Teen Pregnancies Plunge

May 6th, 2014


U.S. rates fell more than 50% across all ethnicities from 1990 to 2010, according to a new report from the Guttmacher Institute.

Nationwide, teen pregnancy, birth and abortion rates have plunged, according to a new report from the Guttmacher Institute, a reproductive-health research and education organization. From 1990 to 2010, the U.S. pregnancy rate for 15-to-19-year-olds fell by 51%, with approximately 614,000 occurring in 2010.

A drop in pregnancies was seen across racial and ethnic groups, though Hispanic and black teens got pregnant at nearly three times the rate of their white peers. In 1990 the white-teen pregnancy rate was 86.6 per 1,000 vs. 223.8 per 1,000 for black teens. In 2010 the rates had fallen to 37.8 per 1,000 for whites and 99.5 per 1,000 for blacks. Among Hispanic teens, the pregnancy rate fell from a high of 169.7 per 1,000 in 1992 to 83.5 per 1,000 in 2010.

Similarly, there was a 66% decline in abortions from 1998 to 2010, when there were a reported 14.7 abortions per 1,000 women. Teen birthrates fell by 44% from 1991 to 2010, with about 34.4 births per 1,000 women.

“The decline in the teen pregnancy rate is great news,” lead author Kathryn Kost said in a statement. “Other reports had already demonstrated sustained declines in births among teens in the past few years; but now we know that this is due to the fact that fewer teens are becoming pregnant in the first place. It appears that efforts to ensure teens can access the information and contraceptive services they need to prevent unwanted pregnancies are paying off.”

In response to the decline, the vice president of education for Planned Parenthood Leslie Kantorsaid in a statement, “Planned Parenthood is thrilled to see a record low in teen pregnancy rates in this country.”


What Americans Think About Birth Control Coverage

April 23rd, 2014

Alexandra Sifferlin

69% of surveyed Americans support coverage for birth control

There’s debate over whether all health plans in the United States should be required to cover the cost of birth control. An overwhelming majority of Americans—69%—say yes, according to a breaking survey published in the journal JAMA.

While this suggests the issue is less divisive than previously thought, it’s still a hot-button topic in the courts. In June, the Supreme Court is expected to reach a decision in the Hobby Lobby case, in which the owners of the arts-and-crafts chain, who are Southern Baptists, contend that their right to exercise religious freedom are infringed upon by the Affordable Care Act provision requiring them to guarantee no-cost birth control and emergency contraceptive coverage for their employees.

Although most Americans are in favor of the mandated birth control coverage—77% of women and 64% of men—it was the least agreed upon when compared with other health services under the ACA provision. Coverage of preventive services like mammograms and colonoscopies, vaccinations, mental health care, and dental care all had more support than mandatory contraceptive coverage, according to the JAMA poll. (Birth control coverage has the most support among women, and black and Hispanic respondents.)

The researchers hope their data can be used to inform the ongoing national debate over contraceptive coverage.

‘The pill is a badge of honour for some girls, but that still doesn’t make us sluts’

April 9th, 2014

A US study has found being on the pill doesn’t make girls any more promiscuous – as some critics have suggested. Well, duh, says Daisy Buchanan, as she praises the NHS for always giving out free contraception

By Daisy Buchanan

Excellent news from the US! Apparently, the availability of free or affordable hormonal contraception does not turn women into insatiable succubi who, given the excuse and opportunity, will become promiscuous enough to make Anthony Weiner look like a giant panda. A study released in the Obstetrics And Gynaecology journal found that, over a year of birth control courtesy of ObamaCare, 70 per cent of women reported no change in the number of partners they slept with – and most of the 13 per cent of women sleeping with more people said it was because their numbers had ‘rocketed’ from zero to one.

You wouldn’t think the effects of contraception on promiscuity would even merit a study, but then you probably wouldn’t think it was OK to say that being on the pill makes a woman a slut – as Rush Limbaugh did before he apologised. Or imply, like Republican Mike Huckabee, that women who need financial help with contraception simply can’t control their sex drives.

When I was at school, being on the pill was a badge of honour – and dishonour. The girls with steady boyfriends who were rumoured to be ‘doing it’ but couldn’t be drawn on the subject could sometimes be tricked into revealing the details of their choice of hormonal contraception. Bags, lockers and pencil cases were regularly searched for sexy evidence. Anyone who asked any suspiciously attentive questions in biology class was suspected.

Of course, some poor girls were on it just to regulate heavy periods, but we wouldn’t listen to the boring, practical truth. As far as we were concerned, if you were on the pill, you were a slut, and we whispered about you and judged you. The obvious feeling we failed to articulate was jealousy. The girls on the pill seemed thrillingly adult, and we knew we weren’t cool enough for their world, so we excluded them from ours.

