Monica Escobedo of Pflugerville was 18 in June 2006 and eager to taste the freedom of being a new high school graduate. She barely got a nibble.
Escobedo discovered she was pregnant in early 2007. That September, her son was born. She was 19. Her on-again, off-again boyfriend was heading on a path to prison. To her relief, her Catholic parents allowed her and her son to live at home, where they spent the next two years.
Escobedo loves her son but says she paid dearly for her “bad decisions.” She struggled to get health care coverage, to pay bills while working as a cashier and to further her education. Now 27, she is in a higher-paying job as an office manager, has health insurance through her employer and lives with a sister in a house her parents own. They are forgiving if the rent is late. She dreams of going back to college and becoming a teacher, but she doesn’t know when that might be.
“I clawed my way out, and I’m still clawing,” she said. “It hasn’t been easy.”
Slightly more than 38,000 Texas teenagers gave birth in 2013, the most recent year for state data. Nearly two-thirds — 24,518 — were Hispanic.
Texas has one of the nation’s highest Hispanic teen birth rates. Although differences in health status among racial and ethnic groups are a major topic in public health, teen pregnancy gets far less attention than disparities in cancer, heart disease and diabetes.
Yet teen childbearing breeds other problems, including health risks to moms and babies and high costs for individuals and taxpayers. Texas puts few resources into preventing teen births, and few organizations have the wherewithal to mount far-reaching campaigns that target Latinos. Many of those organizations rely on relatively small federal grants; some depend on donors.
Escobedo, a first-generation Mexican-American, doesn’t remember any pregnancy prevention programs geared toward Hispanics when she was in school.
“There needs to be resources available to parents so they can talk to their kids,” she said. “My dad didn’t want somebody else teaching us sex education.” So he opted her out of those classes, she said.
Even so, Escobedo is better off than many Latinas who become parents too soon. Some teens get kicked out of the house, fail to finish high school and become mired in poverty. Their children risk repeating the cycle.
Escobedo has shared her story with students in the Austin area, describing the sleep deprivation, dirty diapers and lack of freedom that come with parenthood. The talks were sponsored by two nonprofits, neither of which remains in Austin.
Some Hispanic students have parents who don’t speak English well and don’t know where to turn for help, she said. “I would think a program to reach parents would help. I would like to know how to talk to my son. Nobody had that conversation with me.”
Texas ranks No. 47
Despite the disparity in Hispanic teen pregnancies and births, Texas and the nation have made great strides in reducing teen pregnancy and birth rates overall. Those rates have fallen to historic lows since the early 1990s.
Experts suspect MTV shows “16 and Pregnant” and “Teen Mom” had an impact by showing the not-so-glamorous side of young parenthood. Experts also say initiatives in some states have driven down rates significantly. Colorado provides long-acting contraception, such as hormonal implants, to low-income teens. California is touted for its comprehensive approach to sex education and for providing contraception to teens without requiring parental consent.
The steep drop in rates nationally is “the good news,” said Bill Albert, chief program officer for the National Campaign to Prevent Teen and Unplanned Pregnancies. “The not-so-good news is, nationally, we remain far higher than other comparable countries, and the (teen pregnancy and birth) rates among people of color are far higher. … This is not the time to hang up the ‘mission accomplished’ banner.”
The picture for Texas is darker still.
In 2013, Texas ranked 46th in the nation overall in its teen birth rate and 47th in teen pregnancies, according to the National Campaign’s latest numbers.
In Travis County, Latinas ages 13 to 19 had pregnancy rates that were more than four times the rate for white teens in 2013, according to state data. The birth rate of Hispanic teens in Travis County was more than seven times that of whites.
“It’s a huge issue for us to be looking at and talking more about,” said Gwen Daverth, CEO of the nonprofit Texas Campaign to Prevent Teen Pregnancy. “Nobody is doing what everybody thinks somebody should be doing.”
A spokeswoman for the Texas Department of State Health Services could not identify any state pregnancy prevention programs aimed solely at Hispanic youths.
A smattering of federally funded programs that target Hispanic teens exists around the country. In Travis County, the pilot Peer 2 Peer project began in mid-2014 to train Hispanic teens to be health educators to other Latinos. A goal is to reduce teen pregnancies.
The Austin/Travis County Health and Human Services Department is doing a study to see if expanding the program is warranted, Assistant Director Rosamaria Murillo said.
The project’s budget for 2016 is $587,000, Murillo said. “That will allow us to continue to do peer interventions, but as you can imagine, we can do this education until we are blue in the face.”
She added that, to be effective, a comprehensive approach is needed that includes “wrap-around services and clinical services,” in addition to peer interventions.
Another Austin program aimed at improving college-going rates among Hispanic teens, Con Mi Madre, has had the welcome effect of reducing teen pregnancies, a leading reason teens don’t finish high school. In that program, Hispanic mothers, many of whom had their first child as a teen, are trained to encourage their daughters to plan for college.
