8 ms·

Efficacy of infant simulator programmes to prevent teenage pregnancy

37 points by __rito__ 3y ago

kazinator 3y ago
The dudes that cause teenage pregnancy are also usually infant simulators.
- asu_thomas 3y ago
  Checks out in my observations. Jokes aside, the infant simulators used in the study could not possibly replicate the economic and emotional turmoil of being a working class single mom in 2023 United States. In this respect, the dudes might be even better simulators.
  - local_issues 3y ago
    This study took place in Australia.
    - asu_thomas 3y ago
      Being a working class single mom in Australia is no walk in the park either.
- JimtheCoder 3y ago
  I think that's a little unfair... Teenage boys want to do "the thing" with girls that has an unfortunate side effect of potential pregnancy. We can't act like this isn't natural...we can just make sure they have the tools to be safe and make sure accidents don't happen...
  - deleted 3y ago
    [deleted]
  - thuridas 3y ago
    And some teenage girls too. Unless all those pregnancies come from rape. Don't assume that females are asexual beings of light. The amount of sexual yours for women should tell your something
  - delecti 3y ago
    Your point is valid for situations with relatively similar ages, but the fathers of pregnant teenage girls are on-average older, and not-uncommonly significantly so. https://pubmed.ncbi.nlm.nih.gov/10227344/ https://pubmed.ncbi.nlm.nih.gov/10227344/
- s1artibartfast 3y ago
  I think that is a pretty misandrist take. Sex and sex drive is a part of healthy adolescence for both genders. It has nothing to do with emotional immaturity.
  - giantg2 3y ago
    I assume they mean the mature ones are responsibly using contraception, being cautious not to impregnate anyone. Anecdotally, my experience is the immature and irresponsible types also carry that over into reproductive/parenting aspects of their life.
    - s1artibartfast 3y ago
      Perhaps things are different from when I was an adolescent, but my observation was that teen pregnancy had a lot more to do with family religion and socioeconomic class then safe sex practices.
      - giantg2 3y ago
        My experience would say those things might be correlated with reproductive responsibility, but there were some well-off guys and some not so well off guys I knew who where careless/reckless. I don't think I had enough data on the different religions to form much of a comparison.
monero-xmr 3y ago
The summary is that those with interventions had more pregnancies than the control group without. Reminds me of the “DARE” anti-drug program many in the USA had growing up. From my memory, I’m a little first grade kid and I’m getting worksheets about injecting heroin. The studies show DARE didn’t work, and it was totally bizarre as well from my recollection.
- dragonwriter 3y ago
  The studies show DARE worked at its actual goal (improving participants view of police) but had zero effect on its notional goal (drug abuse). Of course, if you called it a police propaganda program, it wouldn’t be as politically viable.
inamberclad 3y ago
I'd be interested to hear hypotheses for why this program did not reach its intended effect. I'm also curious what the effect would be if teenage boys were included. It seems like a major missing element.
- joenathanone 3y ago
  Theory, the simulation is a poor reflection of reality; Accurately simulating what it would be like to care for a baby is beyond our current technology.
  - jimbob45 3y ago
    Really? I feel like flour babies were pretty effective for as far as you’d want to go with middle schoolers (I.e. no sleep deprivation).
    - lotsofpulp 3y ago
      What is the point of infant simulation if the one of the most impactful part would be skipped? The biggest parts of having a baby, for the mom mostly: 1) physical changes and pains during pregnancy, including lack of sleep 2) physical changes and pains during childbirth, including episiotomy/C section, and dealing with that recovery process 3) while this is all going on, you have to teach this baby to breastfeed. Which then leads to engorgement and other pains for the mom, at least for a few weeks. And all of this is happening while you are on very broken sleep schedules. And assuming you do not have to worry about income/rent/etc.
    - xboxnolifes 3y ago
      If the point of the simulation was to deter pregnancies, I don't see how it could be successful without the biggest struggles of raising children being included. After all, people are willing to have children even when they are aware of these struggles, so reducing the struggles even a little would make having children seem more appealing, not less. Hell, it's possible that teenagers naturally have a larger than reality aversion to having children, and these simulations break down the aversion, increasing pregnancies.
concordDance 3y ago
This is a very confusing result. I could understand no effect, but an effect in the wrong direction?
- lbrito 3y ago
  Yes. >The infant simulator-based VIP programme did not achieve its aim of reducing teenage pregnancy. Girls in the intervention group were more likely to experience a birth or an induced abortion than those in the control group before they reached 20 years of age.
