Teen birth rates decline due to increased condom use

A study released by the Federal Interagency forum on Child and Family Statistics last week showing that teen birth rates on are the decline, continuing a downward decade-long trend. While the number of teens engaging in sexual behavior has stayed the same, birth rates have gone down, seemingly due to an increase in condom usage (up to 63% reporting using condoms during their last sexual encounter).

One thing we can’t conclude from this study–that abstinence-only education can take ANY credit for this decrease. If anything, it shows that what will bring down teen birth rates (if that’s even our goal) is safer sex, not a no-sex message. Another thing not mentioned in the articles about this study are abortion rates, which could also account for the decrease in teen birth rates (note that it’s not teen pregnancy rates, but birth rates).

The study also reported that more teens are finishing high school (88%) and more teens are being incarcerated for violent crimes (17 per 1000 teens).


Pregnant & Poor in Mississippi

Check out this fabulous article by Susan Sharon Lerner from Salon about women’s access to abortions in Mississippi. Unfortunately for women in that state, every barrier that you can imagine has been placed on their ability to access services, we’re talking lack of providers (there is only one in the entire state), waiting periods, high costs, strigent (even bordering on harrasment-like) requirements on the clinic and provider, hostile political climate, coupled with extreme poverty and a twelve week cut-off for abortions in the state, and you have a scary set of circumstances that means a lot of women in that state will continue with unwanted pregnancies.

Lerner sums it all up better than I can: 

It’s hard to imagine someone who can’t afford a bus trip taking responsibility for a new life — especially when she doesn’t want to.

PS If you’re interested in reading more reproductive rights related news–check out my organization’s new blog, Nuestra Vida, Nuestra Voz where I’ll be writing more about reproductive justice and the Latina community.

Update: Another perspective on the closing of NYC Pregnancy Schools

A few weeks ago, I posted about the news (reported by the NYTimes) that they were closing the last four schools for pregnant teen moms left in NYC. My post was pretty much in support of the closings, but I feel the need to bring this topic up again because of an email I received from Yomara Velez, an activist and teen mother herself. Here is some of what she said to me:

While we understand that the schools need much improvement, we must say that we are NOT in support of the school’s closing. Prior to taking a position on this issue, we must think very carefully of how teen mothers will be affected. Yes, some teen mothers are pushed out of high schools and we denounce that type of blatant discrimination! However, this is a very delicate time in a young women’s life and for some of the young women the P-Schools were a safe haven. A place where they did not risk being in the middle of a fight, where teachers understood morning sickness and their children were nearby. The closings of these schools was very poorly executed and communicated. There are students who were interviewed by the NEW YORK TIMES who didn’t know the purpose of the article and when they read it were upset to find out that not only was their school closing but their innocent words were twisted to support the decision. These young women don’t have transition plans, for some of them they don’t know how they’ll deal with child care and conveniently enough the Dept. of Education waited until June, a few weeks before the end of the school year to share their intention. How unfair!!! So, it breaks my heart to see all of these people giving their opinions on the matter yet not stopping to actually hear some of the student’s voices. We need a diverse set of educational option because what works for one sister may not work for another. How can a good advocate for teen mother’s not put teen mother’s needs in front and center of the issue? You hear the voice of professionals who will not be impacted by the changes but rarely do you hear the young women’s stories. If you’re site is about being radical, please reach out to us so you can understand the full picture. I’ve enclosed a bunch of information, including student’s testimonies (see attached). I hope you’ll take the time to read it! I thank you for your posting and I hope you’ll support teen mothers as they struggle to access a decent education.

I appreciate very much that she took the time to reach out to me and explain her position, as well as some of the complexities of the issue. I’m also going to include here some quotes from the student testimonies she sent as well.

I am very upset that the school is closing. I feel like the school has
opened many doors for me and given me many opportunities. I really think the Department of Education is not thinking about the choice they are making to close the schools. I feel like the DOE (Dept of Education) is a failure. They failed to educate us and now they will fail at trying to close the schools. The DOE failed us as young moms and young women of color

-Teen Mother from Martha Nielsen School, the Bronx P-School

The Superintendent made this decision and did not discuss it with us. She didn’t even let us know. It is not fair that we are not going to have a school next year. It is not fair for students and teachers to find out through a news article thatthey will not have a school in September. I am not only trying to keep the schools open for myself but for other teens who are currently pregnant and need somewhere to come back to in September. The school is safe and I like the one floor environment without stairs. You feel comfortable in the school with other teen moms. You don’t feel awkward or left out.

-Teen Mother from Martha Nielsen School, the Bronx P-School

It is surprising that this decision was made seemingly apart from the women attending the schools, and with little plan for their integration into the larger public school system. While I still feel that in the long run, pregnant teens should be provided with extra support within the traditional school system (childcare on site, as well as extra mentorship and tracking), I understand these girl’s concerns about how these decisions were made, and what this means for them in the near future.

