In a bracing piece in The Nation, Sharon Lerner explores, with her usual clarity, why it is that primary prevention--simple birth control--now seems so devalued. Read, scratch your head, and be concerned. Sigh.

It's not every day that you come across something online that you think is truly different, useful and, even fun. The other day I came across a website, "Maria Talks," that I think meets this criteria. The site was created through funding from the Massachusetts government, and it operates in conjunction with the Massachusetts Sexual Health Hotline. As someone who has spent plenty of time searching the web for resources on sexual health and birth control, I think that this site stands out.

At The National Campaign, we often send the message that safe sexual practices among teens are best achieved through ongoing conversation and communication. First and foremost, teens themselves have told us their parents most influence their decisions about sex, and we have long asked parents to take the lead and start that open and ongoing conversation with their children.

I forgot to take my pill...

How many times has this thought crossed your mind?

Kourtney Kardashian recently announced that she is unexpectedly pregnant. While semi-celebrity baby bumps might not be that interesting to most, what's unusual is that she has admitted that the reason she got pregnant is because she used the pill inconsistently. In her own words Kourtney admits, "This probably sounds so dumb, but there's so many times I'll forget to take my pill and I don't think it's that big of a deal, it's just so stupid." While the birth control pill-- the most popular form of birth control in the U.S.--is very effective (you have a 99% chance of avoiding pregnancy if you take the pill), it is only as effective as the user. Nationally, nearly half of all women who have an unplanned pregnancy were using a method of contraception when they got pregnant. Digging a little deeper, half of women who have an unplanned pregnancy and birth admit that although they were using a method, they weren't using it correctly when they got pregnant.

For some of us, remembering to take the pill is easy and has become routine, but for others who are often forgetting to take their pill there might be another way. Consider other birth control options that experts often label as "forgettable". These include methods such as the vaginal ring, which is monthly, the IUD , which lasts 5-10 years, or the implant, which lasts up to 3 years. A method that I don't have to remember sounds great to me, what do you think?

We wanted to fill you in on some exciting news about emergency contraception.

Last week the FDA approved a generic version of Plan B.

This whole thing gets a little tricky since Plan B is available with and without a prescription depending on your age, but we'll try to clarify what exactly was approved. Duramed still has market exclusivity on over-the-counter Plan B which can be purchased by women age 17 and older without a prescription until August 24, 2009. However, the recently approved generic version (which will be marketed as Next Choice™) will be available to women age 17 and younger with a prescription in the near future (hopefully in August, Next Choice will be available over-the-counter as well).

The price of Next Choice™ will likely vary by pharmacy, but will most likely be 20-70 percent cheaper than the name brand version which ranges from $35-70 depending on the pharmacy. Clear as mud? Check out these FAQs for more info.

I don't know about you, but a lower cost version of emergency contraception might be just what I need to stock up on for a rainy day...Not that it's a substitute for birth control, mind you. But you can never be too careful...

Self Magazine's article "Single, Pregnant and Panicked" is still getting some much deserved attention in the blogosphere. Check out Storked! and read Christine Coppa's take on birth control, or lack thereof.

Why are so many young women still getting pregnant when they didn't intend to? Is it that they don't know enough about how pregnancy happens? Or how to use birth control? Or, are they using birth control sometimes, and thinking that's as good as using it every time? Or that they want to know more but are too embarassed to ask? Or that it just won't happen to them? Turns out, the answer is all of the above, and more.

Check out this great article in the current issue of Self Magazine: "Single, Pregnant and Panicked."

It includes findings from some Campaign polling and focus groups that shed light on what single 20-somethings really think—and what they still don't know—about pregnancy and birth control. The findings are pretty shocking.

Check out the full survey.

Here's some of what we learned:

• 54% of sexually active (but not monogamous) single 20-somethings don't use birth control every time.


• While nearly half of our survey respondents said they don't look for information about preventing pregnancy because they already know enough about it, we found that 50% of those women surveyed don't know at what point in their cycle they are most likely to get pregnant, and 23% of women we surveyed think that taking birth control pills increases the risk of getting all types of cancers (NOT true!).


• 21% said finding the right source of information on pregnancy prevention is too hard.


