Pregnancy Free Club

About This Program

Target Population: Parenting teens age 14 to 19 years old who attend an alternative high school for pregnant and parenting students and their children up to 5 years old

Program Overview

The Pregnancy Free Club (PFC) was created to help reduce repeat pregnancies in parenting teens and is a collaborative project between a public health agency and an alternative school. Public Health Nurses meet monthly with parenting teens who voluntarily submit a urine-pregnancy test. They complete a questionnaire which is used to determine health and social service needs. An incentive is provided to all participants. Each school year, the data regarding the pregnancy tests and questionnaires are analyzed. This data illustrates the importance for ongoing nursing support and interventions that are integrated into a school environment.

Program Goals

The goals of the Pregnancy Free Club are:

  • Prevent repeat pregnancies in the adolescent parent population
  • Promote healthy relationships that are safe and abuse free
  • Assure teen parents receive information and resources necessary to access appropriate healthcare
  • Provide information about all contraceptive methods, including abstinence
  • Assure teen parents are aware of their risks for sexually transmitted infection
  • Provide referral to pregnancy option counseling, in the event of a positive pregnancy
  • Assure safe and confidential pregnancy testing
  • Support participants in achievement of their high school diploma
  • Assure parenting education is accessible
  • Provide social service resources as needed

Essential Components

The essential components of the Pregnancy Free Club include:

  • Monthly confidential counseling between a trusted public health nurse and the teen parent occurs as a relationship-based intervention tool.
  • The public health nurse must remain non-judgmental during this visit while advocating for and reinforcing the teen’s healthy choices.
  • Motivational interviewing techniques are utilized.
  • It is essential to meet in a physical space that insures privacy (e.g., small office at school near a bathroom).
  • On-site urine pregnancy testing equipment must be available and easily accessible.
  • A sexuality risk assessment is filled out by the teen parent and reviewed with the public health nurse. This questionnaire asks about behaviors, attitudes, and motivation to prevent another pregnancy.
  • The public health nurse shares scientifically accurate contraceptive information that includes how to be successful using any method ranging from abstinence to intrauterine devices (IUDs).
  • Discussions may include healthy relationships issues and future plans.
  • Public Health Nurses teach them about advocating for themselves and their children regarding healthy relationships, medical care, etc.
  • The public health nurse must be knowledgeable about local medical, social service, transportation, and housing resources and refer as needed.
  • Incentivize teens for participating, (e.g., $5 Target gift cards).
  • Positive reinforcement of any healthy decisions made is given.
  • Public health nurses help coordinate services and follow up on referrals for the teen parents with the partnering agencies and school programs; examples include family violence program and a parenting attachment program.
  • Administrative support is supplied by collaborative partners.
  • Data collection and compilation is supplied by Local Public Health.

Program Delivery

Child/Adolescent Services

Pregnancy Free Club directly provides services to children/adolescents and addresses the following:

  • Teens: Parenting a child (see problems and symptoms listed in parenting component) Young children: Child of a teen parent who is at risk for poor medical care

Parent/Caregiver Services

Pregnancy Free Club directly provides services to parents/caregivers and addresses the following:

  • Teens who are parents have many risk factors regarding their future and their baby’s: repeat pregnancy, sexually transmitted infections, unhealthy relationships, poor medical care for self and child, not completing high school, becoming financial unstable, truancy.
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Only if the teen parent requests the public health nurse speak with either a teacher, parent, or other support person. Otherwise this is a confidential visit. Minnesota has a minor consent law that does not require parental consent to discuss pregnancy prevention information with a health care professional. It helps to have supportive school administration and staff who embrace this work and understand the need for confidentiality.

Recommended Intensity:

One visit with a nurse per month for 15-45 minutes depending on concerns that may need to be discussed.

Recommended Duration:

As long as the parenting teen attends the alternative high school. This could be a few months to a number of years.

Delivery Settings

This program is typically conducted in a(n):

  • Birth Family Home
  • School


This program does not include a homework component.

Resources Needed to Run Program

The typical resources for implementing the program are:

  • Small room for confidential conversation that is attached or close to a bathroom with a toilet and sink
  • A public health nurse
  • Gift card incentives
  • Urine pregnancy tests
  • Plastic urine cups
  • Medical gloves
  • Cleaning equipment
  • Questionnaires and check list
  • Data collection system (e.g., spreadsheet)
  • Referral information for affordable and accessible reproductive health care, other social services
  • Pregnancy prevention education materials

Education and Training

Prerequisite/Minimum Provider Qualifications

A public health nurse (4-year RN) with experience discussing reproductive health issues and knowledge of community resources with an emphasis on teen parent students.

Education and Training Resources

There is not a manual that describes how to implement this program ; but there is training available for this program.

Training Contact:
  • Molly Snuggerud, RN, PHN, Family Health Manager
    City of Bloomington – Public Health Division

    phone: (952) 563-8910
Training is obtained:

Informal consultation is available upon request. A procedural guideline with the survey and checklist tools is available.

Number of days/hours:

Informal consultation is available upon request.

Relevant Published, Peer-Reviewed Research

Schafers, M. A., Jost, R., Pederson, B. J., & Lair, M. (2008). Pregnancy Free Club: A strategy to prevent repeat adolescent pregnancy. Public Health Nursing, 25(4), 304-311.

Type of Study: Historically controlled study
Number of Participants: Not specified


  • Age — Not specified - Adolescents
  • Race/Ethnicity — Not specified
  • Gender — 100% Female
  • Status — Participants were pregnant and parenting adolescents in alternative school settings.

Location/Institution: Not stated

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This article describes the Pregnancy Free Club (PFC), a program established by the local health department, the school district, and a community hospital for adolescent mothers attending an alternative school. Their goal was to prevent repeat adolescent pregnancy through a multifaceted approach. Strategies include the daily presence of public health nurses in the school, monthly pregnancy tests and surveys, health counseling and referral, and group health education classes. The school also provides day care for participants' children. Following program initiation, the repeat adolescent pregnancy rate declined from 25% in the year prior to the program to a mean of 4.7% over 9 years of the program. Limitations include the lack of detail on the study sample and methods and no reporting of any statistical analyses.

Length of postintervention follow-up: Not specified.

Additional References

Herrman, J. W. (2006). The voices of teen mothers: The experience of repeat pregnancy. Maternal Child Nursing, 31(4), 243-249.

Boardman, L. A., Allsworth, J., Phipps, M. G., & Lapane, K. L. (2006). Risk factors for unintended versus intended rapid repeat pregnancies among adolescents. Journal of Adolescent Health, 39, 597.el-597.e8.

Dailard, C. (2000). Reviving interest in policies and programs to help teens prevent repeat births. The Guttmacher Report on Public Policy.

Contact Information

Molly Snuggerud, RN, PHN
Title: Family Health Manager
Agency/Affiliation: City of Bloomington – Public Health Division
Phone: (952) 563-8910
Fax: (952) 563-8997

Date Research Evidence Last Reviewed by CEBC: July 2014

Date Program Content Last Reviewed by Program Staff: July 2015

Date Program Originally Loaded onto CEBC: March 2013