Friday, April 30, 2010

Studies Underestimate Teen Pregnancy Rate

A new study from the Guttmacher Institute finds that teens are at a greater risk for unwanted pregnancies than previously thought.  The study takes into account pregnancy rates among teens which are sexually active, rather than teens as a whole.

The standard methods for estimating pregnancy rates underestimate the rate at which sexually active women, teens in particular, become unintentionally pregnant because does not distinguish between women who are and are not sexually active. According to the study, “only 27% of 15–17-year-olds are sexually active.”  When all teens are included, the unintended pregnancy rate among them is lower than that of all women.  However, when only sexually active teens are compared to sexually active women, the unintended pregnancy rate among teens is more than twice than the rate of women overall.  The rate among sexually active 18–19-year-olds (162 per 1,000) is also more than double the national figure.”

Here’s a chart that breaks down the differences of unintended pregnancy rates for:
All Teens (15-17)
Sexually Active Teens (15-17)
All Women (15-44)
Sexually Active Women (15-44)
40 per 1,000
147 per 1,000
51 per 1,000
69 per 1,000

These new findings reveal that teen pregnancy rates have been understated, an unsettling fact considering the $75 million recently allocated for more abstinence-only education.  Despite a report by the CDC stating that teen pregnancy rates declined by 2% in 2008 after being on the rise between 2005 and 2007, the overall teen pregnancy rates are still very high.  If we are to create effective policies to prevent teen pregnancy, we must have an accurate understanding of teen unintended pregnancy rates. Decreasing the number of teens engaging in sexual activity is a logical goal, but if a disproportionate number of sexually active teens are becoming pregnant then there is a clear failure in the current approach. Teens who choose to have sex need accurate information on how to protect themselves from pregnancy and STIs. 

Thursday, April 29, 2010

Over-the-Counter Birth Control Pill in the US?

Can you imagine living in a world where you could buy your birth control pills the same way you buy aspirin or cough syrup? This is the reality for women in several South American countries where oral contraceptives are available without a prescription. A recent study, conducted by two University of Texas campuses and Ibis Reproductive Health, suggests that many US women would purchase birth control without a prescription if it were available.

The study, led by researchers, advocates and clinicians, comprised of more than 1,000 El Paso women living on the US-Mexico border.  The groups were evenly divided into women who obtained their contraceptive pills in Mexican pharmacies and women who obtained their birth control in US clinics. Women from both groups believed that the facility where they obtained the pills was cheaper than the options from across the border. In addition, 90% of women who got their pills from US clinics felt confident they were given good information and liked the other services offered by the clinic. On the other hand, only 46% of women using Mexican pharmacies felt confident about the information they received and 90% wanted the option to bypass the prescription and be able to send family or friends to pick up the medication.  The research indicates a clear interest in OTC birth control, which begs the question of whether or not it’s time for the US to remove the prescription-only policy for birth control pills.

Access to safe, affordable birth control is imperative to women’s reproductive health.  Many people believe birth control pills are easy to obtain, but not all women have equal access. Low income women and undocumented immigrants disproportionately experience obstacles like lack of insurance coverage, transportation and child care that are exacerbated by the requirement for a physician’s prescription. Making birth control available over the counter would certainly remove/reduce some of these barriers. In a policy review by Guttmacher, Sneha Barot writes that advocates have pushed for oral contraceptives on open shelves because of its relative safety (low risks with high benefits).  In addition, risk factors associated with the pill, like hypertension (high blood pressure), can be tested at self-administered kiosks or checked by pharmacists. These options are simpler and faster than going to the doctor’s office. 

While removing the restriction would increase accessibility, it is important to think about potential unintended consequences.  For example, the need for birth control is the primary reason many women see a physician. At these visits they are likely to receive other important screenings for cancer and STIs. While removing the obstacle of a prescription would increase the availability of the pill, it may also lead to a decrease in the number of women getting these important screenings. Furthermore, removing the prescription requirement for oral contraception could make pills unaffordable for low income women- especially if the end result was the removal of Medicaid coverage.

