Mississippi leads the nation in per capita teen births - a figure that continues to rise, with more than 83 percent of teen pregnancies unintended.
"It's an epidemic," said Anne Norwood, director of three school-based health clinics in Jackson Public Schools. "We are taking care of children who are having children. It's a vicious cycle, and we've got to figure out some way to stop it."
These pregnancies and births cost Mississippi taxpayers at least $135 million annually, not including the millions more to treat sexually transmitted diseases, she said. The state has the highest rates of chlamydia and gonorrhea in the U.S.
In March, Mississippi lawmakers adopted a bill that requires public schools to have an abstinence-only or abstinence-plus program in place by June 2012.
Under the new Mississippi law, the abstinence-only program would give students information about healthy relationships, the benefits of abstinence and the consequences of premarital sexual behavior, including unintended pregnancies and sexually transmitted diseases. Students also would learn abstinence is the expected standard and that sexual activity outside marriage has harmful consequences.
Abstinence-plus education also would encourage abstinence but would include information on contraception and disease prevention when the students do become sexually active.
At least 17 Mississippi schools are using an abstinence-only program titled Choosing the Best. The program was developed by businessman and tea party favorite Bruce Cook.
Choosing the Best officials cite a 2005 study funded by the U.S. Department of Health and Human Services that concluded the program resulted in a 47 percent decrease in teen sex.
South Pike Junior High, which has been using the program, held a rally this summer in which students were told to "Hear Wedding Bells before the Baby Yells" and that "Abstinence is 100 Percent Guaranteed." Those attending received free T-shirts and wrist bracelets.
But the program has drawn its share of criticism. After some parents from Shamrock Middle School in Georgia complained Choosing the Best wasn't medically accurate, administrators dropped it.
After reviewing the Choosing the Best program, the Sexuality Information and Education Council of the United States concluded the most recent edition of the curriculum is medically accurate but provides some misleading information to teens.
Abstinence-only programs are failing to work, said Norwood, who also serves as a professor of nursing at the University of Mississippi Medical Center.
"By the 12th grade, 61.6 percent of students in the U.S. have had intercourse, and it's probably higher in Mississippi."
Teens are constantly bombarded with messages, she said.
"Everything is sex, sex, sex because it's so widely accepted. Not only are teenagers not abstaining, but they're not using any kind of protection."
Because they lack education, they remain uninformed, or in some cases, misinformed, she said. For instance, a lot of younger kids are performing anal or oral sex, believing this is safe, she said.
Any education must be age appropriate, she said.
Although the Brookhaven School District had until next summer, it went ahead and adopted policies for its abstinence-only program.
"We felt it was the best fit for the community," said district Superintendent Lisa Karmacharya.
The district already was doing some instruction through health and biology classes, she said.
"It's an opt-in program. Parents must agree, and they separate the boys and girls."
Some students are taking matters into their own hands.
Briana Wilcox, a 17-year-old senior at Wingfield High School in Jackson, said most peers "get their information from other teens. Sometimes that information is wrong."
She is a member of Teens Helping Teens, and she often shares with students how they can avoid pregnancy and sexual diseases.
That works better than simply discussing abstinence, she said.
"Most teens are sexually active. If you tell them not to do it, they're going to go out and do it anyway."
Mississippi State University-Meridian professor Janet St. Lawrence helped develop the abstinence-plus program Becoming a Responsible Teen. It has been adopted in countries around the globe but not in Mississippi.
"At the moment," she wrote in an email, "I am in Botswana working with partners there as they adapt BART into Tswana culture for delivery in the secondary schools of Botswana."
Earlier this month, New York City officials announced plans to make sex education mandatory in all public middle and high schools to stem the tide of teen pregnancies and sexually transmitted diseases.
The Roman Catholic Archdiocese of New York has questioned the requirement, saying in a statement, "Parents have the right and the responsibility to be the first and primary educators of their children."
This fall, Mississippi parents will be polled for their thoughts.
"One of the bits of information we're missing is, 'What do the parents think?' " said Therese Hanna, executive director for the Center for Mississippi Health Policy. "That's a piece of information that's important to school districts and the state Department of Education."
Some churches have advocated their own abstinence programs.
Many churches have embraced the True Love Waits program, which encourages teens to take a vow of chastity.
Ken Hall, a minister with First Baptist Church in Jackson, said their experience with the program has been positive.
"I'm not naive enough to think everyone who made the True Love Waits pledge followed through on it, but I do know that many students did follow through and remained sexually pure until marriage," he said.
He has performed weddings for some who announced at their ceremony they had made this vow and kept it, he said.
As a teacher, Emily Hildebrand found herself in the unlikely role of confidante when teenage girls advised her they were pregnant.
"They knew about their pregnancy, but they didn't know how they got pregnant," she said. "I told them, 'You've got to talk to your family.' "
Having students go to the auditorium for a program on abstinence isn't effective, she said. "They're reaching these children way too late."
She would like to see schools educate students starting in middle school. "You need to be honest and be real with these students," she said.
That instruction must be backed up by the home, she said. "The peer pressure is high."
She hopes change can come because "we as a state have a lot to offer," she said. "I'm personally tired of being made fun of because I love Mississippi."
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