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Photograph by Michael Amsler Babies making babies: Maria Serrano, 16, hoists her 6-month-old son, Marco. Sonoma County is the only place in the greater Bay Area to clock an increase in teen births. Sex Ed 101 Despite a $165 million state teen pregnancy prevention program, Sonoma County's teen birthrate is on the rise By Janet Wells UP SEVERAL TIMES during the night to feed her 2-month-old daughter Marisa, Michelle Muniz sports the sleep-deprived look of a new mom: distracted, tired smile, eyes a little puffy. Her day starts at 5 a.m., getting Marisa dressed, then revolves around appointments, dirty diapers, feedings, studying, and cleaning house. Pretty typical, except for the homework. As Muniz hones her skills as a parent, she also bones up on 10th-grade math, English, and science. With a light-blue V-neck sweater, black stretchy bell-bottoms, and platform sneakers, Muniz looks every inch a high school sophomore. She had her baby in August, just two weeks after her 16th birthday. "[The pregnancy] was unplanned," the hazel-eyed Muniz readily admits. "It was my not being responsible with birth control." Muniz is well aware that her life is very different from most high-schoolers. She lives in a two-bedroom Rincon Valley apartment with Marisa's father, 18-year-old Mario Onate, as well as his mother and her boyfriend. Graffiti adorn the complex fence, and shopping carts are overturned in the otherwise tidy side yard. Muniz relies on vouchers for milk, eggs, cheese, and infant formula to supplement Onate's income from his job at a lumber company. "My sister was a teen mother. I didn't want to have kids, I wanted to wait until I was married. I saw how hard it was for her, but . . . ," Muniz's voice trails off, then becomes matter-of-fact. "I was looking for love and caring and support in all the wrong places. "Well, not the wrong places," Muniz corrects herself, pausing again. "I was going to get an IUD when I found out I was pregnant." Marisa is one of hundreds of babies born each year to Sonoma County teens. Compared to the statewide average of almost 57 births for every 1,000 teenagers, Sonoma County's rate of just under 38 births per thousand puts it below the statistical red zone. What has local educators and public health officials puzzled, however, is that while the state and national teenage birthrates fell for the sixth year in a row, Sonoma County's teenage birthrate went up in 1997 (the most recent figures available), bucking the trend, and clocking in as the only county in the greater Bay Area to have an increase in teen births. Santa Clara, Alameda, Mendocino, Lake, and Solano counties all have a higher birthrate than Sonoma County, but showed decreases of 3 to 18 percent in 1996-97. Napa, with a teenage birthrate of 34 per 1,000 teenagers, dropped an impressive 23 percent in one year. Even Marin County, with a statewide low of 19 teenage births per 1,000, still carved out a 10 percent decrease. The state spends more than $165 million annually on teenage pregnancy prevention, and numerous programs on the local and federal level target teen pregnancy, with the goal of shrinking a phenomenon that has hefty social and economic consequences for the young parents, as well as for taxpayers. According to a recent report on the consequences of adolescent risk-taking behavior, teen moms are less likely to complete school and more likely to be single parents. Children of teenage mothers are more likely to be in poorer health, have lower cognitive development, and have less success in school. The estimated annual cost to taxpayers of births to young women ages 15 to 17 is at least $6.9 billion in public assistance, health care, foster care, court costs, and lost tax revenues. THE TEENAGE birthrate is a touchstone for myriad social and cultural issues, and is carefully monitored by education and public health officials. So after a five-year decrease of about 10 percent, what happened in Sonoma County to make the birthrate go up by half a percent? Statistical anomaly, says county Public Health Officer Dr. George Flores. "Sonoma County already had one of the lowest teen birthrates in the state. We don't have as much to go down as the state would overall ... although we still have room for improvement, don't get me wrong," he says. "We've had very good participation targeting teen and out-of-wedlock pregnancy and male responsibility." Some educators say, however, that the county's mishmash of prevention programs offer inconsistent information and access. In addition, while some innovative programs get results, others are geared more toward what adults want teens to do and think, rather than toward teens' needs. "We have to provide them with information they can use," says Cindy Dickinson, women's health program coordinator at the Southwest Community Health Center. "We're wanting to make sure they get a comprehensive program that talks about abstinence as well as how to access family planning and how to prevent STDs and how to use a condom." California's education code mandates that schools providing sex education stress abstinence first, and then heterosexual monogamy if teens are going to be sexually active. There is little standardization of sex education in Sonoma County's public schools, with discussions of birth control and pregnancy as likely to be in science or social studies as in physical education class. Teachers have leeway in deciding how and what to present to students, and often invite outside educators to the classroom, which means that sex education comes from groups ranging from Planned Parenthood to those with more conservative agendas. Muniz remembers hearing about birth control, sexually transmitted diseases, and HIV in middle school and in her freshman year of high school. But the admonitions didn't resonate. Like many teens, Muniz had other things on her mind, with an adolescence complicated by family discord. Her parents split up when she was 11, and, until her mother moved to Novato a few years later, Muniz shuttled between two homes. As a freshman, she dropped out of high school and moved out of her dad's house, first to her grandparents, then to live with her