In the struggle to break cycles of poverty, experts have been searching for decades for ways to lower America’s astronomical birthrate among teenagers.
We’ve tried virginity pledges, condoms and sex education. And, finally, we have a winner, a tool that has been remarkably effective in cutting teenage births.
It’s “16 and Pregnant,” a reality show on MTV that has been a huge hit, spawning spinoffs like the “Teen Mom” franchise. These shows remind youthful viewers that babies cry and vomit, scream in the middle of the night and poop with abandon.
Tweets containing the words “birth control” increased by 23 percent on the day after each new episode of “16 and Pregnant,” according to an analysis by Melissa Kearney of the University of Maryland and Phillip B. Levine of Wellesley College. Those tweets, in turn, correlate to increased Google searches along the lines of “how get birth control pills.”
Ms. Kearney and Mr. Levine find that regions with a higher audience for “16 and Pregnant” and the “Teen Mom” franchise had more of a drop in teenage births. Overall, their statistical analysis concludes that the shows reduced teenage births by 5.7 percent, or 20,000 fewer teenage births each year. That’s one birth averted every half-hour.
To put that achievement in context, I’ve been fulminating about the teenage birthrate for years, and I don’t think I’ve averted a single birth.
Because abortion rates fell at the same time, the reduced birthrate appears to be the result principally of more use of contraception. It’s also a reminder of the paramount need for clinics that offer free, long-acting contraception: When a teenage girl searches the Web for birth control, let’s make sure she finds solutions.
Ms. Kearney and Mr. Levine, both economists, are experts in why teenage birthrates are so high in America (one factor: Teenage births reflect poverty as well as transmit it to the next generation). U.S. girls are almost 10 times as likely to have babies as Swiss girls and more than twice as likely as Canadian girls. In no other developed country are teenagers as likely to get pregnant as the United States.
But here’s the good news: Teenage birthrates have plunged by 52 percent since 1991 — one of America’s great social policy successes, coming even as inequality and family breakdown have worsened. The steady drop in teenage births accelerated greatly beginning in 2009, when MTV began airing “16 and Pregnant.”
“It’s another reminder that great storytelling can be a powerful catalyst for change,” says Stephen K. Friedman, the president of MTV.
By all accounts, the MTV shows worked because they focused on compelling stories, not on lecturing or wagging fingers.
“If the government tried this, it would have a good message, but three people would watch it,” Mr. Levine said.
Middle-class Americans tend to think of contraception in terms of condoms or pills, but just as critical is a girl having a prospect of a better life if she delays childbearing. Ms. Kearney and Mr. Levine find that one of the factors in the long-term decline in teenage births is the improvement in job possibilities for women.
For example, girls who were randomly assigned to attend Promise Academy, a middle school in Harlem Children’s Zone, were less likely to become pregnant because they were also more likely to excel and have a shot at college.
As a haughty journalistic scribbler, I tend to look down on television, so it’s a bit painful to acknowledge its potential for good. But the evidence is overwhelming.
A careful study by Robert Jensen of the University of California, Los Angeles, and Emily Oster of the University of Chicago found that before television arrived in Indian villages, traditional attitudes ruled: Women had to get a man’s permission to leave the house, and 62 percent of women said it was acceptable for husbands to beat wives. Then villagers watched Indian soap operas with middle-class urban families in which women aren’t beaten and leave the home freely. These norms infiltrated the village, and the arrival of television turned out to be equivalent, in nurturing more egalitarian attitudes, to five years of female education.
The master of injecting causes into storytelling is Neal Baer, the television producer behind “ER” and “Law and Order: Special Victims Unit.” Dr. Baer, a pediatrician who helps lead the Global Media Center for Social Impact at UCLA’s school of public health, wove issues like vaccination and rape-kit testing into his shows, raising awareness in ways that no news program could. Polling showed that one “ER” episode about cervical cancer doubled the audience’s awareness of links between the human papillomavirus and cervical cancer.
Some more good news. After a hiatus, MTV will introduce season five of “16 and Pregnant” on April 29. Family planning clinics had better stock up!
Nicholas D. Kristof is a syndicated columnist for The New York Times.