- bee_rider 3y ago
  Is it really confusing? When I was growing up, people got really excited about how well they’d done taking care of their… what was it, I think it was an egg? Anyway, the lesson that a bunch of them got was, I think, “wow that was easy and fun, I guess I would be a great parent.”
- anon291 3y ago
  one of the problems with the sort of well-off person who staffs health departments who conduct these kinds of studies is that, in my experience, they are completely insulated from the kinds of environments in which these social ills occur. In their mind, teenage pregnancy is unthinkable and their interactions with children make them want less (this is a common sentiment I hear on reddit, for example). However, not everyone thinks that way. And realistically, this unfortunate gulf that has emerged between the scientific class and those they are attempting to help is the root of many terrible policy decisions. https://www.jrf.org.uk/report/planned-teenage-pregnancy-views-and-experiences-young-people-poor-and-disadvantaged https://www.jrf.org.uk/report/planned-teenage-pregnancy-view... From the article: > Many mothers spoke of their love of babies, often heightened by experience caring for other children."
- troupe 3y ago
  There is a lot of power in suggestion. If you get a bunch of high school students together and really start talking to them about suicide, how they shouldn't commit suicide, how to identify suicidal thoughts, etc. would it be surprising to have a higher risk of suicide in that group than a control group. I'd assume something like having a baby would have an even stronger tendency to do that.
webel0 3y ago
I can’t read the full article. Does it say if students were permitted to opt into the class and, if so, whether they knew that the infant simulator project would be part of the class at enrollment time? In my (US) high school, this project was done in home economics, which was an elective. But it sounds like these were standard health classes.
- humanistbot 3y ago
  Their methodology/protocol paper for the study is open access: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987778/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987778/ tl;dr: Students at schools in both the control and intervention groups took the standard required health class, which includes traditional sex ed. Students at schools in the intervention group had to opt in to the baby simulator. It wasn't a regular class and was independent of the required health class, but it did take place at the school. It was one week, 40 minutes a day to learn about the baby simulator and a few other basics. Students at schools in the intervention group only cared for the baby for 64 hours: 4 days x 16 hours. 'Free childcare' was mandated for the 8 hours they were at school, as they were turned off during the school day.
  - webel0 3y ago
    Thank you. I believe this answers my question: > Individual participants were not blinded to their group assignment and upon giving consent were aware whether they were participating in the VIP intervention or control arm of the Trial. So my read of the results is that participants who were interested in having a child (and were in an intervention school) selected into the VIP program. Participants in the control schools were a more random group.
__rito__ 3y ago
"Between 2003 and 2006, 57 schools in Perth were enrolled into an infant simulator intervention designed to reduce teen pregnancy rates. The program backfired and the girls exposed to the fake infants were more likely to get pregnant in the five years after the intervention." (Source: https://twitter.com/cremieuxrecueil/status/1689361016918835200 https://twitter.com/cremieuxrecueil/status/16893610169188352...)
- s1artibartfast 3y ago
  It would be interesting to see the life satisfaction and happiness survey data 5 years and 10 years out as well. There's a vast number of people that find happiness and purpose in raising a child
  - tenebrisalietum 3y ago
    There's also a vast number of people with issues of all kinds due to shitty parenting and conditions that enable it. I'd say it's common sense that teens are going to be far more likely to be shitty parents than not. Possible exception would be if they are heavily subsidized by their family, in which case any "happiness and purpose" is probably more of an indication of economic stability and more mature people filling in for the role than anything else.
    - s1artibartfast 3y ago
      Presumably a random controlled trial would address differences in family support. Otherwise, I don't necessarily disagree.
zwieback 3y ago
The title of the study is very neutral, as you'd expect from the Lancet, but if I were a reporter I'd headline my piece "Baby simulator makes teenage girls have actual babies". If I were running a program like this in a high school I'd immediately terminate it.
petercooper 3y ago
Forget a simulator, I wish I'd gotten an honest and thorough education as a teenager on what having children entails before setting off down that life path. I suspect society isn't motivated to do this lest birth rates plummet even further..
local_issues 3y ago
