Sex ed could prevent unwanted pregnancies. Indiana doesn't require schools to teach it.

For two weeks, Indiana lawmakers have been locked in debate about how to reduce the number of abortions performed in the state. The current proposal would ban all abortions, except in cases of rape, incest, fatal fetal anomalies or when the life of the pregnant person is at risk.

So far, though, lawmakers haven’t considered a strategy that research shows can be effective in reducing the number of unintended pregnancies and, thus, the number of abortions – teaching young people how to prevent pregnancy.

Studies show that children and teenagers who have received comprehensive, evidence-based sexual education – which teaches about abstinence, contraception and healthy relations, among other key concepts – starting having sex later in life, have fewer partners and engage in fewer risky behaviors.

Indiana doesn’t require schools to teach these concepts, though. It doesn’t require schools to provide any kind of sex ed.

And, if they do teach sex ed, the only thing required by state law is for schools to teach abstinence "as the expected standard for all school-age children" and that abstinence is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases and other associated health problems.

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Schools that offer sex ed must also teach that the best way to avoid an sexually transmitted disease is to establish “a mutually faithful monogamous relationship in the context of marriage.”

Regardless of whether they have a sex ed class, schools are required to teach students about HIV and they must instruct that the best way to prevent HIV transmission is to refrain from sexual activity “until they are ready as adults to establish, in the context of marriage, a mutually faithful monogamous relationship.”

'Lack of understanding'

Nearly half of all pregnancies in the United States are unintended, meaning the pregnant person either wanted to become pregnant in the future but not at the time she became pregnant or one that occurred when she did not want to become pregnant then or at any time in the future. Of those, roughly 2 in 5 will end in abortion according to the Guttmacher Institute, a research and policy organization committed to advancing sexual and reproductive health and rights.

There are many reasons people become unintentionally pregnant. Lack of access to contraception, coercion and sexual violence are just a few.

The author of Indiana's bill seeking to ban nearly all abortions in the state said that lack of knowledge about how their bodies work and how best to prevent pregnancy is another.

During a press conference to introduce Senate Bill 1, which would ban abortions at zero weeks with a few exceptions, Sen. Sue Glick, R-LaGrange said: "We have a number of pregnancies in the state of Indiana that are a result of, I don't want to say ignorance but, a lack of understanding of people's bodies."

Glick then said that a companion bill, designed to aid women, children and families, would direct more money to crisis pregnancy centers “for those people who are childbearing age who have children, that they're not equipped to take care of.”

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The controversial anti-abortion centers counsel women on what to do after they become pregnant. Nowhere in the debate, though, has there been a discussion about any kind of mandatory or comprehensive sex education to prevent young people from becoming pregnant unintentionally.

At that same press conference, Senate President Pro Tempore Rodric Bray, R-Martinsville, was pressed on the issue of mandatory sex ed. He said that if it wasn't taught in all schools, they would work on expanding it. There have been no proposals to do so, though, during the special legislative session that's expected to wrap up next week with the passage of the abortion ban.

Comprehensive sex ed delays sex, prevents pregnancy

Earlier this year, Rep. Sue Errington, D-Muncie, filed a bill that would have required schools that do teach sex ed do so with a comprehensive, evidenced-based and medically-accurate curriculum. House Bill 1047 never received a hearing.

"If the supermajority wants to restrict abortion access in Indiana, we have an obligation to equip our young people with the education they need," Errington said in a news release issued ahead of the start of the special session to pass abortion restrictions. She pledged to continue advocating for comprehensive, medically-accurate sex ed in Indiana schools.

Experts say that kind of curriculum is the gold standard for what should be taught in schools. Studies show that kids who receive robust sex education – medically-accurate lessons that teach about abstinence, contraception and healthy relations, among other key concepts – starting having sex later in life, have fewer partners and engage in fewer risky behaviors. That kind of education is only going to become more important as abortion access gets restricted said Alison Macklin, director of policy and advocacy for SIECUS, a Washington, D.C.-based organization that promotes access to accurate and comprehensive sexuality information, education and related health services.

"We know that comprehensive sex ed significantly lowers teen pregnancy rates versus places where comprehensive sex ed is not being taught," Macklin said.

Because while it may be technically true that abstinence is the best way to avoid unintended pregnancy and STDs, experts say it’s just not practical to expect all teenagers to wait for marriage to have sex.

More than 4,000 Hoosier teens give birth each year, accounting for more than 5% of Indiana’s live births. Indiana’s birth rate among teens is 14th highest in the nation.

Teenagers account for approximately 10% of all abortions in the state annually, according to reports from the Indiana Department of Health.

Indiana County cut teen pregnancy rates in half

While national studies have shown that comprehensive, evidenced-based sex ed programs do reduce teen pregnancy rates, you don’t have to scour the country for evidence. When it comes to preventing unwanted pregnancies, Indiana has its own success story.

A decade ago, Clinton County had a teen pregnancy problem.

Teenagers in small town of Franklin and the surrounding communities were getting pregnant at a rate that was twice the national average.

