Christie Erwin’s heart has had to endure more than most. As the executive director of Project Zero, she and her team work tirelessly to find forever families for foster children in Arkansas. For 10 years now, Project Zero has envisioned a world where no child is without a home; when even if a child is not raised by his or her biological parents, he or she finds adoptive families. So as long as there are waiting children, Project Zero will continue — until the “zero” part of its name is fulfilled.
It’s among the noblest of causes imaginable. Children are innocent, precious; children who are in pain or alone is heartbreaking. It’s an ironic fortune for most people not to have to think about that every day, but not Erwin. She lives for them. As such, her life is a fluid dichotomy of emotion. In 2019, Erwin says that Project Zero helped connect nearly 200 foster children with adoptive parents; however, Erwin also estimates that every year around 200 or more children in Arkansas age out without ever being adopted. One minute, she gets the call that a 7-year-old foster child has been adopted. The next, it’s a 21-year-old who never experienced that and found cycles with destructive behaviors to fill the void in his heart that a family never did.
Like any issue facing our world today, this one is complicated and lacking in definitive answers. But one piece of the puzzle — and a significant one, at that — is teen pregnancy. According to most metrics, Arkansas has the highest rate of teen births in the United States.
“Our very first baby we fostered was from a 14-year-old mama who was naive, left for band camp, had one encounter and came home pregnant,” Erwin says. “[She] hid her pregnancy through the whole pregnancy, except for from her mom, and she gave birth to a baby boy.”
Erwin and her husband, Jeff, became foster parents in 1993. During her time fostering for Bethany Christian Services, she recalls that most of the children they fostered came from teen births. While with the agency, she was involved in a program called Inside Out, which was designed specifically to help teen moms. One particular memory from that period continues to linger in her mind, after all this time.
“I was actually in the delivery room with two 14-year-olds before they gave birth to their babies,” she says. “It was profound. As a mom myself, watching these beautiful young girls become moms in the midst of the trauma and chaos in their own lives, and then bringing another little one into that, it just broke my heart. They needed to be mothered, not to become mothers. That part of it was just incredibly difficult.”
She goes on to say that children who become pregnant while in foster care are among the saddest of examples. They’ve been waiting for a family nearly their whole lives, and then the pregnancy provides that, in a sense. “They see it as, ‘This is something that’s mine,’” Erwin says. “And then the reality sets in, and it’s a very different story. It’s, ‘This is very, very hard.’ I think often those kids end up in foster care as well.”
A study from the National Institutes of Health archives found that among young adults with a history of foster care, 49 percent of young women become pregnant, and 33 percent of young males report getting someone pregnant by the age of 21. Recalling Erwin’s anecdote, it’s easy to see this part of how the teen parent cycle is persistent.
And that’s only the foster-related piece of the puzzle.
According to 2015 data from the Arkansas Department of Health (ADH), Arkansas had a birth rate of 37.6 per 1,000 among teens in the age range 15-19, the highest in the country. The U.S. average is 22.3 per 1,000. Teen birth rates among minority populations are even higher. For the same year among the 15-19 age range, the Black, non-Hispanic teen birth rate was 50.1 per 1,000, and 45.1 among Hispanic females. ADH also lists data breaking the state down by region, in which southeast Arkansas had the highest rate at 49.4, followed by the northeast corner of the state at 46.4. Southwest was 41.7, northwest was 34.1 and central was 30.4.
The percentage of the state’s teen births that result in foster care or adoption is not tracked by ADH nor the Arkansas Department of Human Services. Other conclusions, however, are available. According to a Pew Research Center article from 2019 on the subject, of the approximate 450,000 pregnancies among teens nationwide in 2013, about 61 percent resulted in live births, 24 percent ended in abortions, and 15 percent in miscarriages or stillbirths.
Further, according to ADH, teen mothers are the least likely pregnant demographic to receive prenatal care in the first trimester; participate in WIC at a rate of 79.2 percent (more than 20 points higher than any other age demographic); are more likely to participate in Medicaid; are more likely to experience postpartum depression; are almost as likely to bear a child with low birth weight as women over 35; and teen births have a higher rate of infant mortality (deaths before one year of age).
According to the National Conference of State Legislatures (NCSL), children born to teen parents are more likely to enter child welfare or juvenile systems and are more likely to also become a teen parent. Sons born to teens are more than two times as likely to be incarcerated in adulthood than those born to mothers even as young as 20 or 21.
There is some good news to report, though. Countrywide and here in Arkansas, instances of teen pregnancy are going down. According to the National Center for Health Statistics, the U.S. teen birth rate peaked between the 1950s and ’60s, or what is commonly known as the Baby Boomer era, at 96.3 births per 1,000 females, ages 15-19. Numbers began to decline during the ’70s and ’80s, before rising and peaking again in the ’90s at 61.8. The data has been on the decline practically everywhere since. In 2007, ADH reported a rate of 60 per 1,000 in the state, which fell to 33.5 in 2016, following a similar trend line as the rest of the country. Although, the U.S. is still one of the leaders in teen pregnancy rates among developed nations, and Arkansas still at the top (or bottom) of the country.
