Nearly half of pregnancies in Minnesota are unintended

Recently, the Gattmacher institute evaluated the number and cost of unintended pregnancies on a state-by-state basis. In Minnesota, 44% of pregnancies are unintended. Why are the rates of unintended pregnancies so high? According to Claire Brindis, director of the Bixby Center for Global Reproductive Health at the University of California-San Francisco, difficulty finding family-planning services and lack of access to birth control are major contributors to high rates of unintended pregnancies. Unintended pregnancies cost Minnesota $143 million (limited to cost of delivery & first year medical cost for the infant) in 2006 when only 59% of unintended pregnancies were covered by state programs. Since 2006, Minnesota has seen a drastic increase in those enrolled in state health care programs and the cost of those programs.

Unfortunately, instead of reducing our social and fiscal costs, the Minnesota legislature plans to increase them with the current budget proposal. In addition to implementing the gag rule, the legislature hopes to defund programs that provide access to birth control and education. Eliminating access to these programs will result in more unintended pregnancies. The legislature's move to defund these programs will not save the state money but result in higher costs - every dollar spend for family planning services saves $4 in other state spending. The short-sighted budget containing these measures will likely be vetoed by Governor Dayton, will the legislature come back with a budget that doesn't hurt women and, ultimately, the states bottom line?

Confidentiality's role in supporting adolescent health

The Minnesota legislature is pushing a bill, SF 1017, to remove a minors right to obtain medical care. There is an exception for incest, rape and abuse but only when the abuse comes at the hand of a parent or a legal guardian - the victim would be forced to go in front of a judge to prove that abuse occurred. This bill would not only force rape and many incest victims to confront their assailants to obtain permission for an abortion, they would have to obtain their permission for STI testing, pregnancy testing, alcohol/drug counseling, mental health counseling and all other medical care.

In Minnesota, STI's disproportionally affect teens. According to the American Medical Association, parental consent and notification laws prevent teens from seeking health care. Removing the right to privacy will not only prevent teens from accessing health care but will prevent teens from obtaining the counseling medical professionals provide. Counseling that includes teaching teens about safe sex practices and guidance for talking to parents about sex. Confidential access to medical care has been a cornerstone to improving the health of American teens.

Guttmacher

Research from as far back as the late 1970s has highlighted the importance of confidentiality to teens' willingness to seek care. Recent research confirms these original findings. For example, a study appearing in 1999 in the Journal of the American Medical Association (JAMA) found that a significant percentage of teenagers had decided not to seek health care that they thought they needed due to confidentiality concerns. With respect to reproductive health care, specifically, a 2002 JAMA study found that almost half of sexually active teens (47%) visiting a family planning clinic would stop using clinic services if their parents were notified that they were seeking birth control, and another 11% reported that they would delay testing or treatment for sexually transmitted diseases (STDs) or HIV; virtually all (99%), however, reported that they would continue having sex.

The American Academy of Pediatrics states that parental consent legislation does not increase family communication, but does increase the risk of harm to the adolescent by delaying access to medical care. Physicians agree that minors should be encouraged to discuss their health with their parents/guardians, but should not be forced in order to obtain care. Parental notification/consent laws have been shown to decrease adolescents’ likelihood of seeking health care and use of contraceptives by almost 50% - thus completing the circle - and increasing the rates of teen pregnancy.

MNCASA provides some linkes to take action.

Education and access to family planning can reduce STI cases in MN

April is sexually transmitted infections (STI) awareness month. During April, programs work to raise awareness about the impact of STIs and the importance of discussing sexual health. In Minnesota, The Department of Health currently funds 31 community programs that provide STI/HIV testing, medically accurate sex education, contraception and support groups. While these programs help prevent the spread of STIs and unplanned pregnancy in Minnesota, the state legislature is aiming to eliminate funding (and block federal funding) for projects that deliver these services - even in the face of increases rates of STIs in Minnesota. The family planning special projets (FPSP) grants were implemented in 1978 under Governor Carlson and Governor Pawlenty increased the funding for this program. This bipartisan program provides grants to mostly rural communities helping them provide family planning and education. These clinics serve patients that are more likely to live below the poverty line and have an even greater need for state and federal aid. Last year alone, these dollars provided family planning methods for 25,109 people, 15,101 of which live below the poverty line.

