“We started out with one key question: ‘Do you intend to be pregnant in the next year?’” Buchanan said.
That question came from the clinic’s direct experience. Teens were often ambivalent about being on the pill, what Buchanan describes as “if it happens, it happens.”
Asking about pregnancy as an intention with a time frame made many teens see things differently.
“It forces you to say, ‘No, not really.’ A lot of the time, women weren’t thinking in those terms, “What would I do if I got pregnant next year?’” Buchanan said.
Boulder Valley was first to launch this effort – and soon after it expanded statewide, with an integrated program of expanded health care services at 69 clinics, public education and advertising, community outreach and more.
Buchanan said she worries that the change of administration in Washington will set back family planning efforts, which she regards as crucial.
“Some of the things we know are that (women with) unintended pregnancies are more likely to be victims of domestic violence, the child is more likely to experience child abuse and more likely to enter school not ready,” Buchanan said. “I always say we do the most important work in the world. If we solve this problem, we solve so many other problems.”