• 21% of young adult women said they don't seek out information about birth control and pregnancy prevention because it's too embarrassing to talk about.


• 67% of our respondents (male and female) say they know nothing about IUDs, which the medical community considers the most effective form of long-acting contraception.


• 16% of young adult men say they only use contraception if their partners insist on it.

Many who are taking chances with their birth control say that if pregnancy hasn't happened yet, it probably won't...that's the most magical thinking of all.

Go to self.com to read the article and take the pregnancy quiz that nearly 1,000 women have already failed.  And don't forget to tell us what you think.

Newly sworn in President Obama spoke yesterday of personal responsibility and I hoped he might offer some examples as he had done when campaigning. A few were mentioned, but they tended towards the macro and institutional—understandable given the momentous occasion and the certain knowledge that there were millions of good souls in front of him who were, literally, freezing and had been standing in a huge sardine can for 6 hours or more (not that I am complaining). No time for long lists or numerous examples, eh?

So, to fill the gap: for those of us who worry about family structure and pregnancy planning and best beginnings, what might we say personal responsibility means? Here are four bits and pieces that I have been mulling over:

1. Unless both partners are in a committed relationship, are seeking pregnancy, and are willing to devote two decades and more to child-rearing, having sex without contraception or some attention to family planning is irresponsible.
   


2. It's irresponsible for doctors/nurses/clinics to fail to talk with women about all the effective contraceptive options available to them (and there are lots now).
   


3. When insurance/pharma prescription companies finance Viagra with minimal cost-sharing but get all weird and expensive when it comes to birth control, that's irresponsible.
   


4. Offering a sex education curriculum that does not include generous amounts of attention to respectful relationships and what types of family structures seem to benefit children the most is irresponsible.

I welcome additions....

People all over the country are getting together to discuss ways to improve our health care system, and we want to make sure that the issues we care about most are a part of this dialogue.

This is a priority for us. And not just because it's our job. It's because deciding whether and  when to become pregnant and have children is one of the most important decisions many of us will make in our lives. We think women, men, and families will do better if they have the opportunity to prevent pregnancy and plan families affordably, in consultation with the best medical professionals, and without barriers.

We've asked some of our friends to share some of the challenges they've faced seeking care, and we hope you'll share your stories by leaving comments on this blog post.

"I switched jobs and therefore my insurance plan changed. I went from paying $7 for a month's supply of birth control to more than 4 times as much for the exact same prescription."

"I was having trouble getting pregnant, and did some research on what might be causing my particular issues. I read about a hormone that might help, but my doctor at the time wasn't very familiar with it. He agreed to administer it, but wanted to test for it in my blood after a few weeks. This was impossible, because that particular hormone doesn't show up in your blood. I switched to an OBGYN who knew about the hormone and understood my issues, and shortly after receiving the treatment I was pregnant with my first daughter."

"I decided I wanted an IUD. I had been seeing an OBGYN at a hospital that doesn't do IUD's. I called four different doctors in the area, and no doctors do them. Finally I found a doctor a long way from my house who said she did them, so I made an appointment. I finally saw the woman and she gave me an exam then told me that she would not recommend an IUD --  because I hadn't had a baby, and because she had so little faith in her own ability to insert one properly. I was super excited that I'd taken off an afternoon to drive out to the middle of nowhere for that." 

"When I changed pills based on advice from my doctor to try anther type, the new ones ended up costing me over $50/month (with insurance paying about $5). On other pills, I'd paid $10 -- $15 month, with insurance paying the balance."

"I had been having reproductive health issues for years, and when doctors ruled out endometriosis, fibroids, and cancer, we decided that a hysterectomy would be the best course of action. Since I am done having children, I agreed. After a few more weeks of tests, exams, and follow-up visits, I received a bill from my insurance company for almost $1,000 -- all this on top of my $20 co-pay I was dishing out for every office visit. When I called my doctor to straighten this out, it was explained to me that on top of a $750 deductible for my plan, I have to pay 20% of all the costs beyond that. The good news is that I had met my high deductible for the year. The bad news: my surgery is scheduled for next year."

Further to Laura Sessions Stepp's point that Americans generally have different attitudes towards sex and contraception than Europeans comes this blog post from John C. Dvorak's Dvorak Uncensored blog: Condom Ad you won't see on U.S. TV.  It was posted awhile ago so  think of it as an "oldie."