>How great is the need for family planning services? With the prevalence of abstinence-only education, many sexually active teens and young adults never receive medically accurate sex education. Not knowing how to protect themselves, they are much more likely to have unprotected sex. This has lead to an increase in STIs in Minnesota and the United States. Approximately 1 in 2 Americans will contract an STI at some point in their lifetime with 1 in 4 teens contracting an STI each year. Considering that less than half of adults 18-44 have EVER been tested for an STI (other than HIV), these numbers are staggering. In Minnesota, STI rates increased by 5% in 2010 - chlamydia 6%, syphilis 110% and gonorrhea decreased by 9%. The incidence rate of chlamydia has more than doubled since 1996 and tripled for those 25-39. The incidence of chlamydia infection among minority groups ranges from 2.5 to 15 times the incidence of white Minnesotans. In 2009 alone, there were 370 new HIV cases reported in Minnesota - every day last year, someone found out they were HIV positive. Teen pregnancies already account for a large percentage of births, especially in rural areas and over half of all MFIP (MN welfare program) dollars go to families that begin with a teen parent.

Failing to educate our youth feeds back into these patterns of increased incidence of STIs and more unplanned pregnancies. Undiagnosed and untreated STIs can even lead to lifelong health problems or death. STIs can damage organs (reproductive, heart, joints and brain), increase the risk of infertility and tubal pregnancy, increase the risk of birth defects or stillborns, and increase the risk of transmitting or getting HIV.

STIs are preventable and many are easily treated. While the best prevention method is abstinence, consistant and correct usage of latex condoms is a highly effective method to prevent HIV and STI transmission. Vaccines are also available to prevent hepatitis A, hepatitis B and HPV (the viruses that cause genital warts and cervical cancer). Removing funding for highly efficient public health programs - every dollar spent on family planning services saves taxpayers four dollars in other state medical spending - is short-sighted and ignores 32 years of effective bipartisan public policy. All Minnesotans should have the knowledge and resources to prevent unintended pregnancies. Eliminating state funding and blocking federal funding for family planning in Minnesota will result in more unintended pregnancies, increases in incidence and complications from STIs, and will disproportionately hurt the poor and the youth of Minnesota.

Regular STI testing helps catch infections at early stages. href=" http://sexualhealthmn.org.">Get tested!

Statistics for this post were found at the CDC and MDH
Image from MDH

Cross-posted from Planned Parenthood Advocate: http://www.plannedparenthoodadvocate.org/content/education_and_access_to_family_planning_can_reduce_sti_cases_in_mn

HIV Prevention and Title X

More than 56,000 new cases of HIV are diagnosed every year; the number of new HIV infections in Minnesota rose 25 percent in 2009. This increase brings the number of new HIV cases back to levels seen in the 90's.

According to the Minnesota AIDS project, this dramatic increase in HIV infections can be linked to the decline of comprehensive sex ed in public schools, a general sense that the risk of contracting HIV is low and the perception that HIV is a manageable disease. These and other social factors have contributed to men ages 15 to 24 seeing the largest increase in HIV cases in Minnesota.

Prevention is the key to saving lives and money. Prevention begins with comprehensive sex education. Young people need to know behaviors that put a person at risk for HIV/STIs and the methods to best prevent exposure. Through Title X funding, Planned Parenthood provided counseling, education and conducted 10,000 HIV tests in Minnesota last year. Unfortunately, Title X funding and other preventative care funding is at risk of being eliminated by the GOP majority in the U.S. House of Representatives. While the U.S. Senate rejected the budget bill removing funding from Planned Parenthood, we still do not have a finalized budget.

