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unplanned pregnancies

Texas’ teen pregnancy rate is the result of bad policy choices

From the Rivard Report:

In Texas each year, about 35,000 young women get pregnant before they turn 20. Traditionally, the two variables most commonly associated with high teen birth rates are education and poverty, but a new study, co-authored by Dr. Julie DeCesare, shows that there’s more at play.

“We controlled for poverty as a variable, and we found these 10 centers where their teen birth rates were much higher than would be predicted,” she said.

DeCesare, whose research appears in the June issue of the journal Obstetrics & Gynecology, said several of those clusters were in Texas. The Dallas and San Antonio areas, for example, had teen pregnancy rates 50% and 40% above the national average.

Research shows teens everywhere are having sex. Gwen Daverth, CEO of the Texas Campaign To Prevent Teen Pregnancy, said the high numbers in Texas reflect policy, not promiscuity.

“What we see is there are not supports in place,” Daverth said. “We’re not connecting high-risk youth with contraception services. And we’re not supporting youth in making decisions to be abstinent. We’re just saying that is an approach we want to take as a state – whereas other states have put in more progressive policies.”

Daverth said California invested in comprehensive sex education and access to contraception. There, the teenage birth rate dropped by 74% from 1991 to 2015. The teen birth rate in Texas also fell, but only by 56%.

In South Carolina, young women on Medicaid who have babies are offered the opportunity to get a long-acting form of birth control right after they give birth. They’re also trying that approach in parts of North Carolina. And Colorado subsidizes the cost of long-acting birth control. There, both abortions and teen birth rates are dropping faster than the national average.

Texas makes it hard for teenagers to get reproductive health care, Daverth says.

In Texas, if a 17-year-old mom wants prescription birth control, in most cases she needs her parents’ permission. “Only [Texas] and Utah have a law that if you’re already a parent, you are the legal medical guardian of your baby, but you cannot make your own medical decisions without the now-grandma involved,” Daverth said.

That’s part of the reason, she notes, Texas has the highest rate of repeat teen pregnancies in the country.

Emphasis mine. That’s pretty much our state in a nutshell. The problem is that any effort to deal with this necessarily begins the acknowledgment of the realities of the situation – you know, like that teens have sex and that teens who have sex without access to contraception and good information about reproductive health are much more likely to become parents than teens who do have those things – and we’re no good at that. Shame and denial is so much easier, and we live with the results of that.

The easily predicted results of de-funding Planned Parenthood have resulted as predicted

Who’d a thunk it?

Right there with them

Right there with them

A new study released Wednesday reports that after anti-abortion Texas lawmakers blocked Planned Parenthood from participating in the Texas Women’s Health Program (TWHP) in 2013, fewer low-income women received the most effective kinds of contraception. The study, published in the New England Journal of Medicine, is also the first to analyze the subsequent significant rise in some Medicaid-covered deliveries after the provider’s ouster.

Comparing quarterly medical and pharmaceutical claims from 2011 to 2014, researchers with the Texas Policy Evaluation Project (TxPEP) found that 35 percent fewer patients received highly effective intrauterine devices (IUDs) and implants — known as long-acting, reversible contraception (LARC) — over the four-year period. Claims for the injectable Depo shot, which requires follow up every three months, decreased by 31 percent. Researchers found that the rate of Medicaid-covered deliveries among women in the Depo group then increased by 27 percent.

The reduction in claims, said lead author Amanda Stevenson, highlights the fact that despite recent state efforts to recruit more providers, and claims of successwithout Planned Parenthood, patients have lost services.

“The reproductive health safety net cannot just absorb all of the demand for highly effective contraception when you remove Planned Parenthood from the network,” Stevenson told the Observer. TxPEP’s findings, she said, “directly contradict” claims “that Planned Parenthood can be removed from federally-funded healthcare programs and other providers will just step up to pick up the slack.”

[…]

For this study, TxPEP focused on patient claims that reflect the eligibility criteria for enrollees in the TWHP: legal Texas residents between the ages of 18 and 44 and who live at or below 185 percent of the federal poverty line (an annual income of approximately $44,000 for a family of four). They also compared services in counties with and without a Planned Parenthood health center.

The study found that contraceptive claims decreased most dramatically in counties with Planned Parenthood clinics, while counties without a Planned Parenthood clinic were largely unaffected.

The percentage of women who returned for their birth control shot every three months illustrates the long-term impact of losing Planned Parenthood as a program provider. Before the exclusion, 56.9 percent of patients living in counties with a Planned Parenthood clinic received their follow-up injections. After the exclusion, just 37.7 percent of patients got their subsequent shots.

In addition to cutting family planning funding by more than $70 million, the 2011 Legislature also funneled what remained of the state’s available family planning dollars away from specialty reproductive health providers, including Planned Parenthood. That, compounded by the cuts, led to the closure of 82 family planning clinics statewide; about one third of those were Planned Parenthood health centers.

I don’t even know what else to say, so I’m just going to let this speak for itself. Just repeat after me: Nothing will change until our electoral results change.

The cost of unplanned pregnancies

From Wonkblog:

UnplannedPregnanciesMap1

Unintended pregnancies cost American taxpayers $21 billion each year, according to a new analysis released by the Guttmacher Institute. That averages out to a cost of about $366 per every woman of childbearing age in the U.S. Overall, more than half of U.S. pregnancies are unintended, and roughly 1-in-20 American women of reproductive age have an unplanned pregnancy each year.

Nationally there were 1.5 million unplanned births in 2010. Public insurance programs like Medicaid paid for 68 percent of those births. “On average, a publicly funded birth cost $12,770 in prenatal care, labor and delivery, postpartum care and the first 12 months of infant care; care for months 13–60 cost, on average, another $7,947, for a total cost per birth of $20,716,” the study found.

Both the rate and cost of unplanned birth vary considerably by state. As a percent of all births, unplanned births ranged from 31.8 percent in New Hampshire to 56.8 percent in Mississippi. Overall, states in New England and on the West coast had the lowest rates of unplanned birth, while Southern states had the highest.

In some states — Georgia, Mississippi and Oklahoma — more than 80 percent of unplanned births were paid for by public dollars. Georgia taxpayers spent nearly $1 billion on unplanned births in 2010, as did taxpayers in Chicago. California spent $1.8 billion, while unplanned births cost the state of Texas nearly $3 billion dollars in 2010.

As you will see if you read the study, those figures represent both federal and state money. The amount of its own funds spent by Texas was $620 million, which is still a lot of money that didn’t need to be spent. The study points out that were it not for state programs that fund contraception and women’s health programs, the cost incurred, nationally and by each state, would have been much higher. These figures are from 2010. What has Texas been doing since then? Yep, cutting funding for contraception and women’s health, partly for pure budgetary reasons, and partly due to an ideological war against Planned Parenthood. I’m betting that the $620 million we spent in 2010 would be at least that much, possibly quite a bit more, in the subsequent years thanks to this shortsighted and harmful policy. So the next time Texas Republicans whine about the cost of Medicaid, it would be nice if some journalist type asked them about their own role in that problem.