Story highlights Laura Stepp: A view of an untroubled rural America is out of date

Study shows teen girls have babies at rates a third higher than girls in cities or suburbs

Stepp: They're higher because rural teens have less access to health clinics, counseling

Cities have lowered teen birth rates with education and access to contraception, she says

We have a rosy view of rural America as a place where people wave even if they don't know you, and life isn't affected by what we think of as city problems. So it might come as a surprise that teenage girls 15 to 19 years old in rural counties have babies at rates that are nearly one third higher than girls in the cities and suburbs.

Several major cities are succeeding in lowering teenage birth rates. In New York City, for example, teen pregnancy declined 27% between 2001 and 2010, according to data from the New York City Health Department . It's time for more notice to be paid to teens in rural America.

A study recently released by the National Campaign to Prevent Teen and Unplanned Pregnancy showed that the birth rate of girls in rural counties in 2010 -- the latest available data -- was almost 33% higher than in the rest of the country. It's not for the reasons many people might think, according to my colleague, Kelleen Kaye, senior research director at The National Campaign.

What's not true, she says, according to an analysis of federal data, is what we often hear: Rural teens are more likely than other teens to have sex with older men, or at younger ages, or get married younger. What is true is that they lack health clinics that are easily accessible and that offer contraception as well as counseling. Their parents may not have health insurance that makes birth control affordable. Abortion providers may be hard to find.

Laura Stepp

"Teens in general are more similar than they are different, but their resources may be different," says Kaye, who grew up in a small town in Iowa.

Amen to that. Sixteen years ago, researching a book I was writing about young teens, I spent a year traveling to and from three jurisdictions including Ulysses, Kansas, a town of slightly more than 6,000 in the southwestern part of the state. That year, the teen pregnancy rate in rural Grant County, where Ulysses is located, jumped from eighth highest in the state to second. In a high school of about 500, 25 girls were either pregnant or recently had had a baby; at least two middle school girls were also pregnant.

One girl I was writing about, ninth-grader Amanda Pena, introduced me to several high school friends who were either pregnant or already mothers. Amanda, being raised by her Catholic grandparents after her mother abandoned her, was determined to avoid pregnancy and become the first in her family to get a college degree. She was a very bright young woman and I believed at the time she would achieve that.

I caught up with her recently to see how she was doing.

She told me she did, in fact, get pregnant her senior year in high school. So did several other girls she knew.

They had had some sex education in school, she said, but mostly, they just joked about sex. Her grandparents never talked to her about contraception, and when she got pregnant, "It really changed my relationship to everyone in the family." Her pregnancy ended in a miscarriage, and after graduation she headed off to Kansas State University in Manhattan, Kansas.

In her third year at Kansas State, she got pregnant again and decided against having an abortion. The father of her child refused to marry her even after little Braeden was born.

For a while, she tried being a single mom and continuing classes at Kansas State. She drew welfare payments while hoping Braeden's father would contribute child support. He didn't, and eventually "I just burned out," she recalled. She left Kansas State with only nine classes left before she could graduate. She eventually settled in Overland Park, Kansas, where she works as a supervisor at a heating and plumbing company and lives with Matt Kresyman, her new husband, and Braeden. who's 9.

"I lost my goals of getting a four-year college degree and moving up the ladder like everyone else wants to do," she said.

Amanda said when she goes back to Ulysses to see her family and friends, she listens to the list of babies recently born to single parents and realizes that attitudes about teen pregnancy there haven't changed much. Boys are reluctant to buy condoms at the drugstore, and girls dislike visiting a physician to pick up a prescription for birth control. Both give the same reason: In their small town, "they are afraid everyone will find out." She also hears something else among these teenagers as well as the adults, a kind of "what will happen, will happen" resignation.

Americans know that attitude when applied to teen pregnancy. We heard it not that long ago in the big cities of this country. But some of those cities, like New York City, are beginning to prove that with the right approach to education and contraception, and enough money, the teen pregnancy rate can come down.

It's time for this country to apply and adapt, where necessary, what it has learned to rural America.