Removing funding from preventative health programs is negligent and short-sighted. Public health programs have helped prevent 340,000 babies from being born with HIV. Cutting funding for these programs would have a devastating effect for a generation of children being born with HIV especially when mother to child transmission is easily preventable. Cost to treat one HIV infection is over $25,000 per year, but programs to help cover the costs of these treatments may also be cut pushing the burden onto states. Public Health programs need to be above petty partisan politics, preventing disease and promoting health benefits all.

The importance of Title X

Planned Parenthood has served Minnesotans for over 80 years, helping men and women access comprehensive, medically accurate information and basic health care. 64,000 men and women in Minnesota utilize Planned Parenthood's services every year; 54% of those patients are at or below the federal poverty level and 83% of patients are eligible for health care services at little or no cost. Health care services provided by Planned Parenthood are especially critical in rural communities, where people are more likely to live in poverty and have extreme barriers to accessing health care. Only 3% of Planned Parenthood patients can afford the full cost of their care and, for many, Planned Parenthood functions as their primary care provider.


Recently, the House of Representatives voted to strip Planned Parenthood of all federal funding by zeroing out the title X budget. This move was based solely on politics and ignored 40 years of effective public policy. Every dollar spent on family planning services saves taxpayers four dollars in Medicaid spending, this is an excellent return on investment that is matched by few other federal programs. Title X funding, contrary to the speeches give by many on the house floor, does not fund abortion services.  Title X funds cancer screenings, STI/HIV testing, medically accurate sex education and contraception. The majority of title X patients are low-income women who are uninsured but ineligible for medicaid, making title X one of their few options to access health care services.

Title X grants provide Planned Parenthood of Minnesota with approximately 20% of their funding and eliminating this funding will disproportionately hurt rural Minnesota communities. Rural clinics serve fewer patients and those patients have an even greater need for federal aid. The map to the left depicts the percentage of births per county to mothers under 18.  Teen pregnancy already accounts for a large percentage of births in rural communities. Low maternal age negatively impacts infant health. Infants born to mothers under the age of 20 have a mortality rate 1.5 times higher than infants born to older mothers.

All women should have the knowledge and resources to prevent unintended pregnancies. Contraception services at Title X centers (like Planned Parenthood) prevented 973,000 unintended pregnancies. Without Title X this would have resulted in 406,000 more abortions. Removing funding for Planned Parenthood, one of the few sources for medically accurate sex education and contraception, will result in more unintended pregnancies and will disproportionately impact women in rural communities.


Cross posted from Planned Parenthood Advocate

Lobby for comprehensive sexuality education

Those rallying for choice at the MN capitol today are likely finding their voices fall on deaf ears. In the last election, Minnesota moved from having prochoice majorities to a minority, that will even struggle to uphold any gubernatorial vetoes. The saving grace is that we do have a strong prochoice governor who doesn't believe that its the governments job to legislate a woman's uterus.

For today's prochoice lobby day, I wanted to focus on a bill that should have passed every year, but usually doesn't make it out of committee (even when we had prochoice majorities). The comprehensive sexuality education bill provides schools in Minnesota with support and structure to ensure that all Minnesota kids understand their developing bodies, reproduction and decision making. Over 90% of Minnesota parents want schools to teach sex education that includes pregnancy prevention and abstinence. Yet there has been no move to ensure that Minnesota kids receive this education.

A survey of Minnesota teachers shows that new policies are needed to ensure that kids receive this critical information.  Making sex ed a high school graduation requirement, ensuring districts and school boards develop policies for comprehensive sex education and finally passage of the state comprehensive sexuality education bill will help teachers share medically accurate information with their students.