How does this compare to offering IUDs to a third group?
- foogazi 3y ago
  Or something less invasive like condoms?
  - local_issues 3y ago
    Condoms don't really work at scale so far, compliance isn't great and even when it is they break. Same w/the Pill, it's a bit better but has shitty side effects.
asu_thomas 3y ago
Why are we so anxious to prevent pregnancies instead of addressing the economic issues that make so many hard working people unable to afford raising kids? The current status quo is only poor and rich people have children, but the middle class often cannot afford to, and we try rationalize that by saying the poor children will make up for it, but children raised by poor families are much more likely to be a net cost to society, not to mention the moral failure. Even if for environmental reasons, the results of not acknowledging the real problem have been disastrous. We know that people struggling to pay rent will never prioritize environmental causes because they simply can't afford to, so addressing the economic issues will need to be part of the formula anyhow.
- s1artibartfast 3y ago
  Your assertion and number of children doesn't match up with the actual statistics. The middle class has lots of kids and more than the rich. You could probably find some set of the hyper-rich that start having more children, but it is basically irrelevant to the general trend https://www.statista.com/statistics/241530/birth-rate-by-family-income-in-the-us/ https://www.statista.com/statistics/241530/birth-rate-by-fam...
marcodiego 3y ago
Tldr: After adjustment for potential confounders, the intervention group had a higher overall pregnancy risk than the control group (relative risk 1·36 [95% CI 1·10–1·67], p=0·003).
jjk166 3y ago
It's unclear from this summary whether the intervention group's program was in addition to or in lieu of the standard health education curriculum that the control group had. Either option could be problematic - adding an additional assignment on top of all the regular work would presumably lead to worse academic performance and increased stress; whereas dropping the standard curriculum might mean the girls weren't being as well educated about birth control and related topics. At the end of the day shoving stuff into a curriculum is always going to have issues so it can't be isolated from the rest of the study, but it does raise the question of whether this study has shown infant simulator programs to generally be counterproductive, or just this particular program implementation.
kypro 3y ago
I'm going to give an autistic view because this is one of the many things I'm disconnected from the rest of society on. To be clear, I'm seeking to understand, not be controversial. People get angry at me about my position on this, and this isn't my intention. Specifically what is wrong with teenage pregnancy? I've never understood the shame that is associated with it the West. The vast majority of arguments that can be made against teenage pregnancy can be made against single mums, yet we seem to celebrate them if anything (at least here in the UK). Having kids is one of the most selfless and rewarding things someone can do. While I agree economically it would be preferable to encourage people not to have kids and to focus on careers instead I struggle to justify using this as a reason to discourage people from having children. That said, I suppose the financial situation of the parents could be a factor here depending on the country. Generally teenage parents won't have very high income, but in the UK this wouldn't be an issue. One of the primary reasons women in my family have kids young is for the financial security. Here in the UK having kids is one of the best paths to moving out of your parents home in your 20s if you're from a working class background. But again, this financial argument applies in many other situations. Should single mums not have kids? Should people who can't work because of a disability not have kids? etc... The only other reason I've heard is that teenage parents are too immature to raise children. I don't accept this. The easy argument to make against this is that there are plenty of immature people among my family and friends who have kids. Many of whom do drugs and are generally not great members of society. These people have never been discourage by the state not to have more kids. There are lots of very mature teenagers who can raise children just fine. But I'll accept this is more subjective and nuanced position which I'll need to defend, and I'm happy to do so if necessary. I guess could someone just give a good argument against teenage pregnancy? Ideally one argument that doesn't rely on your subjective values about what a fulfilling life involves? I'll note that I'm talking ~15+ here. My understanding is that there could be pregnancy complications younger than this, although I'll add this applies to older individuals too where I believe similar disincentives should be applied (40+).
- alienicecream 3y ago
  Teenage pregnancy usually involves a delinquent young man knocking up an immature girl and leaving. It's not an abstract moral question, the lives of the mother and more importantly, an innocent child, will be ruined.