If you want to support their campaign to keep the schools open, check out their website or call their office at (718) 991-6003 (ask for Sharim, Leslie, Andrea or Autumn).

Thanks again to Yomara for sharing her thoughts and opinions with me.

Bush supported health care plan costs moms more

An article in the Washington Post today shares the findings of a recent study which compared the out-of-pocket expenses between families with a high-deductible health insurance plan and the traditional employer-based health insurance.

They particularly highlighted how these plans affect the out of pocket costs of childbirth:

The study found that those enrolled in a traditional health plan for federal employees (with a $500 annual deductible and $20 co-payments for office visits) would likely pay $1,455 out of pocket for care during an uncomplicated pregnancy and delivery. That compared to $3,000 for families in a high-deductible plan for federal employees and $7,000 for a high-deductible plan offered through small businesses.

Bush and his administration have been pushing these new high-deductible plans (meaning some people have to pay upwards of $2000 before their insurance kicks in) as a way to reduce health care spending–but only by encouraging individuals to spend less.

The theory is that the plans, by making consumers more aware of the costs of care, give people an incentive to shop for the best prices and to forgo procedures they do not need. A Rand Corp. survey last year found that both employers and plan participants reported spending less on health care under the plans, but in some cases people were skipping necessary care.

This type of policy obviously disproportionately affects low-income people (who are much less likely to be able to afford the high deductibles) and also puts all the impetus for lowering health care costs on the individual rather than the other players in the health care crisis: providers and insurance companies.

With the outrageous rise in maternity care costs, the last thing we need are insurance policies which place the financial burden on the families–particularly when so many women are given interventions they don’t need or want in the hospital. How many women are told the cost of an epidural before they are given one?

Midwifery/Doula News Round-up

This has been a long time coming–the news is piling up!

In an interesting development, Senator Loudon’s legislation to legalize midwives in MO could have also expanded the range of providers who could provide abortions—but the legislators nipped this possibility in the bud.

Oregon birthing center sues hospital for trying to shut them down by prohibiting back-up OB-GYNs.

Maryland judge rules that no mother must be listed on a birth certificate.

Two cesarean deaths spark protests of New Jersey’s high c-section rates.

Apparently May is International Doula Month–from this article and shout-out to doulas in Oregon by doula Vicky York.

60 year old woman gives birth to twins by cesarean section in NJ, breaking a US record.

New birth control pill approved that will allow women to avoid menstruation.

Shark gives birth–asexually?

Popularity of unassisted childbirth grows.

Mother has second baby in car en route to the hospital.

Just a sample–more to come soon.

Nancy Goldstein and Wife featured in NYTimes

In a NYTimes article today, Nancy Goldstein, a reproductive justice rockstar from the National Advocates for Pregnant Women, and her wife are featured for being one of the same sex couples to be recognized by NY State for a marriage ceremony they had in Massachussets in 2004.

Unfortunately they are part of a small number of couples who are being recognized, and only because of a legal technicality. Goldstein and her partner were married before the July 2006 NY Supreme Court decision which came out against same-sex marriage. Only couples married between May 2004 and July 2006 will be recognized by NY State.

“Those midwives are a resourceful bunch,” he said.

Missouri Senator John Loudon of Missouri apparently used “a bit of trickery and an obscure Greek term” to try and pass a measure that would loosen the restrictions on the practice of midwifery. Currently the state only allows certified nurse midwives to practice, but the new bill would widen the scope of midwives who could practice.

The new legislation would significantly reduce the requirements, allowing prospective midwives to get certified by a private entity, even if they lack formal medical or nursing training.

Fellow legislators were outraged by the tactics he used, which included slipping the provision into a 123 page bill about health insurance, without even using the word midwife.

“It shouldn’t have been a surprise to anyone that I would use any means possible to get this done,” he said.

He’s definitely not the first Senator to do some serious political manuevering to get something passed, but it makes me wonder where his strong conviction in favor of midwives comes from. He has already been punished for the deception he is accused of using to get this measure through–losing his post as chairman of the Senate Small Business, Insurance and Industrial Relations Committee.

The bill passed both the House and Senate without anyone noticing the midwifery provision–something that has faced significant opposition in the past. Congress leaders are trying to decide if they are willing to veto the bill (which tries to increase incentives for individuals who buy their own health insurance) based on this provision.

25% of women still cut during childbirth

An interesting article in Women’s Enews today about the persisting prevalence of episiotomies, despite a medical study from two years ago which proves that there is NO MEDICAL BENEFIT.

The article points out that the procedure (which involves making an incision in the perineum, the area between the vagina and the anus, during labor) continues to be employed in one-quarter of births. It was previously thought that making a surgical incision was preferable to the possibility of a natural tear during delivery, and the practice became widely employed by the 1940s with the rational being that subsequent stitching would be easier, as well as avoiding side effects like pelvic floor dysfunctions. It also helps to speed up the pushing phase of labor, by widening the vaginal opening for the baby to exit.