boyfriend, three years her senior. "There are no excuses for pregnancy, of course," she says. "But If I were to be a normal student going to high school, that would have made a difference for me." Family is one of the unsung keys to preventing teen pregnancy, Dickinson says. "What's really lacking, what we all want to work on, is getting parents involved in talking with kids, so parents know their kids are talking about sex and family planning, and kids know what parents are feeling about sexual involvement," she says. "It seems that a lot of parents don't have the skills to communicate. "Kids are looking for information, looking to see if there's someone they can talk to about sex," Dickinson explains. "If they talk with their parents, it means they might end up postponing sex or using protection." Unplanned parenthood: Sixteen-year-old Michelle Muniz returned to classes at Elsie Allen High School after giving birth to her daughter, Marisa. THE FACTORS behind teen pregnancy are much more complicated than many educational policy wonks realize, says Marian Heath Benner, program manager for the teen pregnancy prevention program at the Sonoma County Office of Education. "It's an issue of poverty and an issue of crime and a political issue," she says. Teen pregnancy rates are highest by far among Hispanic teenagers statewide, with more than 100 pregnancies per 1,000. One of the teen pregnancy hot spots in the Bay Area is southwest Santa Rosa, which has a large Hispanic population. "It's a cultural norm, coming from the families, that it's OK to have kids young, OK to be dating older men. That's also exacerbated by poverty," Heath Benner says. "Sometimes the only way out for these girls is to have a baby and get out of the house." Heath Benner's program targets the southwest Santa Rosa area, with a five-year grant for seven elementary schools, Cook Middle School, and Elsie Allen High School. At Cook Middle School, students talk about postponing sexual involvement during the weeklong "Baby, Think It Over" program that gives kids a reality check in the form of an 8-pound computerized doll. Students lug the doll around for four days, trailing the usual baby accouterments--the ungainly diaper bag and stroller. "Baby" is programmed to cry at particular intervals, and if it wakes "Mom" or "Dad" up, they must insert a key in the doll's back to turn it off. The internal computer registers neglect, shaking, or throwing as abuse. Heath Benner took a doll home for her 16-year-old daughter to check out. "After an hour, she said, 'Mom, can you watch this baby for me?' These kids start getting the idea of what it's like to have a baby." At the high school level the focus of Heath Benner's program changes, responding to older teens who are becoming more sexually aware and curious. "Health education has been coming through in the disease prevention-type model, the 'If you do this, you're going to get this. Here are the ways you can protect yourself.' It's the bad side of it," Heath Benner says. "We do the safer sex formula. The safest way is to abstain, but we acknowledge that we have a substantial population of high school students who are sexually active, and [we] want them to be safe. That's why the relationship stuff is so important and birth control is so important. "I started asking high school kids what they wanted to know," Heath Benner adds. "They said, 'How do you have a relationship? How do you break up with someone and stay friends?' We try to focus on that, on how relationships are different, and issues around intimacy. We talk about how men's and women's brains are wired differently. They love that stuff. It makes lights go on for them." But the most effective birth control, says Heath Benner, is hope for the future. "A lot of kids don't have a vision for themselves after age 20. They don't see themselves at age 28 or 30. They don't think, 'If you have a baby now, what's going to happen? How's that going to derail your plans?' " MUNIZ FITS the picture of an aimless teenager, who, by her own admission, spent time doing "stupid stuff" before she got pregnant. She credits Adera High School, a program for pregnant and parenting teens on the Elsie Allen campus in Santa Rosa, with getting her back on track. While she was pregnant, Muniz learned CPR and prenatal care, and got firsthand parenting experience taking care of babies left in the Adera nursery while their mothers went to class. She met other teens in her situation, and received encouragement and support to stay in school. Now that she's had the baby, Muniz is doing home study until Marisa is old enough to receive immunizations and go to school with her. Muniz's advice to other teens has the ring of experience to it: "It's better to use protection if you do choose to have sex. If you get pregnant, that's a bigger responsibility." She had to grow up fast, she says, and accept some drastic changes to her social life. "Sometimes I feel like, 'Can someone come and take her away for a day?' But if I get frustrated when she is, she can feel my stress," Muniz says. "I have to deal with it calmly. "I gave up my friends," she adds, her voice a little wistful. "Some of the closest stop by, but I haven't talked to some since the first visit. What would they be doing for me anyway if they can't handle me with a baby? MARISA WAKES up and begins to fuss in her auto-rocking bassinet. "Is that a dirty diaper or is it a hungry bunny?" Muniz asks, picking Marisa up and swinging her brown-eyed daughter in the air. "This is way more interesting," she says, with just a hint of resignation, as she settles back onto the couch. "That was pointless then. I was a frisky little girl. I'm still a girl, but now I have a little baby, so I can't be off the wall and do crazy stuff." Soon she and Marisa will be leaving the house at 6:45 each morning to catch a bus to Adera. For the first time, Muniz has a future in mind: graduation from high school in two years. "It's really important to get your education, especially if you have a little one to take care of," she says, smoothing her daughter's shock of brunette hair. "You don't want to work at McDonald's all your life." [ Sonoma County | MetroActive Central | Archives ]