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Making Dreams, Not Babies: The Power of Hope in a Teen Family Planning Clinic


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									Creative Nursing, Volume 15, Number 3, 2009


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).

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
childless counterparts (Hofferth, Redi,
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