37 points by __rito__ 3y ago

kazinator 3y ago

The dudes that cause teenage pregnancy are also usually infant simulators.

asu_thomas 3y ago
Checks out in my observations. Jokes aside, the infant simulators used in the study could not possibly replicate the economic and emotional turmoil of being a working class single mom in 2023 United States. In this respect, the dudes might be even better simulators.
- local_issues 3y ago
  This study took place in Australia.
  - asu_thomas 3y ago
    Being a working class single mom in Australia is no walk in the park either.
JimtheCoder 3y ago
I think that's a little unfair... Teenage boys want to do "the thing" with girls that has an unfortunate side effect of potential pregnancy. We can't act like this isn't natural...we can just make sure they have the tools to be safe and make sure accidents don't happen...
- deleted 3y ago
  [deleted]
- thuridas 3y ago
  And some teenage girls too. Unless all those pregnancies come from rape. Don't assume that females are asexual beings of light. The amount of sexual yours for women should tell your something
- delecti 3y ago
  Your point is valid for situations with relatively similar ages, but the fathers of pregnant teenage girls are on-average older, and not-uncommonly significantly so. https://pubmed.ncbi.nlm.nih.gov/10227344/ https://pubmed.ncbi.nlm.nih.gov/10227344/
s1artibartfast 3y ago
I think that is a pretty misandrist take. Sex and sex drive is a part of healthy adolescence for both genders. It has nothing to do with emotional immaturity.
- giantg2 3y ago
  I assume they mean the mature ones are responsibly using contraception, being cautious not to impregnate anyone. Anecdotally, my experience is the immature and irresponsible types also carry that over into reproductive/parenting aspects of their life.
  - s1artibartfast 3y ago
    Perhaps things are different from when I was an adolescent, but my observation was that teen pregnancy had a lot more to do with family religion and socioeconomic class then safe sex practices.
    - giantg2 3y ago
      My experience would say those things might be correlated with reproductive responsibility, but there were some well-off guys and some not so well off guys I knew who where careless/reckless. I don't think I had enough data on the different religions to form much of a comparison.

monero-xmr 3y ago

The summary is that those with interventions had more pregnancies than the control group without. Reminds me of the “DARE” anti-drug program many in the USA had growing up. From my memory, I’m a little first grade kid and I’m getting worksheets about injecting heroin. The studies show DARE didn’t work, and it was totally bizarre as well from my recollection.

dragonwriter 3y ago
The studies show DARE worked at its actual goal (improving participants view of police) but had zero effect on its notional goal (drug abuse). Of course, if you called it a police propaganda program, it wouldn’t be as politically viable.

inamberclad 3y ago

I'd be interested to hear hypotheses for why this program did not reach its intended effect. I'm also curious what the effect would be if teenage boys were included. It seems like a major missing element.

joenathanone 3y ago
Theory, the simulation is a poor reflection of reality; Accurately simulating what it would be like to care for a baby is beyond our current technology.
- jimbob45 3y ago
  Really? I feel like flour babies were pretty effective for as far as you’d want to go with middle schoolers (I.e. no sleep deprivation).
  - lotsofpulp 3y ago
    What is the point of infant simulation if the one of the most impactful part would be skipped? The biggest parts of having a baby, for the mom mostly: 1) physical changes and pains during pregnancy, including lack of sleep 2) physical changes and pains during childbirth, including episiotomy/C section, and dealing with that recovery process 3) while this is all going on, you have to teach this baby to breastfeed. Which then leads to engorgement and other pains for the mom, at least for a few weeks. And all of this is happening while you are on very broken sleep schedules. And assuming you do not have to worry about income/rent/etc.
  - xboxnolifes 3y ago
    If the point of the simulation was to deter pregnancies, I don't see how it could be successful without the biggest struggles of raising children being included. After all, people are willing to have children even when they are aware of these struggles, so reducing the struggles even a little would make having children seem more appealing, not less. Hell, it's possible that teenagers naturally have a larger than reality aversion to having children, and these simulations break down the aversion, increasing pregnancies.