Of course, after a couple of years, everyone was on the pill, or the implant, or the coil, or, for the adventurous, the Nuva ring. Using hormonal contraception doesn’t make me feel like an edgy rebel – but having just renewed my Nexplanon implant for the fourth time, I feel full of thankfulness for the NHS, who make the procedure easy as well as free. Giving women autonomy over their bodies and allowing them to choose to start a family if and when they’re ready is one of the most enlightened, progressive things any country can provide for its ladies. Sadly, we know that we have sisters all over the world who don’t have so many straightforward options.

In the States, Planned Parenthood clinics are being shut down at a record rate. This is partly due to direct pressure from anti-abortion activists, and partly down to a lack of funding – although the centres provide contraception as well as abortion advice and services, they are targeted by pro-life activists. As the NHS faces drastic budget cuts, I fear our sexual health clinics could be under threat too.

The recent, chilling story from Wonder Women about unregulated crisis centres giving women inaccurate abortion advice is a reminder that our right to judgement-free family planning is one that’s definitely worth protecting. Pregnancy should be a joyful life event, and not a biological punishment for having sex, and daring to enjoy your body in an independent way.

Being on the pill doesn’t make anyone a slut. It does demonstrate that you’re responsible enough to plan ahead, work out what your priorities are and focus on your education, career or any one of the hundreds of other important things you might want to do before, or instead of having a child. The pill doesn’t just give women the freedom to have sex without experiencing an unwanted pregnancy. It allows them a life that would not have been possible at the start of the last century.

Daisy Buchanan is a freelance journalist who can be found tweeting @NotRollerGirl

Abortion: A pregnant woman’s right to choose – free of any pressure

April 9th, 2014

I unreservedly support a woman’s right to terminate her pregnancy, and I have no moral issue with abortion. But it’s precisely because I support a woman’s right to choose that I feel uncomfortable about the way that abortion services are run.

There can be few medical procedures so politically charged as abortion. Simply uttering the term polarises people. Battle lines are drawn and there is an expectation that you will join one camp or the other. For or against, pro-life or pro-choice: the narrative rarely extends beyond this simple dichotomy. And, if you are pro-choice, any criticism of abortion is considered a heresy.

I unreservedly support a woman’s right to terminate her pregnancy, and I have no moral issue with abortion. But it’s precisely because I support a woman’s right to choose that I feel uncomfortable about the way that abortion services are run. That there is a financial incentive for pregnancy advisory services to undertake terminations is plain wrong. It is fair to ask, how can they offer independent advice when so much of their income comes from terminations?

Many women seeking advice are scared, upset and vulnerable. While doctors would argue that they remain impartial in the advice they give, research suggests that, although many think they are impartial, in fact they can be easily swayed by subtle external pressures. Why do we think it will be any different with abortion?

It’s not just that women might be swayed into having a termination. The opposite is also true.

Crisis Pregnancy Centres are a group of unregulated outlets across the UK that promote themselves as advisory services for women trying to deal with an unplanned or unwanted pregnancy. While some may claim to be impartial, others are run by pro-life charities. These centres are not regulated by the Department of Health, yet claim to give out reliable health advice.

Worryingly, investigations by this newspaper have shown that the information they share about the physical and mental effects of an abortion is often not supported by medical evidence or in line with official advice from the Royal College of Obstetricians.

What an unforgivable mess. Where are the voices from women’s groups condemning this whole set-up? Where were the feminists after this newspaper also uncovered doctors who were willing to terminate pregnancies for women who did not want to have a baby girl? A few muted whimpers – but nothing more.

Last month, another investigation suggested that the practice has become so widespread within some communities that it is said to have led to the “disappearance” of between 1,400 and 4,700 females. Why aren’t men and women who consider themselves supporters of women’s rights up in arms about this?

What was exposed is pure misogyny, and yet, because it relates to abortion, ideological confusion creeps in. Why can’t you criticise the way abortion services are run while still supporting a woman’s right to choose?

For me, this is a clear example of how farming out services from the NHS to independent providers can go cataclysmically wrong. The entirety of pregnancy advice should be brought back into the NHS, where strict guidelines on impartiality can be enforced and there is no financial incentive for individuals to recommend one decision over another.

I’m pro-choice – and I want things to change to ensure that that choice really is the woman’s.

Women Who Stand By Their NuvaRing

February 13th, 2014

Some are finding it difficult to dump a contraceptive that has been known in some cases to lead to death

There’s the 24-year-old who stopped breathing, had two heart attacks, and died on life support. There’s the mother whose two-year-old son watched her go into a seizure. And there’s the college student who started spitting up blood while having lunch with her dad.