It shows a Mom entering her son's room to give him some timely advice!  How's that for an effective method of birth control?  But, as you'll see, her advice extends beyond the condom.  The fact the we would be unlikely to see such an ad in the U.S. suggests that parents are not as involved as they should be.

What do you think?

Although the National Campaign is not focused intensely on sex education, I am often asked what I think should be taught and when and by whom and under what circumstances, and usually I find ways to refer people to our website, where our "Ten Tips for Parents" appear, along with much else about effective curricula and more. But I am beginning to think that we need a new list—or perhaps an additional list—of topics to discuss with young people as well as among ourselves.

Here is the way I think about it. This nation has been engulfed for years in a series of arguments that touch on sex, love, and relationships—a partial list includes abortion, abstinence-only curricula versus comprehensive sex education, parental consent, and birth control clinics in schools. There are more, too, but those are the biggies.

But I think that while we have all been arguing about such matters, a number of simple, basic ideas has fallen by the wayside. When I speak about them—see list below—people often write them down or ask me to "go slower" so that they don't miss any. Sometimes they are treated like news, even though I would imagine my grandmother might have laid them out quite easily. So, here is my list of topics we need to discuss with teens, in particular, although many apply to young adults as well.

Aunt Sarah's List

1. Sex has risks, meaning and consequences.  Take it seriously....
2. A couple shouldn't have sex if they can't talk about birth control and what they will do if pregnancy occurs. 
3. Girls: Sex won't make him yours and a baby won't make him stay.
4. Boys: Making babies doesn't make you a man.  Being a devoted partner and father can....
5. Babies need adult parents.
6. Babies don't cement relationships; they stress them.
7. Babies don't give unconditional love; they seek and demand it from the adults around them.
8. Children do best when they are raised by parents who are committed to each other and to years of devoted parenting.
9. Getting pregnant, having babies, and raising children is perhaps the most important thing we do (and it also costs a lot).  Therefore, it needs to be thought about carefully, not stumbled into.  We plan many relatively unimportant things all the time: vacations, outfits, dinner, presents, what movie to see....  Doesn't pregnancy deserve at least the same amount of planning?

So, let's see if I have this right: teen pregnancy is okay—"beautiful," in fact—as long as no abortion occurs and as long as there is a shotgun marriage. In addition, becoming a parent at 17 or 18 is preferable to a bit of accurate sex education and preferable to using birth control.

A full seven years ago, E.J. Dionne wrote, "It's better for unmarried teens to avoid premature sex than to use contraception, but it's better to use contraception than to get pregnant." I guess the revision we are asked to swallow is, "It's better to get married as a teen than to use contraception," even though 60% of teen marriages fail, and 80% do when the bride is pregnant.

For sports fans around the world, there are just a couple days left to catch the 2008 Summer Olympics on TV. But for the competitors who made the trek to Beijing, that means just a few more days to score—and I don't just mean on the field (or in the pool or on the court).

Acknowledging that sexual activity is a likely byproduct of housing over 10,000 world class athletes in the same village, Olympic officials started distributing condoms in 1992. While the condoms are generally supplied in the name of HIV/AIDS awareness and prevention, I'm guessing a few unplanned pregnancies have also been avoided thanks to their availability.

In addition to the 100,000 condoms made available to athletes during the current games, Beijing health authorities have also provided local hotels with 400,000 free condoms. Of course, for those not receiving gratis prophylactics, they are always available for purchase and a Chinese condom company, Elasun, launched an Olympic-themed marketing campaign this summer to keep condoms in everyone's consciousness.

infoMania, a Current TV show that recaps each week's glut of online, print, and televised media, features a recurring segment written by and starring the brilliant Sarah Haskins. The Target Women series lampoons how media and marketing attempt to reach women. Having already taken on suffrage, yogurt, and botox, Haskins's most recent episode, Target Women: Birth Control, calls into question why ads for hormonal BC are all about period control and managing PMS symptoms and never about sex or preventing pregnancy.

Enjoy the video (and all of the other Target Women clips) and let us know what you think commercials about contraception should be saying.