Before nearly 1,000 nonprofit leaders, local government office holders and business executives, Mayor Julián Castro lauded San Antonio’s progress as a “city on the rise” in his fifth annual State of the City address last week. Castro noted graduation rates have increased, unemployment has dropped, obesity rates have dipped (coincidently, against the backdrop of the Whataburger logo, a key sponsor, but, hey, that’s a different story) and that teen pregnancy birth rates—a glaring and long-standing problem in the Alamo City—have dropped, too.
Indeed, in 2012 the birth rate of pregnant women between 15 and 19 years old in Bexar County declined by 38 percent since 2000, according to the most recent data available. But that’s not the entire picture—while the numbers shrunk in the immediate past, the overall rate continues to rest well above the national teen birth rate of 29 percent. To cast another shadow on the rosy state of the city, repeat teen births in the county made up nearly a quarter of all 2012 teen births, a figure that’s stagnated in the two previous years.
So it’s no wonder that when presented with the opportunity, the City jumped at the chance to direct federal funds toward teen pregnancy prevention. A slice of flexible federal Medicaid funds, allocated to the state, trickled down to local public health agencies with the goal of subsidizing prevention programs, as per a 2011 legislative budget agreement.
San Antonio’s metro health district made out with $43 million as a result; those funds are now being directed toward several different prevention strategies, including $1.5 million devoted directly to teen pregnancy over the next three years. During an early February City Council meeting, members voted 10-1 to approve the University Health System’s $851,928 investment in contraceptive access. Some 250 teenage girls age 13 to 19 (with parental consent if under 18) can now receive long-acting reversible contraception (LARC) in the form of either an intrauterine device (IUD) or hormone injections (the birth control shot).
Other initiatives in progress include teaching abstinence-plus sexual education at 23 middle schools, a case management program to work one-on-one with at-risk teen moms and a program, led by a teen-centered local obstetrician, that seeks to train physicians on how to cater specifically to teenagers.
Especially considering the massive legislative cuts made to family planning and contraceptive access at the state level, the local government-based investment is a much-needed step in curbing the high teen pregnancy rate, City Public Health Director Dr. Thomas Schlenker says.
“We’ve had our ups and downs and this certainly does not solve all our problems, but it’s definitely a bright spot,” Schlenker tells the Current. “It’s a substantial amount of money that can be applied toward prevention that has never been available before, so it’s a tremendous opportunity for us.”
In addition, teenage girls who give birth at any UHS hospital can now receive the LARC before they leave the hospital (an attempt at reducing multiple births among teens)—a “no-brainer” according to Schlenker, but unfortunately something that hasn’t occurred up to this point.
However, the “no-brainer” decision met heated controversy from the religious right at the Council meeting, who countered the LARCs posed health risks to young women. (Because it promotes teen sex and promiscuity! Because it’s basically abortion! Because the Bible!) Case in point: More than one testifier incorrectly described the contraceptives as “abortifacients” (abortion drugs), another erroneously likened it to chemically induced abortion and another flat out said, “This bothers God.”
Fear-mongering opponents of the voluntary program rattled off a litany of negative side effects, but Schlenker (an Harvard-educated doctor) says those testifiers cherry-picked and misinformed the public. In fact, both birth control methods are FDA-approved and recognized as safe with no identified long-term fertility effects by major medical organizations like the American College of Obstetricians and Gynecologists, the Centers for Disease Control and the World Health Organization.
“I haven’t had any negative reaction whatsoever, only lots of positive reactions except for this very small handful of folks who somehow associate it with abortion,” says Schlenker. “But really, it’s probably the most effective thing we can do to prevent abortion—they seem to be confused about that.”
At the meeting, District 6 Councilmember Ray Lopez rattled off his own list of terrible side effects—dizziness, bloody vomit, stomach pain and skin rashes—eliciting applause from opponents, under the impression he was bolstering their point. Turns out, not so much. The council member was reciting the side effects of aspirin, found on a basic internet search. (Boom!) Lopez, not much of a showman, says he wasn’t trying to play “gotcha” but just wanted to alert the naysayers that most medicines have some uncomfortable results.
“The reality is there are negative side effects to virtually every medicine, even something as benign and common a treatment as aspirin,” Lopez tells the Current.
As a long time Northside ISD school board trustee member, Lopez frequently witnessed teenage repeat births and saw it destroy lives—pregnancy is the primary reason girls drop out of high school and is closely linked to poverty and poor health, according to the National Campaign to Prevent Teen and Unplanned Pregnancy. He argues the Medicaid-based investment is long overdue: “It’s catastrophic, and shame on us for not doing everything we can to change that trend,” he says of the repeat teen birth rate problem.
On the other end, new council member and former Ronald Reagan social aide Mike Gallagher (who replaced Carlton Soules on the dais in District 10) served as the lone “no” vote, citing safety concerns.
But it appears efforts to curb teen pregnancy rates would certainly benefit the community he represents—in District 10, there’s still anywhere between 2.4 to 88.2 teens giving birth per 1,000 women ages 15-19 according to 2012 statistics.
Running on a fiscally conservative platform, Gallagher’s constituents may find it interesting that taxpayers take a big hit when unintended pregnancies occur. In 2012, Bexar County residents spent an estimated $59.6 million on associated costs of teen childbearing, including child welfare, healthcare, lost revenue and incarceration expenses, according to the Metro Health District. And public funding of low-cost contraception saves taxpayers approximately $6 for every $1 spent.
Gallagher did not return calls for comment.