We want to share this interesting and thought-provoking

We want to share this interesting and thought-provoking article by Elizabeth Schroeder, on Chicago’s “Pregnant Men” ads.  Elizabeth is an internationally recognized expert in the field of sexuality education and youth development, and the Executive Director of Answer. We would love to hear your thoughts. 

“Chicago’s ‘Pregnant Men’ Ads: Flipping the Dialogue on Men and Teen Pregnancy Prevention”

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Preventing Repeat Pregnancies

Thank you to today’s guest blogger, Sue Arico! Sue is a longtime TeenNow California member and the former director of the Cal-SAFE program at Sierra Nueva High School. She has a great deal of experience working in teen parent support programs, and recently focused her Master’s thesis on the role of parents in preventing second teen pregnancies.

 

 

Several facts in CDC’s Vitalsigns recent article “Preventing Repeat Teen Births” caught my attention. The first was that one in five births to teens are repeat births, and the second was that although nine out of 10 sexually active teens used some form of birth control, only about half chose to use the most effective types. The article poses the question: “What can be done to prevent repeat teen births?” The answer is to look at best practices, and in California we are lucky to have one program that has been proven to work. California’s Department of Education California School Aged Families Education Program (Cal-SAFE) has been very successful in reducing second teen births! With the Cal-SAFE program, and as a community of researchers, educators and caregivers, we can continue to rally together to support teen parents. We can speak out to protect and preserve a program that we created, and that works!

 “What Can Be Done”?

We must continue doing the work we know is effective–stressing the use of the most effective contraceptives and building trusting relationships which have the capacity to influence those teen parents who need us. Research has shown that having a second pregnancy in the teen years greatly reduces the chance of academic success. Repeat births, which typically occur at a rate of between 16 and 25%, cause a loss of school attendance, slow progress toward graduation and reduce the focus, attention, and parenting that the first and second child will receive from the parent, so it makes sense to focus on reducing repeat births. Once a teen has had a baby, she is at an increased risk of having another.  

Lorraine Klerman of The National Campaign to Prevent Teen Pregnancy, and author of “Another Chance: Preventing Additional Births to Teen Mothers” explains, “The most important factor in preventing subsequent pregnancies may be the strength of the relationship between the teenage mother and the individual working with her.” While sifting through the strategies that have been shown effective to prevent teen pregnancy and second pregnancies, having a close, ongoing, and supportive relationship with the teen is frequently identified as a critical protective strategy. Teens themselves tell us that they wish they had more trusted adults to talk with about important issues including sexual ones.

“What Can Be Done?”

Cal-SAFE is a school-based program, and Cal-SAFE providers see teen parents at school daily. This frequent and ongoing contact helps to build that all-important connection with the young mothers and fathers. Cal-SAFE provides a rigorous education with necessary support to help students who may not have done well in school before, or who may have dropped out, be successful in moving toward high school graduation. Building a vision for a brighter future is a key factor. Seeing students everyday means there is time to delve into their needs, fears, health, child development skills, parenting practices, and education. There is time to have some real discussions around the teen’s goals, hopes and dreams. Family planning (including the use of the most effective contraceptives) and child spacing can fit naturally into these conversations.

Since the Cal-SAFE program is a community linked program, expectant and parenting teens and their children are referred to various community partners to make sure they have all the types of the support they need. For example, Cal-SAFE programs may refer teens to hospital- or community-based childbirth education/parenting classes, such as the Kaiser Permanente teen classes. Family planning and contraception education are a part of best practices for childbirth education classes.

Other resources that help promote success include the Teen Success program, which is offered in many communities throughout the North and central regions and provides weekly support groups with the goal of helping young mothers maintain their family size until they reach their goals. Teen Success groups are run by both Planned Parenthood Mar Monte and Teen Success Inc. If you’re interested in starting a program in your community, you can contact Teen Success through their web site. I have seen firsthand the difference a support group can make. The facilitators are trained and very skilled at talking to the teens about many issues, and especially about issues regarding family planning and contraception. These groups definitely build deep and nourishing relationships with and among the members. Sharing goals helps the group support each other.

