Dina González, GPJ, Argentina

As Argentina’s teen pregnancy rates have held steady over the past two decades despite mandatory sex education, experts and teen mothers discuss ways to address complex factors such as location and family dynamics.

BUENOS AIRES, ARGENTINA – María Alcaraz, 16, suddenly interrupts the conversation. Although the cries of her 5-month-old baby are barely audible, Alcaraz hears them as soon as they start. She lifts her daughter from the cradle, hugs and kisses her, then puts her to her breast to nurse in the room she and her boyfriend rent in Buenos Aires, Argentina’s capital.

“It is the most beautiful thing that I ever saw,” she says, looking at the baby. “She looks a little like me and a little like her father. I am happy. I have younger siblings, but with her, it is different. She is my baby. It is like playing house, but with my things.”

Alcaraz and her 19-year-old boyfriend were both homeless and had known each other for just months when she got pregnant, she says. They were not in school and had not received sex education. They did not use contraception because they had not thought about the risks of having unprotected sex.

After Alcaraz got pregnant, the couple continued living together on the street. They survived by begging for money and picking through the trash to find things to eat.

In June 2013, in the middle of the Argentine winter, the city government gave them a housing subsidy that enabled them to rent the room where they live today.

Argentine authorities have tried to lower teen pregnancy levels by guaranteeing that all students in Argentina have access to sex education, but rates have not budged. Program leaders say that implementing these relatively new policies takes time, especially in more conservative, rural parts of the country.

Experts say that is because teenage pregnancy is a complex issue in which many factors – such as family dynamics, location, and access to education and health care services – play a role. To make the curriculum most effective, they recommend that sex education go hand-in-hand with efforts to help young people plan for the future and develop long-term goals.

About 15 percent of Argentine babies are born to girls and women under 20, according to a 2013 report from UNICEF Argentina. That number represents a nationwide average. In some provinces in the country’s north and northeast, more than 20 percent of babies are born to girls and women in that age group.

The proportion of babies born to adolescents has not changed significantly over the past 20 years.

This is despite a 2006 law that guaranteed all pupils at public and private institutions the right to receive sex education. In 2009, the national Ministry of Education began distributing a curriculum that lays out the requirements for this education for primary and secondary levels.

The curriculum is designed to help children and teens become familiar with their bodies and the changes that occur in puberty; reflect on feelings related to sexuality; develop respect for intimacy; recognize sexual abuse; analyze the roles of women and men in society; appreciate concepts such as love, solidarity and respect for life; and learn about health care, contraception and the prevention of sexually transmitted diseases.

In presenting the curriculum, teachers have younger children draw, paint and tell stories. In teaching teenagers, they give lectures and moderate group debates.

Early sex education is an important part of preventing pregnancy among adolescents, says Silvia Kurlat, a psychologist and president of the Asociación Argentina de Educadoras/es Sexuales, a nonprofit organization that comprises professionals from different disciplines who specialize in sex education. Its work includes assessing educational institutions’ sex education programs, presenting courses and workshops to educators and other professionals, and promoting the distribution of condoms through neighborhood groups.

The city government contracts the organization to train teachers and administrators in the mandatory sex education curriculum, Kurlat says.

The workshop’s reading material trains teachers to overcome the various biases, stereotypes and taboos related to sexuality that they have acquired through cultural and social traditions. For example, teachers are encouraged to dispel the fear that talking about sex will encourage young people to start having sex earlier.

The workshops do not merely present content and disseminate teaching materials, Kurlat says. Presenters encourage teachers to share their doubts and fears with colleagues and administrators. Teachers and administrators discuss their experiences, raise questions and exchange ideas.

Teachers must be adequately trained before they can teach their students about sex, Kurlat says. By sponsoring the workshops, the government is making an honest effort to fulfill the law’s promise. But Kurlat acknowledges that implementing the program takes time, especially in some regions.

In more traditional parts of the country, where people are not used to talking openly about sex, implementing the law entails a cultural shift, she says. Teachers must master the material and methodology, and society as a whole must support the process. Kurlat believes the association’s training of local teachers can initiate that shift but recognizes that the process is gradual.

Ivana Mariangeles Dos Santos grew up in Misiones, the northeasternmost province in Argentina. She became a mother at 16. She grew up in a family of 10 children and says no one talked to her about sex at school or at home.

“I only spoke about sexuality after getting pregnant,” she says. “My mother did not get angry and did not get surprised. I was the third daughter that had a baby young.”

Today, Dos Santos is 22 and has a second child. She lives with the child’s father in Buenos Aires.

In addition to location, a variety of other factors, such as family dynamics, play a role in teen pregnancy, experts say.

Alcaraz grew up in a slum with her mother and five siblings, she says. When she was 12, her teacher told child welfare authorities that she was coming to school with bruises. The judge overseeing her case sent her to a home for minors.

Alcaraz did not like the home, she says. She ran away and started living on the streets. She dropped out of school and so did not receive sex education.

Catalina Carmona, the mother of a 4-year-old girl, became pregnant at 16.

Her mother left when she was a baby, so her father raised her on his own, she says. She received sex education at her school in Buenos Aires. She attended talks on the subject, watched videos and took part in group discussions.

Carmona admits she did not pay attention because she was not interested. Her classmates once talked about condoms during recess, and a friend brought one of her older brother’s condoms to school to show classmates. That was the first time she ever saw a condom.

Carmona’s father died shortly before she became pregnant for the first time. She was sad and confused about what to do with her life, she says. Deciding to become pregnant, she refrained from using contraception.

“I was lost,” Carmona says. “I did not know what to do, and I felt a lot of anger because of not having my mother or my father.”

Carmona went to live with the father, a boy from her neighborhood, but they separated shortly after. She has since started dating another man and is pregnant again. She lives with the father and wants to create a stable family together.

María Belén Ferrero, a social worker who works in a Buenos Aires slum, says that because teen pregnancy is a complex issue, addressing it requires a comprehensive approach.

“To talk about reasons why an adolescent ends up being a mother so young means to talk about life processes, about the meaning of life that each girl has,” she says. “It is not something that can be considered from only one perspective, but the reasons end up being entirely distinct.”

In response to requests for interviews, officials at the Ministry of Education said representatives of Asociación Argentina de Educadoras/es Sexuales were most capable of discussing the sex education program.

Kurlat has ideas for improving the curriculum. All sex education nationwide should include a focus on a life plan for students before and after pregnancy, she says. They should think about whether they want to continue studying, attend college or learn a trade.

“It is not talking only about contraception methods,” she says. “This is necessary but not sufficient.”

Teenagers must clarify their objectives, such as learning a trade, pursuing a degree, or creating a family, and then envision paths they could take to achieve them, Kurlat says. A teenage pregnancy delays such achievements.

The association obtained permission from the Buenos Aires government to include life planning in its workshops for teachers. But Kurlat says life planning should be part of the mandatory national sex education curriculum.

Alcaraz and her boyfriend are taking classes again in primary school, including sex education. But balancing parenthood and school is challenging.

“I have an exam today, and I could not study,” she says. “The baby had a bellyache, and we did not sleep well last night.”

Still, Alcaraz, who is working to rebuild her relationship with her mother, is emphatic that she does not want her daughter to repeat her history.

“I had a very bad time,” Alcaraz says. “I do not want the same thing to happen to my daughter. I take care of her and am concerned that she is all right.”

After feeding her baby, Alcaraz finishes her mate, a traditional tea common in Argentina. She puts a few diapers, a baby bottle, two notebooks and a pen in a pink cloth bag. Then, the whole family goes to school together.

GPJ translated this article from Spanish.