concordDance 3y ago

This is a very confusing result. I could understand no effect, but an effect in the wrong direction?

lbrito 3y ago
Yes. >The infant simulator-based VIP programme did not achieve its aim of reducing teenage pregnancy. Girls in the intervention group were more likely to experience a birth or an induced abortion than those in the control group before they reached 20 years of age.
bee_rider 3y ago
Is it really confusing? When I was growing up, people got really excited about how well they’d done taking care of their… what was it, I think it was an egg? Anyway, the lesson that a bunch of them got was, I think, “wow that was easy and fun, I guess I would be a great parent.”
anon291 3y ago
one of the problems with the sort of well-off person who staffs health departments who conduct these kinds of studies is that, in my experience, they are completely insulated from the kinds of environments in which these social ills occur. In their mind, teenage pregnancy is unthinkable and their interactions with children make them want less (this is a common sentiment I hear on reddit, for example). However, not everyone thinks that way. And realistically, this unfortunate gulf that has emerged between the scientific class and those they are attempting to help is the root of many terrible policy decisions. https://www.jrf.org.uk/report/planned-teenage-pregnancy-views-and-experiences-young-people-poor-and-disadvantaged https://www.jrf.org.uk/report/planned-teenage-pregnancy-view... From the article: > Many mothers spoke of their love of babies, often heightened by experience caring for other children."
troupe 3y ago
There is a lot of power in suggestion. If you get a bunch of high school students together and really start talking to them about suicide, how they shouldn't commit suicide, how to identify suicidal thoughts, etc. would it be surprising to have a higher risk of suicide in that group than a control group. I'd assume something like having a baby would have an even stronger tendency to do that.

webel0 3y ago

I can’t read the full article. Does it say if students were permitted to opt into the class and, if so, whether they knew that the infant simulator project would be part of the class at enrollment time? In my (US) high school, this project was done in home economics, which was an elective. But it sounds like these were standard health classes.

humanistbot 3y ago
Their methodology/protocol paper for the study is open access: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987778/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987778/ tl;dr: Students at schools in both the control and intervention groups took the standard required health class, which includes traditional sex ed. Students at schools in the intervention group had to opt in to the baby simulator. It wasn't a regular class and was independent of the required health class, but it did take place at the school. It was one week, 40 minutes a day to learn about the baby simulator and a few other basics. Students at schools in the intervention group only cared for the baby for 64 hours: 4 days x 16 hours. 'Free childcare' was mandated for the 8 hours they were at school, as they were turned off during the school day.
- webel0 3y ago
  Thank you. I believe this answers my question: > Individual participants were not blinded to their group assignment and upon giving consent were aware whether they were participating in the VIP intervention or control arm of the Trial. So my read of the results is that participants who were interested in having a child (and were in an intervention school) selected into the VIP program. Participants in the control schools were a more random group.

__rito__ 3y ago

"Between 2003 and 2006, 57 schools in Perth were enrolled into an infant simulator intervention designed to reduce teen pregnancy rates. The program backfired and the girls exposed to the fake infants were more likely to get pregnant in the five years after the intervention." (Source: https://twitter.com/cremieuxrecueil/status/1689361016918835200 https://twitter.com/cremieuxrecueil/status/16893610169188352...)

s1artibartfast 3y ago
It would be interesting to see the life satisfaction and happiness survey data 5 years and 10 years out as well. There's a vast number of people that find happiness and purpose in raising a child
- tenebrisalietum 3y ago
  There's also a vast number of people with issues of all kinds due to shitty parenting and conditions that enable it. I'd say it's common sense that teens are going to be far more likely to be shitty parents than not. Possible exception would be if they are heavily subsidized by their family, in which case any "happiness and purpose" is probably more of an indication of economic stability and more mature people filling in for the role than anything else.
  - s1artibartfast 3y ago
    Presumably a random controlled trial would address differences in family support. Otherwise, I don't necessarily disagree.

zwieback 3y ago

The title of the study is very neutral, as you'd expect from the Lancet, but if I were a reporter I'd headline my piece "Baby simulator makes teenage girls have actual babies". If I were running a program like this in a high school I'd immediately terminate it.

