Tuesday, June 18, 2013

Hey Mississippi, Over Here!

According to an article posted on Reuters, “Mississippi will require doctors to collect umbilical cord blood from babies born to some young mothers, under a new law intended to identify statutory rapists and reduce the state's rate of teenage pregnancy, the highest in the country. Under the law, doctors and midwives will be expected to retrieve umbilical cord blood in cases where the father is 21 or older or when the baby's paternity is in question.” 

So I thought I had heard it all and then comes Mississippi!  Don’t get me wrong, in true cases of statutory rape, I agree.   It is a criminal act in South Carolina as well and should be handled by law enforcement.  Solicitor's Offices willing to crack down on statutory rape is a good thing and necessary to change social norms over the next decade.   

My problem is that I think asking the medical community to step in is crossing a line.  Years of research (and experience) have show that teens don't always trust the medical community and seek their care only if confidential.   You’re asking the medical community to cross into a law enforcement role and break their doctor-patient confidentiality.  This idea is potentially costly, not research proven, and  could have unforeseen negative consequences. And after all this time, energy and money, can you imagine the cost of lawyers, storing cord blood (I couldn’t even afford it for my own girls), prison, etc.  and for what?  The baby is here, you did not prevent a pregnancy.  Therefore, please stop referring to this as an “effort to reduce teen pregnancy.” The bigger question of the day is: “Mississippi, what are you doing for the 67.7% of girls getting pregnant in your state that DON’T fall into this law?”

If you are picking up on some “tension” in my blog, you’re right. We often want to “blame” teen pregnancy on someone.  Some want to “blame”  leaders, politicians, parents and every adult in the state.  Stop making teens victims and empower and equip them to become responsible adults.    Mississippi, this won’t cost you a penny.  My advice,

1.    Read Emerging Answers by Dr. Douglas Kirby (20 years worth of experience from the best in the business).

2.    Look at your data, because it tells a clear story.  Your youth are sexually active, not using contraception and most of your pregnancies are to 18-19 year olds.
a.    14.8% of these students reported using birth control
b.    Repeat pregnancies among 15-17 year olds, 11%; among 18-19 year olds 27%
c.    Teen pregnancy rate among 15-17 year olds 30.6; 18-19 year olds 88.7
d.    67.7% of your teen pregnancies were to 18-19 year olds. 

3.    Put your money in a multi-faceted approach that respects teenagers and helps them become responsible adults.  Wouldn’t you prefer they never go out with a 21 year old to begin with?
a.  Start evidence-based programs that build refusal skills in middle school, like Draw the Line, and for those siblings of teen parents or drop outs, provide youth development opportunities like Teen Outreach Programs.
b.  Get rid of shamed-based abstinence education. 
c.   Require sex education in high school.

d.   Get faith communities and parents on the same page with school programming.  We want all our kids to be abstinent, but if you decide to have sex, respect yourself and your partner and use condoms and contraception. 

4.    The medical community’s role is medicine.  Let them do what they are trained to do.
a.    The BIGGIE, get your pencil…….GET YOUR CLINICS OFF THEIR BUTTS!!  Publically funded Title X clinics in your state are failing your teens. 
b.    Work with HHS and Medicaid to increase reimbursements for LARC (Long Acting Reversible Contraception) and LARC in hospital care (before teen moms leave the hospital).
c.    Work with the medical community (family medicine, ERs, pediatrics) to screen all teen patients for their intentions to have a baby and needs for contraception. 
d.    Teen Clinics are necessary in your communities with highest rates.

5.    Don’t ignore your 18-19 year olds. 
a.    Where are they?  Two-year colleges, job training programs, in the work force. Go to them and promote contraception and where to get it free. 
b.    Get them access to reproductive health care that provides birth control counseling.

6.    Most importantly, bring your youth to the table and have them identify solutions. 
We all mean well but at the end of the day we have to all focus on where we will have the greatest impact on teen pregnancy; hit the low-hanging fruit and limit waste of time and money. 

by Polly Edwards Padgett, Senior Program Advisor, SC Campaign to Prevent Teen Pregnancy 

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