Dr. Janet Realini could be in private practice, using her medical degree to treat patients and — in the process — making the money her profession commands. Instead, she's essentially a volunteer who uses her skills to help teenage girls achieve their dreams.

Realini is the president of the board of Healthy Futures Alliance, a nonprofit corporation dedicated to reducing teen and unplanned pregnancies. It's a tough challenge, especially in San Antonio, where the number of teen pregnancies is roughly double the national average.

Teen pregnancy is more than an individual problem —it's one that, in the long run, affects a city's businesses and even its economy. How? Because, as Realini said, “Teen pregnancy makes it an uphill climb for a girl to attend college and complete her education —it's not impossible, but it's much harder.”

When intelligent, talented young women fail to achieve their potential due to unplanned pregnancies, it's a loss for the entire community.

“Teen pregnancy lowers the quality of the work force, and a talented work force is what draws new businesses to San Antonio,” Realini said. “And it's a community issue, because teen pregnancies continue a cycle of poverty.”

Realini believes the key to reducing San Antonio's unplanned pregnancy rate can be found in her “abstinence-plus” curriculum, which combines abstinence with factual information about the effectiveness of contraception. Realini has written a book outlining her strategy: It's called “Big Decisions” and she describes it as “a Texas-friendly, science-based approach used in schools and communities.”

“Preventing teen and unplanned pregnancies is not about abstinence or contraception — it's about both,” Realini said. “As parents, of course, we all want our children to practice abstinence. I'm optimistic — I think we can find ways to help them to wait.”

Belief in that message is what compelled Realini — who enjoyed a long academic career and is the former medical director of family planning for the San Antonio Metropolitan Health District — to leave the public sector for Healthy Futures Alliance, which is a 501(c) nonprofit.

“I wanted to be where I could make the most difference,” she said. “I want to empower young people and better their lives.”

In the course of helping today's young women — and young men — avoid unplanned pregnancies and reach their dreams, Realini believes she's also helping future generations.

“Children thrive when they're born to married, committed, stable parents,” she said. “Unplanned pregnancy isn't about a single individual; it's ultimately about building a better and more productive community.”