About 1,200 to 1,300 mothers and daughters take part in the program each year, and less than 1 percent of the teens get pregnant, Executive Director Teresa Granillo said.
“When you give these girls hope for a different future, they don’t have to live the life they see in their neighborhoods,” Granillo said.
Some families don’t talk about teen pregnancy because they mistakenly think it won’t happen if it goes unmentioned, Granillo said. Con Mi Madre, which has an annual budget of $650,000 and works with girls from sixth grade through college, teaches mothers how to have those conversations.
“Eighty percent of our girls are first-generation college students,” Granillo said.
The National Campaign, citing research, said that fewer than half of Latina teens who have a child finish high school by age 22. Less than 2 percent earn a college degree by age 30.
$9.4 billion price tag
The cost to U.S. taxpayers to finance teen childbearing was an estimated $9.4 billion in 2010; in Texas, it was $1.1 billion, according to the National Campaign.
Half of all mothers who gave birth before age 20 were living in poverty by the time their child was 3, the National Campaign says. Nearly two-thirds were on some type of public assistance. Latinos are more than twice as likely as whites to lack health insurance.
Texas has the nation’s highest rate of repeat pregnancies among teen moms, at 22 percent, according to the Centers for Disease Control and Prevention.
Yet, in Texas, minors are required to get parental consent to obtain prescription contraception, and sex education must be abstinence-based, although school districts may include information about contraception. Not all do.
“Inadvertently, some of the messages about preventing teen pregnancy are interpreted as anti-child, anti-family and anti-baby,” Albert said. “When it comes to sex education in particular, we haven’t done as good a job in developing messages.”
People’s Community Clinic, a nonprofit that provides care to low-income Central Texans, offers the Tandem Teen Prenatal and Parenting Program to promote better health among young families and to reduce the risk of additional unplanned pregnancies.
Tandem provides teen moms with intensive services until their baby is 3 to prevent a second pregnancy, said Robin Rosell, director of the program at People’s Community Clinic.
Last year, 83 percent of the Tandem program teens went back to school or graduated, and just 4.4 percent had another birth within two years, Rosell said. A lot of the reduction was the result of providing long-acting contraception, Rosell said.
Escobedo said she was helped by a kindly obstetrician/gynecologist who treated her like an adult and encouraged her to take parenting classes, which were invaluable, she said. She initially got on Medicaid, but even making about $10 an hour as a cashier, she did not qualify for other services, such as food stamps and child care.
Escobedo’s parents both worked and couldn’t watch her son. An aunt stepped up so Escobedo could keep working.
The cultural dynamics that might influence pregnancy rates are not well understood, Rosell and others said. The Hispanic culture is known to value family and babies and might not attach the same stigma to teen pregnancy as some other groups.
“We need more targeted (campaigns) and programs that are appealing to those girls,” Rosell said. “That’s been the case for years, and especially in a state like Texas.”
But Rosell and others who work with teens are frustrated that those discussions are not happening to the degree they need to be. “I think there’s blame to go around, from leadership, from the Legislature, from the Department of State Health Services,” Rosell said.
Dr. Celia Neavel, director of the Center for Adolescent Health at People’s Community Clinic, also is concerned. She sees many factors influencing teen pregnancy rates.
“Not having opportunities, not seeing a good future for yourself” are among them, Neavel said. “If you don’t have role models who graduate from high school and go to college … that certainly can play a role.
“The best contraceptive is opportunity,” she added. “If you think you are going somewhere, you are going to be much more careful.”
Escobedo said she wasn’t careful. She didn’t think much about the future, nor was she encouraged to go to college, she said. “It seemed like a faraway dream,” she said. “I didn’t have very much drive. I didn’t know what I wanted to do.”
When she spoke to students, she advised them to set goals and think about the kind of future they wanted.
“Give yourself a chance to live and explore those options,” she said she told them. “The person you are in high school is not the person you will become. If you just wait a little and get through those high school years, you can do anything you want. The horizons are limitless.”
In their words
“Nobody is doing what everybody thinks somebody should be doing.”
— Gwen Daverth, CEO, Texas Campaign to Prevent Teen Pregnancy
“I think there’s blame to go around, from leadership, from the Legislature, from the Department of State Health Services.”
— Robin Rosell, director, Tandem Teen Prenatal and Parenting Program at People’s Community Clinic
“The best contraceptive is opportunity. … If you think you are going somewhere, you are going to be much more careful.”
— Dr. Celia Neavel, director, Center for Adolescent Health at People’s Community Clinic
“When you give these girls hope for a different future, they don’t have to live the life they see in their neighborhoods.”
— Teresa Granillo, executive director, Con Mi Madre