But the compositions have changed almost entirely. According to Pew, during the Baby Boomer years, around 85 percent of teen moms were married. Today, 89 percent are out of wedlock.
Many believe more preemptive measures could continue to curb the prevalence of unplanned teen pregnancy in Arkansas, thus preventing many of the aforementioned trickle-downs that are more likely to stem from teen births. As the NCSL said in its 2014 “Teen Pregnancy in Arkansas” report, “Taking steps to address high teen pregnancy and birth rates in Arkansas has potential to reduce high school dropout rates, improve educational attainment, boost tax contributions through higher earnings and improve the economy overall. Reducing births to adolescents also can help strengthen families, improve child wellbeing and assist young people in achieving their goals.”
What those measures look like, however, is a point of contention — at least on the surface.
Heather Hudson, Ph.D., is as much a mirror in passion for sexual health and wellness education as Erwin is for foster children. Hudson, an associate professor at the University of Central Arkansas in the health sciences department, is a Master Certified Health Education Specialist, a Certified Sexuality Educator and is the national delegate for the Arkansas Society for Public Health Education. Even at the upper level that her classes encompass (mostly juniors and seniors), she is discouraged to find that about half of her students come to class with a below-average understanding of sexual health-related topics.
“I often get statements from students saying that they are taking my class as an elective because they lack sexual health and skills and want to learn,” Hudson says. “These are adults, most of which have been previously or are currently sexually active. Many are shocked to see the variety of contraceptives beyond the condom, pill and Nuvaring (all of which frequently have commercial advertisements). I always tell them that it isn’t their fault if they come into this class with a significant lack of knowledge and skills, because they didn’t get sex education in schools, at home and/or they were too afraid to ask questions.”
Hudson believes that this lack of knowledge can have a detrimental effect on one’s college experience, as the majority of teen births in Arkansas are 18- and 19-year-olds. She points at Act 943, passed by the Arkansas legislature in 2015, as a positive movement on that front. The law requires higher education institutions in the state to develop and implement action plans to prevent unplanned pregnancy.
However, as is evident by the data, while such legislative developments are helpful, getting in front of the issue to, as the bill states, “prevent unplanned pregnancy,” can actually err on the side of reactive by the time teens make it to the college level. By that point, according to ADH, nearly half of them will have already had sex, and more than 34 percent will be “currently sexually active.”
Like most in her field, Hudson believes it even more imperative to do a better job of educating adolescents comprehensively before they face the decision to become sexually active. Part of that problem, in her mind, is that the state does not require sexual education in K-12 schools.
In fact, according to the Arkansas Department of Education (ADE), there is no formal requirement to provide any education at all. “Arkansas Code § 6-18-703 provides local school boards the authority to develop policies regarding sexual health education provided by the district,” a spokesperson for ADE tells AY About You.
Arkansas is one of only a few states in the country without some form of sexual education requirement. Much of that is likely boiled down to the main two opposing factions, each of which agrees that Arkansas’ unplanned teenage pregnancy rates are problematic but disagree on many of the preventative measures that have been put forth to correct the course. They are both often generalized as: comprehensive sex education (CSE) vs. abstinence-only and/or abstinence-focused education.
Hudson is very forthcoming about her belief in the need for “comprehensive, evidence-based” education, but she is also quick to dispel a lot of the light that many try to find between the two sides.
“People and parents who initially oppose or are uncomfortable with the idea of CSE have an inaccurate perception of what CSE teaches,” Hudson says. “They hear ‘comprehensive sex’ and get the wrong idea. If people took the time to review the National Sexuality Education Standards for each grade and the topics it covers, they would find that it teaches a lot of different safety, personal and social skills. Comprehensive sex education still teaches that abstinence is the best method for avoiding unplanned pregnancy (and STIs) but provides education on effective condom usage and contraceptives as safer sex methods to reduce their risk of pregnancy, and teaches young people how to find reliable resources needed to obtain additional information and relevant health services.”
The “evidence-based” part of the equation is based on numerous published studies, such as by the University of Washington, the National Institutes of Health, the Guttmacher Institute, the American Journal of Nursing, the University of Arkansas and many others, which find that the type of education Hudson is proposing is more likely to reduce the rates of teen pregnancy than abstinence-only (or Sexual Risk Avoidance Education as it is also referred).
“In terms of teenage pregnancy prevention, evidence-based comprehensive sexuality education has been proven to be more effective (compared to abstinence-only programs or no formal sex education) in terms of reducing rate of sexual activity, unprotected sex, number of partners and teen pregnancy,” Hudson says.
But according to the state code mentioned by ADE, as it currently stands, if a district or local board is to adopt a sex education curriculum in Arkansas, the only requirement acknowledged is the focus on abstinence. Rather than requirements to, as Hudson believes would be more impactful, requiring trained health educators to teach sexuality education, not limiting access to contraception and family planning services, providing adequate time for sex education curriculum to be taught, requiring sex education to be medically accurate, unbiased, inclusive and culturally and developmentally appropriate, and so on.
