Under legislation that took effect on July 1, Mississippi became the first state to require doctors to collect umbilical cord blood from babies born to mothers who were 16 or younger at the time of conception. The law requires DNA tests to prove paternity in situations where sexual abuse is presumed, when the purported father is 21 or older, when the baby's paternity is in question, or when the mother refuses to identify the father. The law also requires collection of DNA samples from products of abortion for all patients under 14 years old. Failure to collect the samples can result in criminal penalties. Proponents say the law is intended to protect young girls and lower teen pregnancy rates.
Protecting adolescent females from sexual abuse is laudable, as is reducing teen pregnancy; but from an evidence perspective, it is questionable whether Mississippi’s legislation will lead to improved outcomes. Research has confirmed a link between childhood sexual abuse and teen pregnancy. However, a review of studies examining that association concludes that experiencing childhood abuse is only a marker in the “constellation of risk factors that increases the likelihood of adolescent pregnancy.” Across the country, 70 percent of sexually active teens had sex for the first time with someone within two years of their same age. Almost one in four babies born to teens in Mississippi is a second or later child for the mother. And teen pregnancy and birth rates in Mississippi are highest for those aged 18 to 19, whom the law does not affect.
From the legal perspective, blanket DNA testing of infants without the consent of the child’s parent or guardian and storing of blood samples raise privacy concerns that warrant significant consideration. The Network’s materials on newborn blood screening provide ample examples that these are important and difficult privacy issues, made even more acute where there is no intention of maintaining samples in an anonymous manner. Moreover, DNA tests on the collected samples are quite costly, at approximately $1,000 per test. And there is risk that pregnant teens will be discouraged from seeking necessary prenatal care from reputable providers if they fear forced testing of their babies.
Mississippi clearly struggles with high rates of teen pregnancy and other sexual health issues. In 2009, Mississippi had the highest teen pregnancy rate and highest teen birth rate in the country. The state ranked seventh nationally in cases of HIV per capita in 2010, and at the same time ranked next to last in the percentage of high school students who report ever being taught in school about AIDS or HIV. Sixty-one percent of high school students in Mississippi reported having had sex, higher than the national average of 46 percent.
Given these statistics, perhaps Mississippi and other states grappling with high rates of teen sexual activity and pregnancy should consider evidence-based policy that does not raise the significant concerns about non-consensual testing. One such policy is requiring comprehensive, evidence and science-based sex education curriculum in all schools. Prior to 2011, state law in Mississippi did not require sex education in public schools. Schools that chose to teach it were required to use an abstinence education curriculum and were expressly prohibited from demonstrating the use of contraceptives, despite the fact that students in Mississippi were having sex earlier than in any other state.
In 2011, the Legislature passed House Bill 999, which requires local school boards to adopt a sex education policy, but allows the school boards to elect between abstinence-only or abstinence-plus curricula. The law requires parents to expressly opt children into the curriculum. Only 68 of Mississippi’s 156 school districts opted for an abstinence-plus curriculum and only 39 adopted a curriculum endorsed by the U.S. Department of Health and Human Services. Hence, the legislation created little change in school curricula.
Comprehensive sex education is bolstered by a large body of scientific evidence supporting its efficacy. At the federal level, the Centers for Disease Control and Prevention (CDC) identifies curricula that effectively reduce risky sexual behaviors for young people. Independent studies have also verified the efficacy of comprehensive sex education programs on reducing risky adolescent sexual behavior. In a literature review that examined studies of prevention programs, researcher Douglas Kirby found that over two-thirds of the comprehensive programs had positive effects. Of those programs, “40 percent delayed sexual initiation, reduced the number of sexual partners, or increased condom or contraceptive use,” and “30 percent reduced the frequency of sex, including a return to abstinence.” More than 28 of the programs studied were successful in reducing unprotected sex.
All states have enacted laws seeking to protect teens from sexual abuse. And many states have also moved to encourage some form of evidence-based sex education programming. Mississippi’s law permits the adoption of such programs, but clearly attempts to address teen sexual health issues at the expense of privacy rights. This approach lacks evidence showing the necessity for or the efficacy of such intrusive actions. Moreover, it may ultimately discourage pregnant teens from obtaining prenatal child care. And the law ignores an achievable, proven approach to improving Mississippi’s adolescent health: comprehensive, abstinence-plus sex education in all public schools.
Prepared by Brett Baulsir, Fellow at the Legal Resource Center for Public Health Policy. Brett is a 2013 graduate of the University of Maryland Carey School of Law and practiced for the Network’s Eastern Region through the Public Health Law Clinic.
The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state. The views expressed in this post do not represent those of the Robert Wood Johnson Foundation.