The key is to ensure that our kids receive medically accurate information and the only way to do that is to develop a state standard for sexuality education as a part of health curriculum.  Unfortunately most curriculum decisions are left to the local school districts where many lack the knowledge and support to provide this information. This decentralized approach to education has resulted in the United States having some of the highest rates of sexually transmitted infections and teen pregnancies in industrialized countries. Providing our kids with information and resources will reverse these trends. Comprehensive sexuality education will ensure they have all the information needed to make choices about their bodies and personal lives.

Family Planning in Greater Minnesota

Entrenched in attempts to balance the budget, the MN legislature will likely cut from all funding areas.  Last week, the MN senate passed cuts to child protection services and no one in the GOP was able to say why kids were in the first round for cuts or how this would effect them. Are these cuts viable or will they just cause more problems down the road? No one seems to know. We can bet that family planning services will likely receive the same blind ax by the GOP controlled legislature.

Family planning works and saves taxpayers money. Every dollar spent on family planning services saves Medicaid $4.02. Are there any other programs that have that kind of return on investment?

In greater Minnesota, access to family planning services is exceptionally challenging. 60% of Planned Parenthood patients live in greater Minnesota and 64% of those patients live in poverty. How will the GOP justify eliminating, in many cases, the only health care their constituents see in a year? Many clinics are located in communities that lack access to adequate primary care services. Will the MN GOP continue to fully fund ineffective 'crisis pregnancy centers' (that spread misinformation about birth control) but cut funding for family planning services that give medically accurate information? Reducing funding for family planning services will only increase the health care disparity between rural and urban women and cost Minnesota taxpayers more in the long run.

On the anniversary of Roe: State of abortion access

On the anniversary of Roe, I began to think more and more about the question 'what good is a 'legal' abortion, when you can't access it?'.  Without access, you have no choice. In a report from 2005, 87% of counties in the US have no abortion provider; in Minnesota, 95% of counties lack an abortion provider. This may seem like a win for anti-choice advocates, but what we really have is a culture that is punishing women because of other's religious beliefs. When a women doesn't have access to family planning resources, the number of unintended pregnancies increase. Later term, more risky abortions happen when a woman doesn't have access to an abortion clinic or doesn't have the funds or means to obtain one.

One of the biggest hurdles for abortion rights activists is that people have forgotten what it was like for women prior to Roe. Anti-choice groups have succeeded in removing real stories of real women from the abortion access fight.  Yes, abortion illicits strong feelings in many people, but we often forget that abortion isn't about you. Its about a woman making a choice about her body and her life. Not yours. You have to think about how you would want your daughter or mother or best friend to be treated when they are making this decision for their life.

As a reminder of what abortions were like prior to Roe, I'd like to share a story about a woman who ended up founding several health care centers that offer abortion care.
Abortion care network

My name is Renee Chelian. In 1966, when I was 15 years old, I had an illegal abortion. It was a very brave decision that my parents helped me with. My father took me because my mother was six months pregnant with my younger sister, and he was afraid for her safety as well as mine. We were blind folded and taken to some kind of warehouse. When the blind fold was removed there were many other girls there. No one talked for fear of being turned away. It was dangerous, it was very expensive, my parents could have been jailed, I don’t know who did my abortion – I’m sure not a doctor and I could have died or had serious complications or been left infertile. And we could tell no one out of fear and the stigma associated with a crime that so many other women were also risking their lives for.

I was willing to risk my life for a second chance. I didn’t know then how this experience would change me forever. After the legalization of abortion in 1973, I became passionate about working to ensure that NO woman would ever have to experience another back alley, illegal abortion.

As we learn more about Dr. Kermit Gosnell's practice in Philadelphia, we can see the parallels. Limiting access to abortion and preventing funding for abortion hurts women. You can put all the legal blocks you want, women will still seek out and obtain abortions. And desperate women, who don't know where to turn, may end up dying.