The study cited by this article, which reviewed over 50 years worth of data and research on the use of episiotomy came to these conclusions:

The JAMA researchers found that the benefits traditionally attributed to routine episiotomy do not exist. They also found that episiotomy actually increases the risk of severe tearing, pain with intercourse, incontinence and other pelvic problems following delivery. Based on these findings, the researchers called for an end to the procedure, except when the health of the fetus is at risk.

This is a huge step forward in recognizing something that midwives have known for a long time–this intervention is unnecessary and actually harmful in many cases. I witnessed the detrimental effects of episiotomy firsthand while observing in an Ecuadorian maternity ward. The doctors (actually medical students) there told me that while they knew that it was counter-indicated to perform routine episiotomies, they continued to do it anyway, for ALL women who labored at their maternity. One woman who I accompanied during her labor, whose pushing stage only lasted maybe 30 minutes, then required almost an hour and a half of stitching for the episiotomy she was given.

The article goes on to explain why there hasn’t been a more significant decrease in the use of the procedure in the two years since the study was released–the difficulty of educating older doctors.

A study published last year in the Journal of Reproductive Medicine showed that physicians in practice 15 years or more perform episiotomies 50 percent more often than those in practice less than 15 years. “I can’t wait for the doctors who do routine episiotomies to fall out by attrition,” says Hoskins. “That’s too long to wait.”

This is similar to the reason why in places like Ecuador, they are still employing old standards of episiotomy indications. In many foreign countries, particularly in Latin America, they follow the American College of Obstetrics and Gynecology Guidelines. They use the US curriculum for teaching their students, and rely on the research and developments that come out of the practice in the US. The problem is, it can take a significant amount of time for these things to filter down, particularly to the level of public maternity practice in Ecuador. The accountability in those countries is not the same, and there is often times a stark difference between private maternity care and the services offered to low-income people in public hospitals.

Woman catches baby during cesarean section

This article from the Australian newspaper The Age, tells the story of one mom who had an “assisted cesarean section,” where the mother is conscious and even is the first to touch her child–by helping pull the baby out of the womb.

Called “assisted caesarean”, the procedure allows the mother to be the first to hold her child, with her hands guided into the womb by medical staff. In what is believed to be only the third assisted caesarean in Australia in recent years, Perth mother Naomi Chapman, 38, helped deliver her third baby, Thomas, on April 2.

It’s definitely an interesting concept, which aligns with the desire of midwives to include women in the birth process. With the help of midwives, mothers and fathers have been catching their own babies for years now. But is this just an attempt to make an entirely medicalized process seem more mother-friendly? Luckily both the mother and doctor in this situation don’t want this procedure to encourage c-sections:

But women should not consider assisted caesareans ahead of vaginal birth. “I still think a vaginal birth is the best way to birth your baby,” Ms Chapman says. “I don’t want women to choose to have a caesarean because of this,” [Dr. Gunnell] says. “We need to be very clear that this is not a good alternative to a vaginal birth; the caesarean section rate is very high.”

Transgender people in the media: Anti-trans women bias?

I haven’t touched much on transgender issues so far in this blog, but recently there have been three interesting pieces.

The first is a story on ABC News, I Want to Be Seen as Male, about a transgender (female to male) teenager, Jeremy and his process and struggles around transitioning. I thought it was a (surprisingly) thoughtful piece.

The second is a short film, Mookey’s Story: A Transgender Journey,  that has been entered into the VC Filmfest in Southern California, also about a transgender (female to male) person and his transition. It’s good to see trans people of color being discussed and highlighted as well.

It’s important to note that these stories–which represent trans people in a mostly positive and humanistic light (yay!)–are both about trans MEN (female to male). Trans activist and writer Julia Serano, author of the upcoming book Whipping Girl: A Transsexual Woman on Sexism and the Scapegoating of Femininity, has written some really interesting stuff about the representation of trans women (male to female) and I think this is another example of her theories about how most depictions of trans women in the media are negative (like trans women prostitutes) and focus a lot on their appearance (particularly the act of getting dressed or putting on make-up).

A Transsexual Woman on Sexism and the Scapegoating of Femininity

The most recent example of trans women being represented in the media is the NY Times video and article about a shelter for homeless transgender youth in Queens, NY. While not an entirely negative depiction, it does paint these women in a light which emphasizes their difficult pasts: broken homes, sexual abuse and drug problems. A very stark contrast to the seemingly well-adjusted trans men in the first two pieces.  

Is this just another reflection of sexism? There has been some discussion around the idea of trans male privilege (that by living and identifying as men, trans men achieve some level of male privilege), and this seems as if it could be related. I also think that people are more frightened by the idea of men giving up their male privilege to become women than the idea of women wanting to be men, leading to what could be called trans woman phobia. Just some thoughts.