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Creative Nursing, Volume 15, Number 3, 2009 ARTICLES AND ESSAYS Making Dreams, Not Babies: The Power of Hope in a Teen Family Planning Clinic Kimberly Raines, CRNP, MSN Teenage pregnancy is a signiﬁcant social issue in the United States, resulting in in- creased levels of poverty. Most public health family planning efforts have traditionally focused on teaching teens the how-to of contraception, with little focus on teaching the why-to. During my time as a nurse practitioner in a public health department family planning clinic, I developed a method to open discussions with patients about the pos- sibilities of a future that includes delayed childbearing. My experience with this strategy taught me that hope may indeed be the most powerful contraceptive of all. he teen pregnancy rate is at an historic low in the United States (Martin et al., T 2007 ). These numbers reassure those of us who work in family planning that we are doing something right. We like to think that the U.S. public health care system is doing an excellent job dispensing birth control to those who can least aﬀord the emotional and ﬁnancial responsibilities of parenthood: teenage girls. Sadly though, there is much work yet to be done; each year in the United States, 750,000 teens become pregnant (Guttmacher Institute, 2006). ONE NURSE PRACTITIONER’S EXPERIENCE As the nurse practitioner in a busy Birmingham, Alabama public health family planning clinic, I cared for hundreds of teens from low-income households. As any- one who has worked with this population in this setting knows, the challenge with these patients was not necessarily getting them on birth control, but rather keeping them on birth control. Just down the hall, the prenatal clinic’s appointment book Kimberly Raines, CRNP, contained far too many names of my former patients lost to unplanned pregnancy. MSN, has been an RN Most of my young patients were still in high school and at the age of looking for more than 20 years. forward to an exciting future. Only . . . they weren’t. For so many of these teens, She earned certiﬁca- faith in a better tomorrow was simply not part of the landscape. Instead, many of tion as a nurse prac- our adolescent patients assumed that their lives would be eternally bound by the titioner in 1997 and is cycle of poverty. In our society the road to independence begins with a college currently an adjunct faculty member in the degree; however, teen mothers are much less likely to attend college than their baccalaureateprogram childless counterparts (Hoﬀerth, Redi,
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