Ways to lower teen pregnancy? No 'magic doll' solution, researchers say

Educators around the world have tried many strategies for preparing young people to avoid teen pregnancy, including one innovative tool: the "magic doll" program, meant to mimic the difficulties of parenthood. Yet the idea may work against its purpose, as three Australian health organizations reported Thursday in the journal The Lancet. 

For years, researchers and teachers have been experimenting with how to educate young people about the challenges of teen pregnancy: sex-ed programs for contraceptives, sex-ed programs for abstinence, and even TV shows. In the most recent study, educators used an "infant simulator" program, including "magically" life-like baby dolls that try and simulate the challenging experience of teenage parenthood.

In the study, teenage girls received a life-like, life-sized robotic baby, meant to help them see why they aren't yet ready. It can laugh, cry, and know when it is "fed," requiring around-the-clock attention meant to teach students about real-life parenting's demands.

But the most successful efforts often focus on the teens' future, not scare tactics, some experts say. 

In this study, researchers assigned 57 secondary schools – with students age 13 to 15 – to either an experimental group, whose students received the robot baby curriculum, or a control group with more traditional health education. The team then followed up with the girls to see whether they had become pregnant by age 20.

In the control group, who had received a more general health curriculum, 4 percent had given birth at least once, and 6 percent had had at least one abortion. Among the girls who had completed the robotic baby curriculum, however, 8 percent had children, and 9 percent had had abortions: the opposite of the intended effect. 

The intervention came too late in the girls' lives and did too little to emphasize the challenges of child-rearing, Julie Quinlivan, a professor from the University of Notre Dame Australia, wrote in an accompanying commentary. A robotic doll cannot truly explain what having a child is like, and the program did not involve the other crucial actors in teenage pregnancy: teenage boys.

She also noted research that children from poorer backgrounds are more prone to teenage pregnancy, and suggested interventions focus on their particular educational and economic needs.

"We cannot afford the quick fix, especially when it doesn't work," Dr. Quinlivan wrote. 

So what strategies do work?

In the United States, the teenage pregnancy rate has dropped by almost half since 2006, the US Center for Disease Control and Prevention (CDC) announced in April. The CDC found huge geographic and racial disparities in teen pregnancy rates, however, and suggested that local solutions to related challenges in teens' lives can help bring the rate down further.

"We can ensure the success of teen pregnancy prevention efforts by capitalizing on the expertise of our state and local public health colleagues," said Lisa Romero, a health scientist in CDC’s Division of Reproductive Health, in a press release. "Together, we can work to implement proven prevention programs that take into account unique, local needs."

Such initiatives can help create a culture where a girl's friend circle helps her avoid teen pregnancy, Bill Albert, the chief program officer for the National Campaign to Prevent Teen and Unplanned Pregnancy, told The Christian Science Monitor at the time. 

"We talk about teenagers and teen influence almost always negatively when, in fact, it can be and often is a force for good. I think that one of the driving factors is that fewer teen mothers beget fewer teen mothers," he said.

The culture that teens themselves have created can be supported and replicated elsewhere.

"The messages and the programs should become even more targeted and even more nuanced so that we reach young people where they are, in relevant ways and ways that speak to them," Mr. Albert told the Monitor. "I think one of the headlines is not to hang the 'mission accomplished banner.' There's still considerable work to be done."