Though they are designed to help deter teen pregnancies, school programs that involve the use of "baby simulators" may have the opposite effect, according to an Australian study published today.
The investigators found that girls enrolled in schools that employed infant dolls and education sessions that simulate what having a baby might be like, were about 36 percent more likely to have a pregnancy -- at least one birth or abortion by age 20 -- compared to those in schools that only employed the standard school curriculum.
"We were very surprised" Sally Brinkman, lead author and associate professor at Telethon Kids Institute at University of Western Australia told ABC News. "It’s one thing to get results to say it doesn't work, it’s another to get results that does the opposite."
The study, published in the journal The Lancet, followed more than 2,800 teen girls, age 13 to 15 years old at 57 schools in Australia tracking them until the age of 20.
Brinkman said this is the first study to link actual medical and birth data to a study that evaluates the use of simulator dolls and its effect on teen pregnancies.
The infant dolls, central to these baby simulator programs, are designed to look and behave like real babies. They can cry and burp and require diapering, feeding and care throughout the day and night.
A set of lessons -- including education sessions, workbooks and a video documentary of teenage mothers talking about their own lives -- supplement the experience by exploring "the physical, emotional, social, and financial consequences of becoming pregnant and dealing with parenthood," according to the doll manufacturer Reality Works.
In a statement sent to ABC News Reality Works CEO said the program studied was far different than what they recommended.
"The study being released today by The Lancet was not a representation of our curriculum and simulator learning modality but the researchers "adaptation" and is consequently not reflective of our product nor its efficacy," Timm Boettcher told ABC News. "The RealCare Program, is a combination of curriculum and hands-on aids, and if they are being tested and judged for effectiveness should be judged in their entirety."
The Reality Works program, he said, is 14 hours of class time with "learning activities and a prolonged take home simulator experience," while the Australian version studied was "a mere 2.5 hours" of class time.
While the study was done in western Australia, more than 89 countries use these simulators, including the U.S.
According to the Brinkman, both students and school staff who completed the Australian government-sponsored program ended up liking the experience.
"A lot of the teenagers become attached to their fake babies" and it allows the administrators "to engage the teenagers," Brinkman said.
If they participated in the infant simulator program, teen girls were not only more likely to be pregnant, but also more likely to keep their pregnancies, according to Brinkman.
She said the findings held true even after they took into account various factors, including socioeconomic status, education, family type, prior sexual experience, psychological distress, prior responsibility for caring for a baby and toxic habits.
"School is starting, this is a really good time to be talking about sex education," Dr. Cora Collette Breuner, a professor of adolescent medicine at Seattle Children’s Hospital and chair of the Committee on Adolescence at the American Academy of Pediatrics told ABC News.
However, Breuner said there wasn’t enough evidence to cite the programs as a cause of increased pregnancy rates, at this point.
She said it was unclear if different socioeconomic backgrounds or changing education levels may have played a role in pregnancy rates, as well.
"I welcome controlled studies looking at teen pregnancy prevention trials," she said. "I am grateful people are looking at this."
Though she believes there should be more research into the programs and that school administrators should not panic.
"If I were an educator and had this in my school, I wouldn’t stop doing [the program] based on this article, but I would take a look at it," she said.
She added that this study helps “pull the lens back" on the programs and that educators and researchers should "take a long hard look at it and consider that [they] may not be an effective intervention or taking a look at the way [they are] done."
While the study does not explore the reasons behind the spike in teen pregnancies associated with the electronic infants, the study cites other smaller studies that suggest few girls believed caring for their own infant would be the same as caring for a simulated infant.
The teen who found it difficult to care for the simulator tended to believe it would be much easier to look after their own baby, the study said.
Another paper mentioned in this research suggested that girls at risk of becoming pregnant enjoyed the attention they received while looking after their doll, which may have reinforced the desire to have a baby of their own.
"The main thing to get out is, even though people like these programs, it doesn't seem to work,” Brinkman said.
After an initial cost of $500 for a starter pack, each baby costs approximately $1,000, according to the company.
"It is a high cost to the schools and the education system," Brinkman said. "Even worse, they may be doing harm. Seems like a very silly waste of public funding."
Dr. Shali Zhang is a chief resident in dermatology at Emory University School of Medicine. She is also a resident at the ABC News Medical Unit.