We need to critically think about the feasibility of an over-the-counter birth control pills option in the US. The vast majority of people would agree that increasing access to birth control is a good thing.  But is OTC birth control the best way to do this? What do you think? Will oral contraceptives ever be available over-the-counter in the US?

Thursday, April 15, 2010

Nebraska Passes Two Extreme Anti-Choice Bills

This week Nebraska has passed not one but two anti-choice bills.  On Monday, a bill was approved which mandates that women seeking an abortion must be screened for mental health problems.  The second bill was passed on Tuesday, effectively criminalizing abortions at and after 20 weeks of pregnancy based on the unfounded speculation that a fetus can feel pain beginning at 20 weeks.  These laws greatly restrict women’s access to reproductive health care and also aim to challenge Roe v. Wade

As  Robin Marty at RH Reality Check duly notes, the bills are in direct contradiction of each other: one law ( claims that before 20 weeks a woman’s mental health status should be extensively evaluated before obtaining an abortion, however the law that bans procedures after 20 weeks ( disregards the impact of mental illness by failing to include an exemption for the women’s mental health.  Furthermore, there is lack of evidence that supports the assertion that fetal pain exists. As Caitlin Borgmann, a law professor at The City University of New York, succinctly states "There is certainly no solid scientific evidence establishing that a fetus can perceive pain at these earlier stages, so any court decisions to uphold such broader laws could only do so by disregarding the importance of good scientific evidence.” It is inconsistencies like this that cause conservatives claims to care about the health and welfare of women to fall extremely flat.

The passage of this bill is clearly an attempt to bring anti-abortion cases before the Supreme Court and challenge Roe v. Wade. This abortion ban is the first law in the nation that restricts abortion on a premise other than viability, which contradicts over 3 decades of judicial precedent set by Roe v Wade.  As the liberal leader of the court, Justice Stevens, is set to retire, it is crucial that Obama’s nominee be able to counter the conservative strongholds of Scalia, Thomas, Roberts, and Alito.

Monday, April 12, 2010

Justice Stevens Announces Retirement; Replacement Nominee Must Support Right to Privacy

Since Justice John Paul Stevens announced his retirement from the Supreme Court last week, the question of whom President Obama will nominate to take Stevens’ place is on everyone’s minds.  As the most senior Justice in the court, Stevens’ role is a substantial one in the upholding of Roe v. Wade.  Appointed in 1975 by Gerald Ford, Stevens has been one of the strongest supporters of the right to choose.

Along with the question of who will replace Stevens, is how his departure will change the dynamics of the court. Stevens holds a unique position on the bench; He is the most senior justice and also left-leaning.  Right now, the nine justices are narrowly divided on issues related to reproductive health: three justices support the constitutional right to choose (including Stevens); four oppose the constitutional right to choose; one has yet to rule on any cases addressing a woman's right to choose; and one has a mixed record on the right to choose, and has voted to uphold substantial restrictions, including the Federal Abortion Ban. 

This will be the second opportunity President Obama has had to nominate a Justice to the Supreme Court.  Last year Obama nominated the first woman of color to serve on the High Court, Justice Sonia Sotomayor, to replace Justice David Souter.  Since Souter and Stevens are considered to have liberal voting records, the appointments of their replacements are not expected to shift the political make-up of the court.  However, with four members of the court in their seventies, future retirements are almost a certainty. It is crucial that the Obama administration ensure that any current or future appointee fully support a woman’s constitutional right to privacy.

In the fight to uphold Roe v. Wade, the Supreme Court plays a critical role that should not be overlooked.  We need to remember that access to safe, legal abortion care hangs in the balance of the Supreme Court.  There is no doubt that the anti-choice movement will use this vacancy as an opportunity to further their attacks on nominees who have taken pro-choice positions. America's pro-choice majority must fight back.  This vacancy also gives anti-choice politicians the chance to make abortion a prominent issue in the 2010 mid-term congressional elections.  It’s imperative that the Obama administration doesn’t succumb to the pressure to choose a moderate candidate in an effort to avoid controversy.  Tell President Obama to say no to the right wing and nominate a pro-choice justice. Sign our petition and help protect the court today!

