- It kind of felt like my whole life just flashed in my face because I was like, "Wow, everything's about to change."

- [Michelle] 16-year-old Sara Fernandes looks like your typical teenager.

She attends school in downtown Providence.

- [Teacher] And the hypotenuse, it's always opposite of right angle or the longer side in the right triangle.

- [Michelle] So does her boyfriend, 17-year-old Caleb Faria.

They've been together two years.

- [Caleb] It's like (imitates wheel squeaking) - [Sara] This one's squeaks too.

You don't hear it?

- [Michelle] But when they head home to Pawtucket, there's a lot more than school work on their minds.

They have a five month old daughter named Skyler.

Fernandes remembers taking a pregnancy test in the high school bathroom which confirmed she was pregnant.

Soon there was a swarm of classmates in the bathroom.

- They were like, "Oh my god, Sara's pregnant!

Sara's pregnant!"

- Did you start noticing a difference in how people were treating you?

- Most of it was people being rude to me.

- Yeah.

- They were saying that I was a slut and a whore and you know, all that stuff that wasn't true.

- [Michelle] After finding out they were expecting, the couple transferred to Nowell Academy, a charter school that serves pregnant, parenting, and underserved youth.

- At my other school, nobody was pregnant and nobody had kids and it was just weird.

But here it kind of felt like I belonged.

- [Michelle] Nationwide, fewer teenagers are having sex and those who do are more likely to use contraception.

- Especially in the last 10 years, we've seen significant declines in the rates of teen pregnancy.

- Sounivone Phanthavong manages the Department of Health's Adolescent School and Reproductive Health Program.

In 2012, about 30 of every 1000 pregnancies in Rhode Island was to a teen between 15 and 19 years old.

That number dropped to 12 of every 1000 pregnancies in 2021.

- I think it's improved access to care, improved education, and more information about sexual reproductive health.

- [Michelle] While the number of teens giving birth has declined, the cities facing among the highest poverty rates in the state are also grappling with the highest rates of teen pregnancy.

The number of teens having babies in Central falls, Pawtucket, Providence, and Woonsocket combined is more than three times higher than the rest of the state.

- Teen pregnancy is no different than other health outcomes that are impacted by social and environmental conditions that influence those experiences.

That might be impacted by access to healthcare, it may be impacted by their access to employment and socioeconomic status.

- Okay.

- [Michelle] 30-year-old, Adaysa Rodriguez says she's proof of that.

The mother of five had her first child at 16.

- Perfect!

You look pretty.

- [Michelle] Before she became a mom, Rodriguez says she already felt like one.

She helped her single mom take care of her two younger siblings.

- Let's go.

It was overwhelming.

I felt like it was a lot for me, but I just wanted to help my mom and make sure she was okay.

I would even cook for her.

- What was it like to find out you were pregnant at 15 years old?

- I was scared.

I felt like the world dropped on me.

I didn't tell my mom until I was five months pregnant.

I hide it very well 'cause I had a small belly.

- [Michelle] Rodriguez was living in Central Falls when she gave birth to her daughter Anyelie who was premature.

She ended up being homeschooled for a few months, but still graduated from high school.

- When they called my name, I wanted to scream "I did it!

I did it."

- [Michelle] She says it was a special moment to have her daughter and mother in the audience, especially because her mom was a high school dropout.

Rodriguez's mom gave birth to her when she was a teenager.

Caleb Faria's parents were also teenagers when they had his brother.

- I was never given the talk or anything, but when I told my parents that we were pregnant, my dad was like, "And I was about to talk to you guys about that too."

- So he just missed his window of time to have that conversation?

- Yep.

- Were you guys using any protection?

- No.

- Thoughts and prayers.

- But you make light of it, but you knew what the risks were.

- Yeah.

- Yeah.

- [Michelle] According to data from the State's Department of Health, among sexually active high school students, 10% used no method to prevent pregnancy during their last sexual intercourse with an opposite sex partner.

Susanna Magee is a clinical professor of family medicine at Brown University.

She says finances prevent more teens from using contraception.

- Kids have to have money in order to have contraception unless they have access to a Title 10 healthcare site where they can get that for free.

Or some offices, private offices will offer condoms for free.

- What organs do you need to give birth?

Yeah.

- A uterus.

- A uterus.

What else?

- Ovaries.

- Ovaries.

Uh-huh.