Another great resource for reducing second pregnancies is the Nurse Family Partnership. This home visitation program has a wonderful track record, and because they meet with the mom during pregnancy and continue until the child is older than one year, they are able to build those trusting relationships that are so vital to help support the teens in their decision making. Because they are RN’s, referring the youngest teens and others who are at high risk medically and for repeat pregnancy is important.

Making referrals to the programs mentioned above, as well as other great programs in your community, along with making sure teens have a healthcare provider for prenatal/post partum care, sexual health, lactation, spacing childbearing, and thorough contraception education, are key goals for the Cal-SAFE program.

Two other community partners that share many of the same goals as Cal-SAFE are the Adolescent Family Life Program (AFLP), and the Cal-Learn Program, which is based on the principles of AFLP. They support pregnant and parenting teens, to obtain a high school diploma or its equivalent, to ensure the healthy development of their baby, to prevent additional teen pregnancies, and to break the cycle of welfare dependency. Both provide case management services to expecting and parenting teens in California, make home visits and build trusting mentoring relationships with the students.

 

 “What Can Be Done?”

An obvious answer is to continue to support and fully fund the Cal-SAFE program! It was created in our state, for California’s expectant and parenting teens. Data collected since the inception of Cal-SAFE has shown a significant decrease in the number of repeat births. Experts report rates of 16% to 25% for the general teen parent population in the United States. The Cal-SAFE program has a repeat birth rate of 8%.

Check out the Cal-SAFE program’s 12 year evaluation showing more positive outcomes!

http://www.teennowcalifornia.org/2000-2012CalSAFEEvalRptFINAL12Oct5.pdf

Reading Deeper Into The FDA Announcement on Plan B One-Step

On April 30th, the FDA announced it would approve the amended application by Teva Women’s Health, Inc to lower the age requirement for accessing Plan B One Step from 17 to 15. The product will still only be available in retail establishments with an on-site pharmacy, but may now be available in the family planning aisle, and during hours that the pharmacy is not open. The ruling doesn’t apply to the other emergency contraception drugs, Plan B or Ella.

While we laud the decision to make emergency contraception more accessible, the details are problematic. Under the new ruling the label must read “Not for sale to those under 15 years of age. *Proof of age required.* Not for sale where age cannot be verified.” This means a 15 year old will have to provide proof of age in order to access Plan B One-Step. According to an article published on Forbes.com, when asked how a 15 year old can provide identification an FDA spokeswoman replied “a passport or birth certificate.” Per the FDA’s press release, “Plan B One-Step will be packaged with a product code prompting a cashier to request and verify the customer’s age.” 

This requirement could easily create a situation where a person of any age could be denied the sale if they do not have the proper ID. Marcia D. Greenberger, from the National Women’s Law Center (emphasis added) points out “While an improvement over current policy, today’s announcement is still disappointing. Because all women will be required to show an ID to establish their age, those without IDs could be denied access.”

While any progress towards greater access to emergency contraception can be seen as a victory, this ruling still brings cause for concern.  Emergency contraception is most effective when it’s taken early on after unprotected sex. Therefore, any delays in being able to purchase this contraception can lead to unintended pregnancy. 

On April 4th, 2013, Federal Judge Edward Korman found against the FDA’s current age restriction policies in Tummino v Hamburg, and gave the federal government 30 days to remove all age restrictions on the sale of emergency contraception. In doing so, he stated:

“…she [Secretary of Health and Human Services Sebelius] has failed to offer a coherent justification for denying the over-the-counter sale of levonorgestrel-based emergency contraceptives to the overwhelming majority of women of all ages who may have need for those drugs and who are capable of understanding their correct use.” (pg 12)

The FDA has until May 5th to comply with the federal court ruling to provide all emergency contraception over the counter to anyone, regardless of age. So why approve an amended application five days before a court ruling would have made this matter moot?  National Women’s Law Center Vice President Judy Waxman suggests “This triggers their intention to file an appeal even if they haven’t yet. This decision doesn’t comply with the judge’s ruling.”

We’ll be waiting to see what the fallout of this ruling will be. What do you think? Is this decision a victory or a stall tactic?