Prenatal Drug Education in Public and Private Schools of Nebraska

Article excerpt

Use of alcohol, tobacco, and other drugs by pregnant adolescents is a significant national health concern. In the United States, 78% of adolescent women have engaged in sexual intercourse by age 20. Each year, more than 1 million teen-age women ages 15-19 become pregnant resulting in a rate of 70 pregnancies per 1,000 young women. Furthermore, 19% of high school seniors report daily smoking, 33% of high school seniors engage in occasions of heavy drinking of alcoholic beverages, and 7% of high school seniors have tried an illicit drug.[1]

Use of tobacco, alcohol, and other drugs by pregnant women has been associated with a variety of adverse reproductive outcomes. In 1990, 18.4% of women giving birth reported smoking during pregnancy; prenatal exposure to cigarette smoke i a risk factor for low birth weight, prematurity, SIDS, and other maternal and infant health problems.[2-5] Excessive maternal alcohol consumption during pregnancy can result in problems ranging from miscarriage to Fetal Alcohol Syndrome (FAS).[6,7] In 1990, Levy and Koren[7] found that 25% of women reporte ingestion of alcohol at some point during their pregnancy. Use of other drugs, including cocaine, during pregnancy is associated with fetal distress, impaired fetal growth, and developmental problems during and after infancy.[8]

A positive association exists between drug/alcohol use and sexual behavior amon teen-agers. Teen-agers who smoke are more likely to engage in early sexual activity and often do not practice consistent contraceptive behaviors.[9] Likewise, for teen-agers who used illicit drugs at onset of sexual activity, th probability of becoming pregnant as an adolescent is higher than that of the general adolescent population.[9] Several studies documented that social, psychological, and familial factors are similar for adolescent mothers and adolescent drug users.[10] These factors contribute to increased risk in adolescents for substance abuse during pregnancy.

Substance abuse prevention among pregnant teens should provide a multifaceted approach which includes educating the general public and expanding the scope of patient education through the health care system. However, perhaps the most important and effective strategy involves health education through the school system. Comprehensive school health education (CSHE) offers the greatest opportunity to reach young women and men at a period in their lives when critical decisions about sexuality and drug use are made.

Comprehensive school health education assures that all dimensions of health are addressed and that the school health curriculum is systematic and sequential from kindergarten through 12th grade. Interaction with a broad array of community agencies and coordination with other disciplines to avoid duplication and to share resources also are essential components of CSHE. A designated professional is typically responsible for overseeing a plan for training and continuing education of teachers and others involved in such a program.[11-14] While it is difficult to measure the extent to which comprehensive school healt education programs are implemented in Nebraska, such programs are a legislative mandate in the state.

A literature review indicated little is known about the nature and extent of education in schools regarding hazards of drug and alcohol during pregnancy. This survey investigated prenatal drug education presented by public and privat elementary and secondary schools in Nebraska. The survey focused particularly o the grade levels and subjects in which the education was presented, the amount and type of training teachers have in prenatal drug education, barriers to providing this education, and perceived needs of the teachers.

SURVEY PLANNING

Respondents

The Nebraska Dept. of Education identified categories of teachers in public and private schools in the state who might teach prenatal substance abuse education in their classes. …