Monday, April 5, 2010

$250 Million Too Much

With the health care reform law totaling 2,000 plus pages, it’s not surprising that some terms slipped through without much fanfare. Among the major changes, a provision passed without much discussion: $250 million in abstinence-only-education programs. Are you shocked? Outraged? You should be, and rightfully so. If you thought funding for failed abstinence-only programs ended with the Bush era….think again! In his wish for bipartisanship, Obama has done a disservice to millions of teenagers by funding programs that put them at an increased risk for unintended pregnancy and STIs.

$250 million over a period of five years will be allocated to states to fund abstinence-until-marriage programs. It is well-established that these programs are ineffective at preventing unplanned pregnancies or reducing the rate of STI transmission. In fact, in April 2008, a panel of public health experts testified “that there is no evidence base to support the current massive federal investment in abstinence-only programs.” Those who have been paying attention to the sex-ed debate were not surprised to learn that after years of restrictive funding for abstinence-only programs, teen pregnancy and abortions are on the rise for the first time in ten years. By not adequately addressing teens need for age-appropriate, scientifically based sexuality education, these programs will continue to put teens at an increased risk for STIs and pregnancy. Just one disturbing example of the serious lack of education, is the fact that 24% of teens believe that using more than one condom (double-bagging) is more effective at preventing pregnancy and reducing STI transmission.

Valerie Huber, the executive director of the National Abstinence Education Association believes an “overly sex-saturated culture” is a major contributor to teen sexual activity. If Huber’s hypothesis had any merit, any culture with a high exposure to sexual content would also have high incidents of teenage pregnancy. However, when we look at countries like France and Britain, where people are just as, if not more, sexually aware, her theory falls flat. With teen pregnancy rates four to two times less than the U.S., they must be doing something right. But guess what’s nowhere in sight? Yep, you got it – no abstinence only policies. According to Advocates For Youth, European youths have more access to low cost contraception (through their national health insurance) and sex-ed is an integral part of school curriculum, in which educators respond to all of students’ questions with accurate and comprehensive information. If politicians and advocates like Ms. Huber were truly concerned with reducing teen pregnancies, they would look to the successful methods of other countries rather than pushing for programs that are wrought with political and religious ideology.

It is clear that the best strategies for addressing teen pregnancy and STI rates involve ensuring youths have the correct information to make wise decisions about sex. The Obama administration has certainly taken a step towards better policies by including $75 million a year over the next five years for programs that teach abstinence and about contraception. An additional $114.5 million of the 2010 budget was designated for sex-ed programs that have been evaluated and proven to work (which, of course, excludes ab-only programs). While this overall shift is commendable, the continued funding for failed programs cannot be ignored. The health and welfare of America’s youth is too valuable to be used as a political bargaining chip. 

Friday, April 2, 2010

Dr. Tiller's murderer sentenced to life in prison

A Kansas judged sentenced Dr. George Tiller’s murderer, Scott Roeder, to life in prison with a possibility of parole after 50 years.  The judge was left to decide whether to sentence Roeder to life with a possibility of parole in 25 years or 50 years. In the end, the judge administered the harsher sentence because of evidence that Roeder stalked Dr. Tiller before the shooting.  The prosecutor identified the extreme actions of anti-choice zealots as a form of domestic terrorism and requested the maximum sentence to deter other anti-abortion fanatics from committing violent acts against abortion providers. 

An attorney for the Tiller family told the court "The impact of his death on women throughout the world is like an earthquake.  They ask, 'Where can I go? What will I do?' I have to say, 'I'm sorry, I can't tell you.' That's the impact of this crime."  Since Dr. Tiller’s death, the state of Kansas has not had a late-term abortion provider.  Dr. Tiller was a strong advocate for women’s rights, firmly believing women should be trusted to know what is best for themselves and their families.  The sentencing of his killer is a small concession for his untimely death.