petercooper 3y ago

Forget a simulator, I wish I'd gotten an honest and thorough education as a teenager on what having children entails before setting off down that life path. I suspect society isn't motivated to do this lest birth rates plummet even further..

local_issues 3y ago

How does this compare to offering IUDs to a third group?

foogazi 3y ago
Or something less invasive like condoms?
- local_issues 3y ago
  Condoms don't really work at scale so far, compliance isn't great and even when it is they break. Same w/the Pill, it's a bit better but has shitty side effects.

asu_thomas 3y ago

Why are we so anxious to prevent pregnancies instead of addressing the economic issues that make so many hard working people unable to afford raising kids? The current status quo is only poor and rich people have children, but the middle class often cannot afford to, and we try rationalize that by saying the poor children will make up for it, but children raised by poor families are much more likely to be a net cost to society, not to mention the moral failure. Even if for environmental reasons, the results of not acknowledging the real problem have been disastrous. We know that people struggling to pay rent will never prioritize environmental causes because they simply can't afford to, so addressing the economic issues will need to be part of the formula anyhow.

s1artibartfast 3y ago
Your assertion and number of children doesn't match up with the actual statistics. The middle class has lots of kids and more than the rich. You could probably find some set of the hyper-rich that start having more children, but it is basically irrelevant to the general trend https://www.statista.com/statistics/241530/birth-rate-by-family-income-in-the-us/ https://www.statista.com/statistics/241530/birth-rate-by-fam...

marcodiego 3y ago

Tldr: After adjustment for potential confounders, the intervention group had a higher overall pregnancy risk than the control group (relative risk 1·36 [95% CI 1·10–1·67], p=0·003).

jjk166 3y ago

It's unclear from this summary whether the intervention group's program was in addition to or in lieu of the standard health education curriculum that the control group had. Either option could be problematic - adding an additional assignment on top of all the regular work would presumably lead to worse academic performance and increased stress; whereas dropping the standard curriculum might mean the girls weren't being as well educated about birth control and related topics. At the end of the day shoving stuff into a curriculum is always going to have issues so it can't be isolated from the rest of the study, but it does raise the question of whether this study has shown infant simulator programs to generally be counterproductive, or just this particular program implementation.

kypro 3y ago

I'm going to give an autistic view because this is one of the many things I'm disconnected from the rest of society on. To be clear, I'm seeking to understand, not be controversial. People get angry at me about my position on this, and this isn't my intention. Specifically what is wrong with teenage pregnancy? I've never understood the shame that is associated with it the West. The vast majority of arguments that can be made against teenage pregnancy can be made against single mums, yet we seem to celebrate them if anything (at least here in the UK). Having kids is one of the most selfless and rewarding things someone can do. While I agree economically it would be preferable to encourage people not to have kids and to focus on careers instead I struggle to justify using this as a reason to discourage people from having children. That said, I suppose the financial situation of the parents could be a factor here depending on the country. Generally teenage parents won't have very high income, but in the UK this wouldn't be an issue. One of the primary reasons women in my family have kids young is for the financial security. Here in the UK having kids is one of the best paths to moving out of your parents home in your 20s if you're from a working class background. But again, this financial argument applies in many other situations. Should single mums not have kids? Should people who can't work because of a disability not have kids? etc... The only other reason I've heard is that teenage parents are too immature to raise children. I don't accept this. The easy argument to make against this is that there are plenty of immature people among my family and friends who have kids. Many of whom do drugs and are generally not great members of society. These people have never been discourage by the state not to have more kids. There are lots of very mature teenagers who can raise children just fine. But I'll accept this is more subjective and nuanced position which I'll need to defend, and I'm happy to do so if necessary. I guess could someone just give a good argument against teenage pregnancy? Ideally one argument that doesn't rely on your subjective values about what a fulfilling life involves? I'll note that I'm talking ~15+ here. My understanding is that there could be pregnancy complications younger than this, although I'll add this applies to older individuals too where I believe similar disincentives should be applied (40+).

alienicecream 3y ago
Teenage pregnancy usually involves a delinquent young man knocking up an immature girl and leaving. It's not an abstract moral question, the lives of the mother and more importantly, an innocent child, will be ruined.