Dec 06 2013Remembering U.S. Women Too
A recent opinion piece in the New York Times highlights the amazing work that is underway to increase access to family planning for 120 million women around the world. Donors, researchers, governments, and others have come together to increase access to life-saving contraceptive methods and to encourage the use of real-time data to identify supply chain issues and increase the use of best practices for delivering family planning methods. Folks covering this effort note that it has a chance to save the lives of 3 million children and that the investment in family planning will result in "millions of children who are healthier, stay in school and together drive greater prosperity on a massive scale."
While the life circumstances of most women in the United States are better than those mentioned in these articles, it is worth noting that in the developing world, investing in family planning has been identified as a critical way to improve overall life outcomes for women and families. As we debate access to and coverage for contraception in our own country, let's remember that family planning has been recognized as critical and important for increasing educational attainment, improving the health of mothers and babies, reducing relationship conflict, reducing health disparities, and reducing public spending.
To clear up any misconceptions, while there are some methods of family planning that you can buy at the store around the corner, the easiest to use and most effective methods require a visit to the health clinic and quite a bit of money. Recently it seems as though people are more interested in making it harder to get family planning than it needs to be. Wouldn't it be great to follow the lead of other countries and recognize the value and importance of family planning in the United States too?
Dec 03 2013A Pause and a Party
Gentle and loyal readers of this space know the following by heart: Teen pregnancy and birth rates are at historic lows. Thanks to teens themselves, since peaking in the early 1990s, teen pregnancy is down 42% and the teen birth rate is down 52%. There has been impressive progress in all 50 states and among all racial/ethnic groups. That, my friends, deserves a pause and a party and that is exactly what we are doing today.
The National Campaign is holding an event today at the Newseum in Washington, DC, to celebrate one of the nation's great success stories of the past two decades--the truly remarkable, off-the-charts declines in teen pregnancy and childbearing. We hope that you will be there in person. If not, join us virtually following the hashtag #52percent. (See what we did there? Clever huh?)
As part of the thanks teens celebration, we are releasing some new materials including estimates on the public costs of teen childbearing, new public opinion survey data, and brand new PSAs developed in partnership with BET, the Ad Council, and Havas Worldwide.
Costs of Teen Childbearing.
Reducing teen pregnancy not only improves the well-being of children, youth, and families, it saves taxpayer dollars. Teen childbearing in the United States cost taxpayers (federal, state, and local) at least $9.4 billion in 2010, according to an updated analysis we are releasing today. These public sector costs would have been even higher had it not been for the roughly 50% decline in the U.S. teen birth rate between 1991 (the peak year for teen childbearing) and 2010. The estimated national savings to taxpayers in 2010 alone due to the substantial decline in the teen birth rate between 1991 and 2010 was $12 billion.
The overwhelming majority of teens say they don't want to get pregnant or cause a pregnancy. That is reason enough--gracious plenty enough as my grandmother used to say--to help young people navigate their teen years absent pregnancy. For those unmoved by the personal, there is the public. The steep public costs associated with teen childbearing are just one reason why policymakers and others should not let their foot off the gas when it comes to investing in preventing teen pregnancy.
Greatest Story Never Told.
You know that teen pregnancy and childbearing are at historic lows. Duh. Most adults, however, do not. It seems that when it comes to teens, sex, and pregnancy, most adults see little more than a blur of bare midriffs. In fact, fully 49% of adults inaccurately believe the nation's teen pregnancy rate has increased over the past two decades, according to new survey data also released today by The National Campaign. Just 18% of adults believe the teen pregnancy rate has declined.
The Buttered Biscuit.
It wouldn't be a party without laughter. We hope some new PSAs just might do the trick. Several new PSAs about preventing unplanned pregnancy, including the still-high rates of pregnancy and childbearing among those age 18-19, are also being released today. Featuring funny and endearing scenarios about awkward birth control conversations (trust me, they are...well... really funny and really endearing), the new spots remind teens and young adults that moments like these shouldn't stop them from getting important information about birth control.