- [Michelle] Medical students at Brown University are trying to reduce the teen pregnancy rate in Central Falls.

- Where are sperm produced?

- [Michelle] They teach sex education to students at Calcutt Middle School.

The program Sex Ed by Brown Med began in 2014.

Magee is the program's faculty advisor.

Before you guys started this program 10 years ago, what sex education were these students receiving?

- At the time, it was really just the physical education teacher teaching sex ed.

It was very much about anatomy, very little about actual sex or STI prevention or those sorts of things.

- We're gonna be talking about birth control and different ways to prevent pregnancies from happening.

- [Michelle] Talking about sex can be awkward, but Miranda Lassar, a second year medical student says many students warm up to the conversations.

- They really reflect the energy in the room.

And so when the energy in the room is that we're just talking about this, you can ask me whatever you want and I will answer your question with zero judgment, then I think the awkwardness is removed.

- [Michelle] Parents of seventh grade students choose whether they want their children to take the class and most do.

The eight lessons cover a range of topics.

- We talk about anatomy, reproductive anatomy, we talk about puberty, we talk about the menstrual cycle.

- [Michelle] Students are also taught about pregnancy, sexually transmitted diseases and contraception.

Seventh grader Quentin Dunbar says everything he's learned in this class is new information.

- Like how to be safe and stuff.

- Like condoms?

- Yeah.

- There's probably people out there who worry that giving information means the behavior will increase and there's a lot of information about the fact that that's not true.

Harm reduction information does not increase a harmful behavior.

- What's this?

- [Michelle] The teen pregnancy rate in Central Falls has dropped significantly in recent years, but Magee says it's hard to attribute that to the program.

- At the same time that Sex Ed by Brown Med was happening in Central Falls, there was also a clinic that had started at the high school that was a Title 10 site, so there was contraception available, there was some education happening from the physician who worked there.

So that obviously had to have been impactful as well.

- [Michelle] There's still a Title 10 funded health clinic at the high school.

Sounivone Phanthavong from the Department of Health says it's one of the ways the state is working to reduce pregnancy among teenagers.

- We fund Title 10 family planning service sites that offer high quality, affordable, confidential if needed, reproductive healthcare services.

We also make sure we are implementing evidence-based programming in different settings that serve young people that may be in schools, in communities, and after school programs.

- [Michelle] Back at Calcutt Middle School, students also learn about healthy relationships and consent.

- So the first question that I have is, would it still be abuse if they didn't mean to hit you?

- [Michelle] They're asked to write anonymous questions on post-it notes for the medical students to answer.

- [Miranda] So this is a number that you can call.

It's a 24 hour hotline if you have any concerns of sexual assault.

- Adaysa Rodriguez says it's important students learn about abuse and consent.

For her, it's personal.

- When I was 14, I was raped by a close friend of mine.

- [Michelle] She says it changed how she viewed herself.

- Hey, come on guys.

- [Michelle] Several years later, she was in an abusive relationship with someone else.

She hopes other teens in a similar situation will get help.

- Yo, I need you to look both ways.

Okay, come on.

Don't think just because you are in love with a person, it's okay for them to physically, emotionally, or mentally abuse you.

I feel like everybody has a voice and everybody can speak.

In front of me.

- [Michelle] Rodriguez's life revolves around her family.

She also works as a medical assistant.

The days are long, but she says her education has been key.

- Good morning.

- What's your advice to other teen moms who are watching this?

- Don't drop off out of high school.

Get a career.

'Cause without a career nowadays, you are not going to move forward.

If you have a support system, use that support system.

Go look for help.

- Well, I think all babies look alike when they're first born, they're all wrinkly.

- [Michelle] Fernandes and Faria rely on their support system.

They say they've been able to stay in school because of the help they receive from their parents.

- I couldn't imagine being able to come to school and go to work without both of our families.

Like, "Oh, if you need help, let me know.

We'll watch her."

- Yeah.

- And even our parents are like, "You can't afford formula, so I'll buy it this week and you just get it next week."

- [Michelle] The couple says having Skyler has changed their lives for the better.

They both say they're more motivated to do well in school because they want to give their daughter a good life.

Still, they would not advise other teens to follow their path.

- Don't get pregnant.

Mostly because I don't know if their family's supportive.

I feel like if they did get pregnant and they weren't ready, it would be more harm to the baby.

Not everybody matures that quickly after getting pregnant as a teenager.