The accounts of women experiencing the negative side effects of the NuvaRing contraceptive are gruesome, and their stories are part of the evidence that led to the $100 million settlement last week with NuvaRing maker Merck & Co. The pharmaceutical company agreed to hand over $100 million for liability lawsuits claiming the ring caused blood clots that sometimes led to heart attacks and even death, although Merck denied fault. The women argued they were not adequately warned about these side effects, and about 3,800 of them are eligible to partake in the settlement.

Despite the well-publicized risks, some women are finding it difficult to ditch a contraceptive that has provided them with consistency and convenience. Oftentimes, finding the right birth control takes years of trial and error, and side effects range from weight gain to decreased libido. For this reason, when women find the right contraceptive, they tend to develop a certain loyalty to it.

Sarah, 26, a graduate student in New York City, struggled with finding the right birth control since she was 20 years old. During the year she was on the pill, she put on weight and was constantly having mood swings. She’d feel depressed one day and highly irritable the next. She switched to the NuvaRing five years ago after a friend suffering similar effects made the swap, and it has been smooth sailing ever since. “I hated the whole contraceptive experience, but with the NuvaRing I don’t experience any of that,” she says.

The NuvaRing ring is a flexible ring that women insert inside their vagina and remove for the week of their period. Like an oral contraceptive, it releases the hormones progestin and estrogen (though at lower levels), preventing ovulation and sperm from reaching the egg, but you don’t have to remember to take a pill every morning. Women prefer it for its convenience, the localized hormones, and the fact that there’s less accountability. In 2012, there were about 5.2 million prescriptions in the U.S. for the NuvaRing, according to IMS Health, a healthcare technology and information company.

According to the American College of Obstetricians and Gynecologists (ACOG)–the medical authority on all things related to baby-making–NuvaRing leads to a slight increased risk of deep vein thrombosis, heart attack, and stroke. And, as highlighted in a safety warning on NuvaRing’s website, the danger is higher for some women, like those over 35 who smoke more than 15 cigarettes a day or women who have multiple risk factors for heart disease. Its typical use failure rate is 9%, the equivalent of an oral contraceptive, according to the CDC.

Following the settlement Friday, Merck issued a statement saying, “We stand behind the research that supported the approval of NuvaRing, and our continued work to monitor the safety of the medicine.”

Though the side effects of the NuvaRing are very real, for many women it bears no complications. “I am extremely busy with very irregular hours and travel for my job,” says Julie*, 27, who works for a film production company in Los Angeles, California, “so the NuvaRing is the ideal fit for my lifestyle. I have virtually no side effects, so I plan to remain on it for the foreseeable future.”

Other women simply shrug off the dangers. “Every drug you take comes with risks, from Asprin to birth control to allergy medicine,” says Ricci Ellis, 31, a respiratory therapist in Little Rock, Arkansas, who switched from the pill after consistently forgetting to take it. “For me, the benefits of NuvaRing far outweigh the risks.” Because she’s not not a smoker and leads an active and healthy lifestyle, Ellis considers herself relatively safe from the risks of blood clots, strokes, and sudden death.

“It is absolutely essential that people are aware of the risks associated with each method of contraception,” says Bill Albert, the chief program officer at The National Campaign to Prevent Teen and Unplanned Pregnancy. The American Heart Association (AHA) recently recommended that women considering birth control get screened for high blood pressure, which can put them at a greater risk for clots and stroke. ”Equally important, however, is how such risks compare to those of other methods, and to pregnancy as well.”

According to Albert, the side effects need to be placed in a broader context so that they are neither dismissed nor viewed with disproportionate alarm. “One of the highest risk of blood clots comes with pregnancy. Consequently, if an individual is having sex and doesn’t want to get pregnant, skipping birth control altogether for fear of blood clots is not the best way to protect your health,” says Albert. “This is not meant to be cavalier, but the doubling of a rare risk is still rare.”

Medical experts are careful to not trivialize the risks, but Dr. Eve Espey, the chair of ACOG’s Committee on Health Care for Underserved Women and a professor in the Department of Ob-Gyn at the University of New Mexico’s School of Medicine, says the NuvaRing settlement hasn’t changed how she counsels her patients. “It’s always tragic and horrible when a woman has a bad outcome or dies from a blood clot. But to then label that method as dangerous often translates into more unintended pregnancies with a higher risk than using the method,” says Dr. Espey. Though popular for its convenience, the NuvaRing isn’t the most effective form of birth control out there. And neither is the pill. The intrauterine device (IUD) and the implant are considered the two safest and most effective forms of birth control available, with a typical use failure rate of 0.8% and 0.05% respectively.

When asked if women currently using NuvaRing should talk to their doctors about other options, Dr. Espey said, “How do you prepare for the event that’s so rare?”

But it’s making Sarah think twice. “I’m definitely concerned about the risks,” she says. “I am making an appointment with my gynecologist to discuss options.”

*Name has been changed for privacy.