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One Heroic Woman Tackles Teen Pregnancy and Poverty—Others Need to Wake Up

Three words: affordable longterm contraception.

Photo Credit: Hasloo Group Production Studio/


Claudia Haltom was a juvenile court judge in Memphis who, as she puts it, got tired of taking babies away from teenagers. The final straw came when a 17-year-old mother of three stood in front of her, pregnant. “Who is taking care of your other children while you’re here?” Haltom asked. The girl didn’t know.

During her 17 years as a judge, Haltom witnessed firsthand the hardship and pain and poverty sometimes faced by young women who get pregnant before they are ready—or better said, by both the young mothers and their little ones. She can rattle off statistics. “In 2011, 606 girls between the ages of 10 and 17 gave birth in Shelby County [the area surrounding Memphis]. Over eighty percent of those pregnancies were unintended. Almost all were paid for by TennCare, Tennessee’s Medicaid program. Half of those babies will still be on public assistance at age 13. Less than 50% of their moms will graduate from high school or get a GED by the time they turn 22.” But what drives her are the individual stories behind those statistics—years of listening to heartbreaking testimony and looking into the eyes of young moms who wanted something better for themselves and their kids.

When girls came into her courtroom, Haltom would ask them about what they wanted out of the future. Many had big dreams. College, trade school, and travel were on their lists. But consistently she bumped up against one specific factor that made such dreams unlikely:

I always asked ‘What are your plans for more children?’ They would say, ‘I’m on the pill.’ And I would ask, ‘Have you taken it today?’ In 17 years not one had actually taken it that day. They had lots of good reasons – on drugs, just put out of apartment, no government benefits, the unaffordable price tag of $30/month pills. But what it added up to was an epidemic of unintended pregnancies.

Haltom saw a spiral of dreams abandoned and multi-generational poverty. She decided to do something about it—to ensure that every woman or youth in Shelby County has access to a kind of birth control that actually will work for her, if that is what she chooses.

The Pill has a  9% failure rate overall and an 18% failure rate for teenagers. This means that on the Pill, 1 in 11 women gets pregnant every year, and it’s worse when life is chaotic, like when a teen is trying to juggle school and parenting and making ends meet. Young moms can get caught in a vicious loop. But it doesn’t have to be that way. With a top tier long acting method like an  IUD or implant, the annual pregnancy rate drops  below one in five hundred.

Haltom started looking for options and ran across research at Washington University Medical School in St. Louis—known as  the CHOICE Project. In the CHOICE Project, over 9000 females age 14 and up were given the contraceptive of their choice for free. The researchers presented the  top tier methods first. These methods are known to be cheaper in the long run and to have a higher satisfaction rate (85% vs. 50-60% for the pill, patch and ring), but they can have an up-front cost of $800 to $1600 dollars. With the information available and barriers gone, three fourths of the study participants chose a state-of-the-art IUD or implant, and the teen pregnancy and abortion rates plummeted. Haltom had what she was looking for.

In 2011, she launched  A-Step-Ahead Foundation, which seeks to reduce barriers so that every teen or woman who wants a top-tier contraceptive in Shelby County can get one. No barriers, just choices. A Step Ahead has four goals: