NEW YORK— Each year, about 750,000 American girls under the age of 20 become pregnant. It’s one of the highest rates of teen pregnancy in the industrialized West. New York City's rate is especially high: more than 20,000 teenagers become pregnant each year. For those who keep their baby - more than half of teen moms around the country - the decision often leads to dropping out of school, unemployment and poverty.
As a young teacher in the Bronx in 1959, Michael Carrera saw how teen pregnancy in one of New York City's poorest neighborhoods foreclosed the hopes of many young girls and boys who became parents long before they were capable of taking care of themselves, let alone a family.
His interest led him to develop a pregnancy prevention program for the Children's Aid Society in 1984, a program he has run ever since. It is one of the relative few with proven effectiveness: Participants in the Carrera after-school program have half the pregnancy rate of other New York teens from similarly poor backgrounds.
The program starts before students reach puberty, with schoolchildren only 10 or 11 years old, and lasts through high school. There are sessions after school each day and on many Saturdays, as well as over the summer.
Sex education is only part of it. Carrera, who has a graduate degree in psychology, says the key is to address all of a child's needs, from physical and mental health, to knowledge and practical skills, to the need for achievement and a sense of mastery. These things, he says, help young people envision and plan futures of attainment.
“When young people believe that good things are going to happen in their lives, when they feel there is promise of success, they reduce risks on their own," he said. "So, we don’t prevent teen pregnancy - they do."
In addition to attending workshops on sex, relationships and family-life, students train in individual sports, such as swimming or squash, and take classes in self-expressive arts, such as writing. They learn how to find and keep part-time jobs and open their own bank accounts. They also receive educational and college counseling, and full medical and dental care.
22-year-old Kaity Modesto stayed in through college, getting job-coaching, and even money for workplace attire. As for sex and relationships, Modesto said she learned things her parents had not known to teach her.
“Even how to say no - it’s very hard in some circumstances as a woman, to say no," she said. "Because you might like someone, but you’re not ready for that step, and you think you should be. And [in] those kinds of things, the program definitely made [helped] me build confidence.”
“The program saved my life. It saved my life," said Felipe Ayala, who now works as the program’s college advisor. One of the first participants in 1984, he came from a tough neighborhood. He said most of his peers ended up in prison, became addicted to drugs, or were killed in gang or drug violence.
“The program kept us involved in things, and made sure we weren’t looking to have sex," said Ayala. "We weren’t in lonely places with young women, we weren’t taking young women to have sex with them, and becoming fathers before we were supposed to.”
Carrera, now in his mid-70s, said he seeks to give participants everything that he wanted for his own children. He said he looks for that same "desperation to help" in prospective staff.
"I say to them sometimes, 'I wish I could take an MRI of your soul, because I want to see if you understand the importance of gentleness and generosity.' I want to feel that they really do believe that these young people have gifts and talents, and no matter how deeply they're buried, or what the appearance of the young person, that they're going to be working with them weeks and months and years in order for it to be surfaced and used. That's the kind of desperation I'm talking about," he said.
The Carrera program is not cheap. The investment of $2,500 per child per year is perhaps the main reason it has not been more widely copied.
Still, it now reaches 4,000 students in 12 states, including 2,000 in New York City. And it could expand in the future: The Obama White House honored it with a “social innovation” award, and in 2010 ordered for the first time that federal funding for sex education go only to programs of proven effectiveness in reducing teen pregnancy.