It鈥檚 time for educators to double down on prevention efforts.
With the U.S. Supreme Court鈥檚 Dobbs v. Jackson Women鈥檚 Health Organization decision overturning the right to an abortion that was guaranteed by Roe v. Wade, accessing an abortion may become near impossible for many students. Preventing unintended pregnancies and thus the need for abortions is the best way to help students in this post-Roe era. As adolescent-health researchers and parents, we believe schools have a major role to play.
Schools have played a vital role in the decline of teen pregnancies, births, and abortions over the past 30 years by increasing the availability of comprehensive sexual-health education and providing greater access and links to contraceptive services. During this time, the number and percentage of school-based health centers providing contraceptives on-site rose; the decision to include those services is most often made at the school or district level.
Schools are the most common and most regulated source of formal sexual-health education for youth. Students need sexual-health education that is medically accurate and age-appropriate. Importantly, comprehensive sexual-health education includes both the benefits of delaying sexual intercourse and provides information about reproductive development and contraception. This is the gold standard for sexual-health education. Students have options, and they should know about them.
For decades, child-development experts have recommended that sexual-health education start in elementary schools as part of comprehensive K-12 health education taught by trained health educators. While the instructional focus differs depending on the age of the students, concepts such as healthy friendships, self-image, and personal boundaries should be discussed with students as early as kindergarten. Age-appropriate skill-building elements, such as decisionmaking and accessing reliable information, should be incorporated throughout.
These topics and skills are the building blocks for teens to understand and practice giving and seeking consent, pregnancy and sexually-transmitted-disease prevention, and healthy romantic relationships.
The evidence is clear that content matters. When armed with comprehensive education鈥攚hich includes information about contraception and not just abstinence鈥攕tudents make sexual-health decisions that protect themselves from negative outcomes.
One study showed states with mandated, comprehensive sexual-health education have lower rates of sexually active youth and higher rates of contraception use when youth are sexually active compared with states that mandated abstinence-only sexual-health education.
Finding the best sexual health education programs can feel daunting, but it doesn鈥檛 have to be.
In addition to providing sexual-health education, schools have also aided in expanding students鈥� access to and use of contraceptives through school-based health centers and community partnerships. Having school-based health centers reduces the barriers related to stigma, confidentiality, transportation, cost, and scheduling many students face when trying to find reproductive-health services. In the absence of on-site services, school staff can connect students to youth-friendly reproductive-health services in their communities.
Here鈥檚 the challenge: Thirty-three states mandate sexual-health education in schools, but only 13 of them require the classroom discussion of contraception, and only 12 require that the instructional content be medically accurate. Furthermore, because of district-related policy barriers, less than half of adolescent-serving school-based health centers provide contraceptives on-site, according to recent data. Thus, restrictive policies, not parents, as often supposed, seem to be a significant hurdle. (Note: Most parents, regardless of political affiliation, support comprehensive sexual-health education in schools.)
We have work to do.
Educators can prevent unintended teen pregnancies, decrease the need for abortions, and improve health for the young people they work with.
District leaders, first and foremost, can allow school-based health centers to provide contraceptives, mandate K-12 health education, and make comprehensive sexual-health programs the only option for their schools. Despite state mandates and requirements, local norms about sexual-health education in schools often shape policies and practices around what actually gets taught. Provide your students with access and information.
Finding the best sexual-health education programs can feel daunting, but it doesn鈥檛 have to be. The Office of Population Affairs Teen Pregnancy Prevention Program, run by the U.S. Department of Health and Human Services, currently funds comprehensive sexuality education in 29 states. The program has identified more than two dozen evidence-based comprehensive sexual-health education curricula and served over 1.4 million youth since its inception in 2010.
If your state isn鈥檛 currently funded or sexual-health education and contraceptive access are uphill battles where you live and work, there are other ways to support your students in this post-Roe time.
If you are a school leader or teacher, you can direct students to resources outside of school. Nationwide organizations such as Amaze, Planned Parenthood Federation of America, and Advocates for Youth offer reduced-cost reproductive-health services for youth, open access curricula, fact sheets, and videos.
Local and state health departments also often have free online resources available for youth to use for sexual-health decisionmaking. For example, the Baltimore鈥檚 health department hosts the UChoose program, which disseminates information around contraceptive options, relationships, reproductive-health service locations, and parenting as a teen.
You can also answer students鈥� questions about sexual-health. Keep an anonymous box for students to submit questions that they may be unable or afraid to ask in an open setting. It鈥檚 OK if you don鈥檛 always know what to say; you can ask others for guidance. The same national organizations mentioned above, along with colleges and universities, have experts that can help you provide thoughtful and accurate responses to student questions.
Ultimately, ensuring access to contraceptives and offering comprehensive sexual-health education are among the strongest strategies to prevent unintended teen pregnancies and the need for abortions. Now, more than ever, youth will need these preventive tools. The full impact of the Dobbs decision remains to be seen, but through advocacy and partnerships, educators can make a powerful difference in the health of our young people right now.