I recently heard a story about a woman named Leila.  She had a young son who had numerous medical problems.  In order to care for him, she dropped out of school but soon lost her job because of the numerous doctor appointments for her son.  Leila soon found out she was pregnant. She knew that she could not have another child. Leila spent weeks getting the money together for an abortion, even selling her belongings on Craigslist.  She felt relieved when she had gotten together the money but then found out at her appointment that the cost was $100 more than she had. She broke down and tried to sell everything that she had in her diaper bag.  Luckily for Leila, the clinic was connected with the National Network of Abortion Funds and they were able to provide Leila with the funds to obtain an abortion.  Not everyone is as fortunate as Leila, NNAF is only able to help 1 in 9 women who call for help. (Leila's full story is here: the National Network of Abortion Funds (NNAF))

Another story about the challenges of accessing an abortion is a little closer to home, coming from Minnesota.

Prochoice Resources

"I was 29 with a 11 year old and a 2 year old, I was in a very bad abusive relationship with a man and I got pregnant, I knew from the start that I couldn't keep the baby, I knew that I would be stuck and have to take the abuse forever, and even worse I knew that my children would have to endure the abuse if I stayed. I had nowhere to go, no money and no one to talk to. I called the Hersey Abortion Assistance Fund number and for the first time in 2 months I felt I could breathe again, the lady that I talked to seemed so caring and understanding. They don't just give you money they help you emotionally and when you go through something like that it means more than all the money in the world. I could never thank them enough. And just so you know I got rid of the boyfriend, and me and my 2 kids have never been better.. Thank you so much" -Denice, age 30

Abortion opponents strategy for targeting public funding are two-fold, first to immediately reduce access and secondly as a broader strategy to recriminalize abortion. The limits on abortion coverage overwhelmingly affect the most vulnerable among us. Anti-choice legislators are even trying to limit access to birth control. We know that prevention works. We need to fund more family planning services, not remove funding.  When you eliminate or limit access to care, you create desperate situations for women.

We often assume that because someone identifies personally as 'pro-life', that they are 'anti-choice' but I would argue that for the majority of Americans this simply isn't true. I think the majority of Americans are pro-life AND pro-choice. I made a choice as a teenager (and now my child is a teenager) but it was my choice to make.  All women should be able to make that choice without restrictions or limits or social stigma. To accomplish this, we need equality in comprehensive family planning access, including equality in funding for our health care programs.


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If you would like to donate to an abortion fund and help women who wouldn't otherwise have a choice, here are some links:

National Network of Abortion Funds
Prochoice Resources (Twin Cities)

Obama administration: Birth control is too politically risky

When did birth control become such a political football? I'm not talking about abortion. I'm talking birth control pills; that medicine most women take at some point in their lives to prevent pregnancy. The political fight over birth control access ramped up significantly with the health care reform debate and is back as the committee appointed by members of congress now debate what should or should not be covered as preventative medicine.

If birth control is specified as a preventative, insurance companies will cover the total cost of the prescription (meaning no copay for women).  For many, a copay may not be a big issue. They may not see the importance or impact of providing free birth control to low income women. To those who are barely getting by, a $10-$50 expense per month is significant. A college student making 12K per year (my sister made less than this as a student) per year as a waitress and has a $50/month prescription has to spend 5% of her income. 5% of her income just for birth control. And people wonder why there are so many unplanned pregnancies.

Sadly, the Obama administration seems content to sit back and let the chips fall as they may.
The Nation

Douglas Laube, a veteran ob-gyn and chair of the board of Physicians for Reproductive Choice and Health, who attended a fall meeting with White House staff to discuss the issue, described members of the administration as appreciative of the importance of birth control – but also worried. “Nobody in that room disagreed,” said Laube. “It all had to do with the potential political fallout.”

If the GOP, who fights access to family planning at every turn, REALLY cared about reducing the numbers of abortions, they would fight FOR expanded coverage of birth control. We need a leader to stand up and protect women's access to comprehensive health care. Prevention works. Prevention saves money. Prevention saves lives.