Fertile Ground (Part 6 of 6): The Price of Unplanned Pregnancies

The Price of Unplanned Pregnancies in Texas

The Texas Tribune wraps up its excellent video series about Texas' women's healthcare crisis with a focus on San Antonio.  Featured in this 6th and final part  of the series is teen pregnancy and its effects on San Antonio families, as well as on the fiscal costs for taxpayers. 

In the video, San Antonio Children's Shelter President and CEO Annette Rodriguez makes an eloquent case for family planning as a key part of efforts to prevent child abuse and neglect.  Healthy Futures of Texas president, Dr. Janet Realini, expresses dismay that the 2011 Texas Legislature's Family Planning funding cuts are resulting in many more unplanned pregnancies and many "ripple effects" in San Antonio -- and throughout Texas.

Theresa De La Haya of University Health System (UHS) explains that the cuts have meant that UHS is no longer able to offer preventive care and birth control to over 10,000 patients per year; but only to about 2,300.

The video highlights the epidemic of unplanned pregnancies among young adults in Texas and the costs, both in financial and in human terms.  Nearly 57% of Texas deliveries are paid for by Medcaid, and 47% of Texas births are the result of unplanned pregnancies.

You can view all 6 of these must-watch videos at the Texas Tribune website.  

Contraceptive Coverage Now Required!

As of August 1, most health insurance plans are now required to cover certain women's preventive services without co-pays or deductibles, including contraception, well-woman visits, breastfeeding counseling, and breast and cervical cancer screenings. An estimated 47 million U.S. women will now have guaranteed access to recommended preventive services with a new insurance policy, or when their policy next renews. Certain health insurance plans are exempt from this requirement, including nonprofit religious organizations and health insurance plans that have maintained "grandfathered" status.

Coverage without out-of-pocket cost for these additional women's preventive services -- including contraceptives -- is a provision of the Affordable Care Act (ACA). The required preventive services are those in the Guidelines for Women's Preventive Services, recommended on the basis of scientific evidence by the independent Institute of Medicine.

Sarah Brown, CEO of The National Campaign to Prevent Teen and Unplanned Pregnancy, applauds the new benefit requirements: "Helping women and men plan and space their pregnancies through the use of contraception reduces maternal and infant mortality, low birth weight, and prematurity. In addition access to contraception improves educational attainment and reduces poverty. It also helps to reduce abortion."

At present, half of all U.S. pregnancies are unplanned. In Bexar County, more than 6 in 10 pregnancies among young adults are unplanned. Nearly all American women who have had sex have used contraception, and for many women in Texas, cost is a barrier to access.

Controversy about the women's preventive care provision of the ACA has focused on the objections of religious organizations. The Obama Administration is revising the regulations concerning this provision so that religious organizations will not be required to cover contraception, to refer their employees for contraception, or to subsidize the cost of contraception. Instead, insurance companies will be required to offer coverage to women directly.

Teen Pregnancy and High School Dropout

Only 4 in 10 teen mothers finish high school, and nearly one-third of teen girls who have dropped out of high school say that early pregnancy was a key reason. A new report from The National Campaign to Prevent Teen and Unplanned Pregnancy and America's Promise Alliance details the close connection between teen pregnancy and high school dropout, and highlights what communities and schools can do to both prevent teen pregnancy and keep students in school.

The report looks at several examples of communities using innovative and evidence-based strategies to reduce risky sexual behavior, teen pregnancy, and school dropout.  Examples include the University of Texas Prevention Research Center in Houston, working with Harris County school districts to implement It's Your Game: Keep it Real!, an evidence-based sexual health education curriculum shown to help middle school youth delay the onset of sexual activity.

The report highlights things that schools and communities can do to reduce both teen pregnancy and school dropout. The first suggestion is to ask parents.  It is often reassuring to school leaders to understand what parents in their district want schools to do about teen pregnancy prevention. Surveys show that most (73%) adults wish young people were getting more information about both abstinence and contraception, and most parents support school based sex education, including education about condoms and contraceptives.

Other helpful measures include: educating community leaders and parents about the link between teen pregnancy and school dropout; providing professional development for district staff and teachers; outreach to administrators; enlisting new "champions"; and sharing best practices with other communities.