Nov 26 2013Thanksgiving With the Fur-Babies
Thanksgiving, just two days away, is a time to sit down and reflect on what we're thankful for this year (and to gorge ourselves with pumpkin pie, of course).
#1: I'm thankful I'm not traveling home to Michigan as a winter storm is brewing this week. Airport delays, traffic back-ups, breaking your key off while trying to unlock the frozen car door (yes, this happens sometimes when you live in the tundra of Michigan)...so, no thanks. I'll be staying in DC and enjoying a quiet and relaxing long-weekend--just me, my husband, and our two dogs, Bonnie and Clyde.
This brings me to number two on the list...
#2: Ah, yes, babies. Babies are cute and I'm thankful I can look at pictures of yours on Facebook without my own waking me up early this long weekend. Bonnie and Clyde are all the babies I want this Thanksgiving. Sorry, Mom.
So instead of the mommy thank-you lists that run around the Internet this time of year, I'm writing a few of the reasons why I'm thankful I have dogs, and only dogs, and that's thanks to birth control. So, on to #3...
#3: I'm thankful my dogs will be there on Thanksgiving Day to eat all the bits of food that will be dropped. I haven't picked up pieces of food, dropped ice cubes, or had to get up and throw away an apple core in years.
#4: I'm thankful that after a long day of eating turkey, mashed potatoes, and pie...and then maybe some more mashed potatoes later on for good measure...I won't have to go through a bed-time routine. I can just pour another glass of wine and the dogs will take care of themselves.
#5: I'm thankful that the next day, after a long day of eating, my dogs will sit at the door quietly (though staring a hole through me) and will force me to get out and walk off that extra piece of pie. Without them I might get through the entire House of Cards series without moving.
The reasons why I love and am thankful for my mutts could go on and on. And I'm sure one day I'll revise this list to be why I'm thankful for children (no, it's still a not yet, Mom). But until then, I'm enjoying the fur-babies I have and am thankful for the many choices of birth control out there that allow my husband and me to plan for a family when we're ready.
Nov 21 2013Implementation Matters
So much of public policy work focuses on passing legislation and securing funding for programs. Less attention is typically paid to the less sexy but equally important task of figuring out how programs are carried out once they're passed and funded.
When it comes to preventing teen pregnancy, there have been game-changing developments on the legislative funding front. In 2010, Congress enacted two complementary federal funding streams for evidence-based teen pregnancy prevention programs. The Teen Pregnancy Prevention Program (TPPP), administered by the Office of Adolescent Health (OAH), provides $105 million annually for five-year competitive grants to a range of organizations, most of which are to replicate a variety of models already proven to change teens' behavior. The Personal Responsibility Education Program (PREP), administered by the Administration on Children and Families (ACF), provides $75 million annually for five years. Most of the PREP funds consist of formula grants to states and territories, also to replicate effective programs.
There is a growing commitment on the part of public and private sector funders to invest dollars in programs that work, and the TPPP and PREP grants are leading the way. While it is too early to have outcomes from the programs, two new reports shed important light on how these programs are being implemented and the picture so far looks rosy.
A report by the Bridgespan Group describes how OAH selected the evidence-based programs and grantees (a process they describe as being as competitive as getting into Yale or Cal Tech!), and provided high-quality program support. It gives high marks to OAH and the grantees for their efforts to ensure that effective programs are being implemented "with fidelity" to the original model. While not always easy, this increases the chance that programs will achieve similar positive outcomes to the original evaluation. The report underscores the importance of providing adequate planning time, training, and resources to "do evidence based programs right."