Health leaders got a federal grant to implement robust, evidence-based sex ed programs for middle and high school students. The county cut its teen pregnancy rate in half, said Lorra Archibald, executive director for Healthy Communities of Clinton County.

The Clinton County program took a broad approach from the beginning.

“Everyone just assumes you go to birth control, that’s always the assumption,” Archibald said. “Really that’s not the first step. The first step is communication.”

The program hosted small-group sessions teaching parents how to raise the topic with their teen children and talk about their values, Archibald said. Next came an evidence-based curriculum in local middle schools called “Draw the line, respect the line,” which encouraged students to think about their goals in life and how a teen pregnancy might affect them, taught them what consent means and discussed healthy relationships. At the high school level, the program used a more traditional teen pregnancy curriculum, “Reducing the Risk.”

Archibald described the programs as “abstinence plus.” So while it does teach that abstinence is the best way to avoid pregnancy, STDs and other health complications, as is required by state law, it also teaches students how to practice safe sex if, and when, they choose to have it.

The decrease in teen pregnancies likely stemmed from a combination of fewer teens having sex and more teens using contraception if they decide to be sexually active, Archibald said

“We know that abstinence is the only 100% percent effective way to prevent pregnancy and STIs, and I hope that every teenager practices abstinence but in reality that isn’t what happens,” Archibald said. “And there are kids and teenagers out there who aren’t practicing abstinence – we have to protect those teenagers as well.”

State of sex ed in Indiana unclear

Some schools do teach some kind of sex ed, but how many and what their curriculum looks like is unclear. The Indiana Department of Education doesn’t track that information.

In 2018, lawmakers passed a bill requiring schools to give parents more notice before teaching sex ed and two opportunities to opt their child out of the instruction. It was a compromise with conservative groups like the Indiana Family Institute and Advance America who wanted to see the law changed to require parents to opt their children into sex ed before they could receive it.

At the time, then-Sen. Karen Tallian, D-Portage, sent out her own informal survey to more than 200 school districts. Of the 149 districts that responded, 131 said they had a regular curriculum for sex education according to Tallian’s results. Districts that didn’t have a curriculum said it was due to a decision of the superintendent or school board, a lack of funds or policy reasons. For most districts offering sex education, it was included as part of a larger, required course like health or biology. About one-third of districts that responded to Tallian’s survey and indicated they offered sex education did so through an outside provider, while the rest used existing staff.

Tallian suggested the issue be sent to a summer study committee but that effort failed.

Conservative groups have pushed back against sex ed requirements in the past, arguing that parents should have more say in what their children learn at school.

"We’ve been informed, around the state, there’s a lot of times where the schools don’t tell the parents anything," said Eric Miller, a socially-conservative activist and founder Advance America, during a committee hearing at the time.

"Public schools are attempting to influence the child's attitude, behavior and actions involving sexual activity," Miller said, "and I believe that's inappropriate." 

The last several years have seen a growing number of people – including lawmakers – questioning the motivation of schools and teachers with some accusing them of “indoctrinating” students with leftist ideology. There has been little evidence to back up the claims, though.

Micah Clark, executive director of the American Family Association of Indiana, said he supports abstinence education and believes all schools are already teaching it. Should changes be made to Indiana's laws governing sex ed, Clark said he'd want to ensure there's parental involvement.

"I want parents to know what is being taught and I want parental involvement on those sensitive subjects so parents know what their kids are being taught and parents can approve of what is being taught," he said. "It is such a delicate topic. It is a values-based subject."

Schools pull back on sex ed

Even though recent bills, including one seeking to ban critical race theory from schools and another that some called book banning − it would have criminalized school librarians and teachers if they gave student access to "obscene materials" − haven't been passed in Indiana, the conversation alone has caused some schools to rethink the sex ed they offer.

Tammie Carter is the chief executive officer of LifeSmart Youth, an organization that provides medically-accurate and evidence-based sex ed programming to schools. Age-appropriate lessons start in the fourth grade and build on each other as students get older. They teach about changing bodies, healthy relationships, different types of sex, reproductive health and contraception, among other topics. The organization works with nearly 100 schools in 19 districts around the state, she said, but they used to work with more.

A handful of districts ended their partnership with LifeSmart, Carter said, after the last legislative session.

"Some schools decided they were going to take it in-house," she said. "They were getting flack from parent groups."

Carter said the organization has always been transparent about what they teach and allows any parent with concerns to review their curriculum. And the group offers resources to parents, to help them start conversations around bodies, sex and healthy relationships at home, too. Some parents fear that teaching their child about sex means they'll have sex sooner, she said, but the opposite is true.

And, she said, some people are just uncomfortable with the word "sex."

"But we all have a body and everybody deserves the right to be educated about this body they live in," she said. "Unfortunately, we live in a state that doesn't believe that's the case and a lot of kids aren't getting the education they need."

IndyStar reporters Shari Rudavsky and Lizzie Kane contributed to this story.

Call IndyStar education reporter Arika Herron at 317-201-5620 or email her at Arika.Herron@indystar.com. Follow her on Twitter: @ArikaHerron.

This article originally appeared on Indianapolis Star: Indiana abortion law: Schools are not required to teach sex ed