General Articles

Thinking Over ‘Baby-Think-It-Over’ (and Other Infant Simulators)


Diana Zuckerman and Jessica Becker, “Dolls Are Not a Substitute for Babies,” National Research Center for Women & Families (2010); Mari L. Borr, “Baby Think It Over: A Weekend with an Infant Simulator, Journal of Family & Consumer Sciences Education (2009); Judy Didion and Helen Gatzke, “The Baby Think It Over Experience to Prevent Teen Pregnancy: A Postintervention Evaluation,” Public Health Nursing (2004).
Infant simulators are intended to give adolescents a realistic preview of the realities of raising a baby, in hopes that teens will “think twice” about engaging in unprotected sexual intercourse. Although infant simulators can be as simple as a sack of flour or chicken egg which must be carried around and tended by the adolescent learner, more expensive and sophisticated simulators exist, such as the computerized ‘Baby Think It Over’ (BTIO). When BTIO cries, the learner must insert a special key and simulate feeding, bathing, diaper-changing and comforting until it ceases crying. Care sessions last from 5 to 35 minutes. Didion and Gatzke (2004) conducted a study on the long-term impact of BTIO on learners in a program in the rural Midwest. Borr (2009) studied the short-term impact of BTIO on learners who took it home for one weekend. Zuckerman and Becker (2010) summarized three additional studies that involved a range of learners: middle and high school, male and female, and urban and suburban.
Key Findings:
  • In focus groups of rural Midwestern 11th graders who had experienced BTIO as 8th or 9th graders, “students remarked that the experience scared them and therefore they intended to be more cautious” about engaging in sexual intercourse.1 Females reported that their male peers did not take the experience seriously, given their expectation that females would inevitably take responsibility for child care in real-life situations.
  • Midwestern high schoolers who took BTIO home only for one weekend reported no significant increase in communication with their parents regarding issues related to sexuality: “Many participants said their parents thought taking Baby Think It Over was a good idea…however, they also often had trouble in stating why their parents thought it was a good idea.”2 The most common effect that learners reported was lack of sleep, due to the need to tend to BTIO throughout each night.
  • In a Midwestern urban middle school in a lower-income Hispanic neighborhood, a study of a BTIO intervention actually found an increase in the percentage of girls who wanted to be a teen parent after experiencing the infant simulator. In this population, where girls already had some experience as babysitters, it is possible “that since these girls had some experience with real babies, they also knew that real babies provide some positive payback for all the hard work: a human response to being cared for and loved, such as a genuine smile.”3  


Infant simulators are likely to be crowd-pleasers as a tool for certain aspects of sexuality education. They are “life-like”, appeal to experiential impulses, and have proven memorable among learners. Sexuality educators need to consider several issues when contemplating whether to purchase these expensive teaching tools: is the objective to 1) increase responsible parenting skills, 2) increase parent-child communication about sexuality in the home, 3) increase use of contraception and condoms among sexually active learners, or 4) delay the initiation of sexual activity altogether?
Each BTIO simulator may cost between $250-$500 depending on the quantity purchased and any accompanying accessories. While there is mixed evidence that the presence of the ‘infant’ in a learner’s home increases parent-child communication about sexuality issues related to pregnancy and parenting, BTIO teaches nothing about gender roles, condoms, or other contraception. Adolescent learners in BTIO studies have expressed a desire to learn more about these topics after reflecting on the experience of tending to the ‘infant’. In the words of one student in Didion and Gatzke’s study, “That baby shows you what it’s like to have one, but it doesn’t show you how to prevent it.”4
Tending to BTIO leads to a lack of sleep for the learners – this effect may impact their academic performance if enrolled in school, and should be considered by school-based program planners before committing scarce resources to this costly intervention.
Some learners in these studies express a newfound admiration for teen and single mothers. With the experience of struggling alone to feed, change, and comfort an infant, they began to see that the much-maligned, stereotyped Teen Mom must rise to challenges they have never had to face. Program planners might be surprised to know that BTIO may actually de-stigmatize teen parenting for some learners.
Finally, do infant simulators unintentionally instill negative attitudes about babies and parenting in general? Although intended to create negative associations with teen parenting, do the simulators ultimately contribute to social attitudes that diminish the general desirability of children? One in five children and teens in the U.S. lives in poverty, and budgets for public schools and public youth programs are under constant political assault. Future research might consider whether ‘pregnancy-aversion programs’ such as BTIO reinforce attitudes that imply children’s needs are an inconvenience the public can’t afford.
1 Didion J, Gatzke H (2004). The baby think it over experience to prevent teen pregnancy: A postintervention evaluation. Public Health Nursing 21(4):331-337.
2 Borr ML (2009). Baby think it over: A weekend with an infant simulator, Journal of Family & Consumer Sciences Education, 27(2):45-55. <>
3 Zuckerman D, Becker J. Dolls are not a substitute for babies. National Research Center for Women & Families, December 2010, accessed 6 February 2012, <>
4 Didion and Gatzke, 335.