A second report, by Mathematica Policy Research, looks at how states have gone about implementing PREP, including 1) who to serve, 2) how to reach them, 3) where services will be provided, and 4) what evidence-based programs to use. The report contains a slew of fascinating details about the decisions states made and what these important grants look like in communities across the country. Not surprisingly, there is considerable variation among states since the program offers quite a bit of flexibility to respond to local circumstances. However, some common themes emerge: a strong commitment to using programs that work, targeting funds to high-risk youth, and making thoughtful decisions to make the most of available resources. Again, the report highlights the commitment to providing solid program support and infrastructure to ensure high-quality results.
Together, these reports confirm that TPPP and PREP are well on their way to helping more than 400,000 young people avoid teen pregnancy. They also serve as excellent models of how to implement evidence-based programs on a large scale.
Kudos to the federal agencies, grantees, and the various organizations helping grantees to implement the programs well. Now, let's make sure Congress continues funding them so these impressive efforts can continue.
Nov 12 2013Global and Local: Thank you, birth control!
Sarah Craven is a really smart friend of mine who also happens to be Chief of the Washington Office of the United Nations Population Fund, so our professional lives cross. Sort of. Sarah spends her life thinking about reproductive and maternal health issues in places like Malawi and the Congo. My central focus is collecting good data on and promoting a conversation about birth control in the United States. But we care about the same things--advocating for the rights and well-being of women and girls so that everyone gets to choose if and when to have children. Thanks Sarah for saying "Thanks, Birth Control" today and in the tireless work you do every day.
At the ripe old age of 37, I gave birth to my oldest daughter. This was deemed a "geriatric pregnancy" and later in the pregnancy I was informed I had an "incompetent cervix" all leading me to believe that some new, less demeaning maternal terminology was in order.
Thanks to birth control, however, I was able to have my first child when I was at the right stage in my life to be a parent. I had already seen the world, married my soul mate, graduated from law school, paid off my student loans and bought my first home. I was ready to be a mother, the most important, wonderful, and nerve-wracking of all of my life accomplishments to date.
My daughter is now 14, a high school freshman, with the world as her oyster. Her biggest decisions are how to fit in one more AP credit or what to wear to the homecoming dance. And when she is ready, my daughter will have the information and services she needs to avoid an unplanned pregnancy so she can have the same opportunities that I had to finish her education and tackle the world before she has to tackle changing diapers.
Unfortunately, not all 14 year old girls are so lucky. The high rate of adolescent pregnancy globally is the focus of a new United Nations Population Fund (UNFPA) State of the World Population report, Motherhood in Childhood, Facing the Challenge of Adolescent Pregnancy. Country-by-country data found in the report shows the disproportionately high pregnancy rates among young girls globally in rural and impoverished areas of developing countries, as well as in higher income countries.
In developing countries, 7.3 million girls under 18 give birth each year, with two million of these births to girls age 14 and younger. High rates of adolescent births persist among developed countries--including the United States, which has the highest rate of adolescent births among higher income countries at 31 births per 1,000 teen girls annually.
This premature entry into motherhood adversely affects opportunities for education, health, and long-term employment. For adolescent girls in the U.S. who have a baby, only half complete high school by age 22, compared to nine of 10 girls who do not have a baby. Adolescent pregnancy among girls in developing countries often results from not being able to make choices about their bodies and decisions being made about their bodies that are beyond their control, such as child marriage.
We need to change the game for adolescent girls. To reduce the global rise in adolescent pregnancy rates we need changes in attitudes and the actions of the societies in which girls live. Girls must be better educated, child marriage must be eradicated, attitudes must change about gender roles and gender equality, better support must be provided to adolescent mothers, and more access to sexual and reproductive health--including contraceptives--is desperately needed.
Access to education, family support, and yes, birth control, were all factors in my being able to be a good parent and hopefully my daughter will have access to the same rights. We must expect and demand the same opportunities for all girls around the world. Childhood should never be derailed by motherhood.
Sarah Craven is the Chief of the Washington Office of UNFPA, the United Nations Population Fund. A lawyer by training, Sarah advocates for the rights and well-being of women and girls around the world. She is the proud mother of three children.