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Second Chance Club helps teen parents cope by Heather Woolwine Public Relations Cathedra Johnson glows, as do most mothers, when she mentions her twin sons. But unlike most mothers, the 16-year-old Johnson must balance adolescence, schoolwork, and motherhood for two 10-month-old boys who suffer from severe asthma. “Both of them have to get one treatment of Pulmicort at bedtime,” Johnson said. “But if they get sick then they have to have an extra treatment of albuterol every six hours. It takes about 15 minutes with each child.”  Despite what many would view as a hardship, Johnson is proud of her situation, especially since she received her “second chance.” The Second Chance Club, located at Burke High School and the brainchild of MUSC’s Jann Owens, R.N., and Jan Key, M.D., Pediatrics, strives to prevent repeat pregnancies of teenage mothers before they graduate from high school. The club’s staff consists of a social worker, a pediatrician, a nurse practitioner, a project evaluator, a research assistant, and a licensed professional counselor. With 15 active members, the club is designed to reduce the rate of second births among participants through weekly group meetings with topics including pregnancy prevention, parenting skills, vocational counseling, prenatal education, and other topics related to the teens and their children. “We have three main goals concerning our teen mothers,” said Julise Washington, Second Chance social worker. “We do everything we can to make sure they graduate from high school without a second pregnancy, become responsible mothers, and become educated on their health and the health of their children.” Washington works with members on a daily basis along with Owens, who serves as the club’s health care supervisor.   Key, Owens, and Washington developed the club’s curriculum, paying special attention to topics most people take for granted like basic nutrition, physical and Pap smear exams, and domestic violence.   “While we stress the curriculum and the club’s goals, we recognize that these girls were forced to grow up quickly concerning many life issues,” Washington said. “For many of these girls, we’re all the support that they have, and we remind them that although they have children, in many respects they are still children themselves. That’s why their education is so important.” Washington described an often-overlooked difference in the way uneducated adolescents think abstractly. “They don’t think in the abstract,” she said. “Their thought process is ‘I don’t have sex often enough to get pregnant, if I take birth control then I’ll gain weight, or we use condoms,’ when they’re not using condoms correctly. Because of our health-based and parenting approach, we’re able to get the message across to our moms through education and group therapy.” Washington also said that just telling teen mothers or at-risk teens that they may become pregnant if they have sex isn’t enough, that everything must be broken down into steps and mini-steps. “You cannot expect these young women to have basic knowledge about sex and health that you and I take for granted,” she said. Key sees most of “her” mothers during the Mother-Baby Clinic held every Tuesday from 1 to 5 p.m. in Rutledge Tower, but she also remains on-call 24/7. During clinic, moms and children can see a physician at the same time with the Adolescent Medicine Clinic providing primary care services like maternity counseling, gynecological care, immunizations, treatment of acute illnesses, social work assessments, and counseling services. In an effort to save time for the busy moms they service, clinic staff remind club members to access Women, Infant, and Children’s Services at the Health Department where they may receive nutrition counseling, milk vouchers, formula, and baby food while pregnant or nursing. “Our participants want to be the best mothers they can be, just like everyone else,” Key said. “They really turn into supermoms, and we don’t give up on them until they do.” This attitude is what Key believes makes the club so successful, despite the failure of other programs similar in design. “This is not just about whether or not they have another baby. It’s about how well they do in school, what kind of parents they want to be, and their career plans,” she said. “Our program is very intensive and personal; we support them, yet teach them about independence. We must do everything it takes to make a sustained change in the lives of these mothers and their children so that the vicious cycle of teen pregnancy is broken.” With national teen pregnancy levels showing a downward trend, the future looks promising for Second Chance. The completion of recent data analysis about the program demonstrated the program is responsible for a dramatic decrease in the number of repeat births in the intervention zip codes. Key mentioned other side effects that seem attributable to the program. “We encourage our mothers to read a book a day to their children,” she said. “And while the national statistics state that children born to teen mothers will more than likely be late talkers, the children in our program are the opposite. They are amazing little students.” “Being a part of this club has taught me a lot of things about my health and how to be a good mom for my babies,” Johnson said. “I do it because it makes me feel better, and it’s nice to be around other girls going through the same things. They always make sure you’re doing the right thing and staying in school.” Taking college preparatory courses and making As and Bs, Johnson plans to take summer school courses to catch-up with her class. Still not ready to commit to a total plan for the future (as most teenagers aren’t), she believes she may go into military service and then on to college. Fortunately for Johnson, the father of her children is involved in their lives. But for many of the club’s participants and other teen mothers, this is not the case.  And while Key and her colleagues recognize the need for fathers to be more involved with their children, she cites difficulty in enrolling them in a school-based program because most of them are adults no longer in school. In terms of the future of the club, several ideas look promising to Key.  One concept is to use the same model and program, but involve the sisters of the members in order to postpone their first pregnancies. “The literature suggests that if a sibling has a teen pregnancy then other female siblings become more prone themselves,” Key said. Another idea, dubbed the Best Chance Grant, serves not only to inform teens and their parents on the best health and sex education, but also would encourage teens to become involved in organized activities like drama and a pregnancy prevention club prior to any pregnancies.  “Here, our goals would be getting the parents to become the educators, teaching parents and teens how to communicate and develop a healthy relationship, and teaching parents and teens the facts they don’t know about health and sex,” she said. But before these other two programs take shape, Key and her colleagues are currently working on ways to spread the current Second Chance Club to more high schools in the Charleston area. “I don’t know of another program, even similar in design, that can demonstrate the great decreases in second pregnancies like our club,” Key said. “We’ve even been accused of being too good to be true because we are a small program. If we can expand to other schools and make sure that they get the details right, then we have a real chance on a state and national level of helping teenage mothers break the cycle.” For more information on the Second Chance Club, contact Washington at the Burke High School Based Health Center at 727-2184.       Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.