That education code dates back to 2010, and Arkansas has remained at or near the top of the U.S. in teen pregnancy rates since (and actually perform worse vs. our peers in recent years). When asked if ADE felt like these policies were effective or if it believed more could be done by way of preventing unplanned teen pregnancy in Arkansas, a spokesperson for the department’s answer was a reiteration of the current law.
“Arkansas policy allows for local school boards to have the autonomy to address the needs of the students they serve, as well as to incorporate local resources that may be available,” the response said.
When asked if the department felt it had a role to play in teen pregnancy prevention at all, the spokesperson said, “The Arkansas Academic Standards for Health and [Physical Education] address the following: demonstrating healthy relationships and interaction with others; utilizing effective communication skills; differentiating between healthy and unhealthy behaviors and how those behaviors impact relationships with peers and adults; and the understanding of human growth and development that includes examining factors around human production.”
Just as important to the conversation as the curriculum is the people who deliver it. At present, when schools do present some form of sex education to students, it’s often conducted by members already on staff with that particular school. In a 2017 article, the Arkansas Democrat-Gazette reported anecdotes from an education seminar conducted in the same year that discussed the topic of sex/abstinence education in schools. “The topic makes some health teachers, who often double as coaches and physical education teachers, uncomfortable,” the article said, citing attendees from the seminar.
Hudson believes schools should hire professionals designed specifically to fulfill those roles, rather than teachers without the interest, aptitude or comfortability.
“For sex education to be successful, those who teach sex education must have a desire to teach the content (rather than being forced), have confidence in their ability to teach sex education (so they are less likely to skip content or rush through it), be supported by administrators (so they are given adequate time to teach it), and must be adequately and extensively trained (to make sure they are teaching the curriculum with fidelity),” Hudson says. “It’s recommended that schools hire health education or health promotion specialists to teach sex education, preferably who have national certifications as a Certified Health Education Specialist (CHES), Master Certified Health Education Specialist (MCHES), or Certified Sexuality Educator (CSE). Certified Health Education Specialists and Certified Sexuality Educators are trained to develop and implement accurate, developmentally and culturally appropriate behavior change programs tailored to specific priority populations.”
Hudson also suggests that schools could better involve parents and guardians in the process. One example of which she provides is by hosting a night at the school where adults could ask questions about the curriculum to the educators, be informed as to what (and why) their child is being taught, and “how it can enhance the health of their children.”
“While this is anecdotal, one theme that is mentioned over and over in papers from my students is the lack of sexuality education in schools as well as at home. Many students state that they were scared or uncomfortable to talk to their parents about sex and contraception,” Hudson says. “My students who have parents that allowed and answered their questions usually acknowledge their appreciation for them, which I think is significant. However, the majority of my students say the opposite; that their parents ignored or discouraged any developmental, relational or other sexuality-related questions, or only answered them in ways that instilled fear or shame. Even parents (from previous focus groups) have stated they avoid answering sex-related questions or having ‘the talk’ with their kids because they are not very knowledgeable about pregnancy prevention, or contraceptives, or they are uncomfortable or lack confidence answering questions, as they never received formal sex education either.”
In a disheartening parallel to the cycles and solitude of waiting children, teenage parents — moms especially — are often ostracized, outcast and altogether alienated post-pregnancy. Some might opt for abortion to avoid such a social climate. Some will give their child up for adoption, half of whom are likely to age out of the foster care system without ever being adopted. The majority keep their children to raise on their own, many of whom drop out of school in order to do so. No matter the outcome, it’s often hard to escape the scarlet letter.
“I’ve held babies in my arms that have been placed for adoption by teen mamas who have made a sacrifice and have been courageous,” Erwin of Project Zero says. Her opinions related to teen pregnancy tend to revolve around her personal perspectives — as a foster parent and adoption advocate, as well as an adoptive mother. Erwin has six children, two of which were adopted. One of her adopted children’s biological mothers aged out of foster care, and the cycle repeated itself. From her vantage point, unplanned teen pregnancy evolves from chaos, confusion, and lacks of self-esteem and confidence.
Though occupying a different vocation, Hudson is just as passionate about being supportive and keeping the best interests of the teens (and, if applicable, their kids) at heart. Maybe that’s the million-dollar puzzle piece — that no matter if it’s a professor at UCA or the leader of a foster care/adoption nonprofit, there’s a role to play to reach a similar conclusion. For Hudson, that might look like a world where everyone is educated to make informed decisions, thus living healthier and safer lives; for Erwin, it’s a world with zero children waiting to find forever families. The way to each’s goals might follow the same path.
“It makes me sad that our society is harsh on teen parents, especially teen moms, yet we don’t educate teens on ways to prevent pregnancy other than abstinence,” Hudson says. “Students come into my class holding a lot of shame stemming from damaging messages from when they were younger about teens who are sexually active. But good kids have sex too. We have to be realistic and protect our teenagers. We can’t keep doing the same things … and expect different results. The results are evident: We have the highest teen birth rate (and second-highest teen pregnancy rate) in the nation. We need to do better.”