Nineteen-year-old Claudia Rivera shares a single-story tract home in Liberal with her boyfriend, 20-year-old Jesùs Varela. Last month, Varela’s mother moved in so she could watch Rivera’s baby boy, Fabian, while Rivera works at the Dollar General store and Valera pulls down a shift at the local meatpacking plant.
Getting pregnant at 17, Rivera says, changed her life – and her plans to go to college.
“I had him three months after I graduated,” she says. “I was going to go to school. But when it was my due date, that’s when classes started. So I delayed it two years, and now next year for sure I’m going.”
The same year Rivera became pregnant, her best friend also had a baby. In Liberal, she says, teen moms aren’t that unusual. In fact, southwest Kansas cities like Liberal, Dodge City and Garden City have the highest teenage birth rates in the state.
These towns also happen to have large Latino populations. Close to 60 percent of Liberal’s 20,000 residents are Latino. Many, like Rivera’s parents, emigrated from Mexico to work in the meatpacking plant.
Surveying southwest Kansas
The high teen pregnancy rates in this rural part of the state first caught the attention of Dr. Romina Barral, a physician specializing in adolescent medicine at Children’s Mercy Hospital in Kansas City, Mo.
“When I came here to Kansas, I noticed that the teen pregnancy rates were higher than the rest of the country,” Barral says. “In fact, it was three times higher in the Latino or Hispanic community compared to other ethnic groups.”
According to the National Campaign to Prevent Teen and Unplanned Pregnancy, 6.4 percent of Latinas ages 15 to 19 will give birth. That may not sound like a lot, but it’s the fourth highest rate in the country.
Barral, along with Juntos, a research center for advancing Latino health, has been surveying Latino youth in southwestern Kansas to understand why the numbers are so high. And what she found is that teens there know even less about safe sex and contraceptives than she expected.
“These are teens that are raised in a very conservative community,” Barral says. “So basically they’re engaging in sexual behaviors without knowing exactly how to prevent their consequences.”
Like all public schools in Kansas, Liberal High School, which Rivera attended, is required to teach about contraceptives and sexually transmitted diseases. But Rivera says she never learned how to get the pill — or that she had other options.
“I knew that there was birth control, but I thought that there was only the pills,” Rivera says. “I didn’t know about anything else, like the Mirena. But I didn’t ask my mom ’cause I was scared. She’s like, ‘Why are you having sex?’”
Mirena is a popular hormone-releasing IUD that lasts as long as five years. Barral thinks contraceptives like this should be readily available to teens like Rivera. She says that would be a big step in modernizing the state’s outdated approach to teen reproductive health.
“These methods are now first-line and should be offered first to these teenagers so that they can have their contraceptive needs covered for three to five years. Even up to 10 years if they choose a certain type of IUD,” Barral says. “So they can go ahead and enjoy their friendships, study and achieve their academic goals.”
Access to care an issue
Vincent Guilamo-Ramos is a professor at New York University who has studied adolescent health among Latinos for more than two decades. He says that while the national rate of teen pregnancy has decreased significantly in the past 20 years, it’s still unacceptably high for Latinos: About three out of 10 Latina teens will get pregnant before the age of 20.
That doesn’t mean Latino teens are more likely to engage in sex compared with other ethnic groups. Rather, Guilamo-Ramos says, the difference has to do with the resources available to them.
“If you’re Latino, you’re less likely to have a routine source of primary health care,” Guilamo-Ramos says. “You’re more likely to be underinsured or not insured, or you may be less likely to have access to reproductive health services.”
There are any number of reasons why that may be so. Many Latinos don’t have jobs that offer health benefits. Limited English proficiency can be a barrier. So can immigration status.
Crucially, Guilamo-Ramos says, teen pregnancy can perpetuate the cycle of poverty. Teen moms are more likely to drop out of school and face greater economic hardship than older mothers.
Rivera recognizes this. But she’s not sure she would have done anything differently.
“It's kind of like a yes and a no,” she says. “If I was going to tell myself, ‘Don't have sex without a condom,’ it's kinda like, ‘Well, I don't want my baby right now.’”
Now, Rivera says, she’d tell herself to wait – at least until she completed her education. At the moment, Rivera is focusing on work and saving money so that she can afford community college next fall.