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About one-third of teen girls become pregnant at least once by age 20 and fully half of all pregnancies in the United States are unplanned.  Not too good

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Recently in Public policy Category

Apr 24 2012

starsThe Best Lobbyists

California_YLT_members_at_Capitol_2012.jpg

I think there are many misconceptions out there about lobbyists. We're all having steak at The Palm, right? We push and cajole and buy our way to a vote we want. We're straight out of casting for the movie Thank You For Smoking, a comedy I highly recommend by the way, despite not being anything like the so-called M. O.D. (Merchants of Death) lobbyists portrayed in the film.

Last week, with the help of many colleagues, I trained 15 teenagers from all across the country on how to be lobbyists--specifically how to advocate for evidence-based teen pregnancy prevention programs--then sent them off to Capitol Hill to meet with members of Congress and their staff and, well, lobby. As members of The National Campaign's Youth Leadership Team (YLT), I expected this group of youth leaders to be impressive, but I was blown away. These are some of the most thoughtful, smart, eloquent, and--yes--fun, kids I've ever met. So what could I possibly teach them? Well, I told them what to expect, such as hallway meetings and remembering to turn off your cell phone ringer, and to remember to make "the ask" (in this case, to protect funding for evidence-based teen pregnancy prevention programs). I reminded them that every lobbyist has tough meetings and not to be discouraged. But most importantly I told them to share their stories. Why does this issue matter to them? Why is this so important for all American teenagers?

And now I get to the "wow" factor. These teens blew me away with how they told some of the most heart-wrenching stories and deftly wove those into a narrative about the need to prevent teen pregnancy--and to do so using programs that are proven to work. Here were a group of young adults who spoke of being the child, sibling, or friend of a teen parent. Here were teens who had seen up close what happens when one of their peers gets pregnant. This is what we call grassroots lobbying at its best. Members of Congress need to hear these stories, happening in their own states and districts, and they need to hear it from those impacted right now.

As one Hill staffer wrote to me immediately after a meeting with a YLT member, "impressive constituent." All I would add is to make that plural. Impressive indeed.

Apr 18 2012

starsChicken or Egg...Prevention or Intervention...Right or Left...Wrong or Right

No one can say that the beginning of 2012 hasn't been exciting, and sometimes disturbing, when it comes to the issues related to teen and unplanned pregnancy. Every day we find ourselves reading, interpreting, responding, reacting, supporting, and sometimes denouncing the multiple opinions that appear in the media about these issues.

I, like many others, had hoped that by 2012, we as a country would have reached a consensus that the best way to ensure a healthy beginning for a child--physically, mentally, and emotionally--is to have the child born into a two-parent loving family who is ready and prepared to welcome a new life. And that the well-being of those children in the long term would be among the highest of national priorities.

Instead, it seems that policies are being promoted by people who will never diaper, clothe, feed, or house the very child whose life may be created as an effect of those policies. Many would argue that intercourse outside of marriage has become accepted, but some people of faith--policymakers included--still see sex within marriage as the only acceptable option. As a Christian, I agree with the latter perspective in principle, but I also realize that throughout history, from before Christ to over 2,000 years after Christ, the human body is weak when it comes to sex and boys and girls and men and women too often ignore the advice of parents, teachers, pastors, doctors, and friends who suggest that waiting to engage in sex until after one says "I do" is the preferred way of beginning a family.

My dilemma with this tug-of-war between aspiration and reality is complete confusion as to how our political and religious leaders can stubbornly ignore the fact that, regardless of religious doctrine, women and men continue to engage in sex--much of it premarital, much of it unprotected. As a result, many children are born to parents who aren't prepared for them. The young child is then handicapped with the shackles of poverty before he or she is even given a chance to pursue a different path of life.

Whatever our view of the rightness or wrongness of sex outside of marriage, we as a society cannot continue to ignore preventive methods that save children from a life of hunger, scarcity, and poverty. Is it right to knowingly deny women the opportunity to prevent a pregnancy? Is it right to dictate to women how they should live their lives? Is it right to support pharmaceutical companies as they manufacture, advertise, and sell products to correct erectile dysfunction, while denying women the ability to protect themselves from the very men who are chemically prepared to penetrate their bodies?

Who determines what is right and what is wrong? Why do women have to continue to be the victims of outdated, ill-purposed, and shortsighted policies in the name of an individual's idea of what's right? I know that the debate will continue because too many of us are silent and depending upon someone else to pick up the fight for us. But, if we don't speak up then the next issue forced upon us will be even more restrictive and destructive. For me, the time is up to be quiet...what about you???

"Chick" photo by Bahman Farzad.

Mar 23 2012

starsLanguage Matters, Values Matter More

I've been fortunate enough to spend some time recently with federal grantees and other leaders working to address teen pregnancy all over the country. Even though my colleagues and I are often invited to national meetings and gatherings to provide information and advice to these state and local experts, I always walk away feeling like I have gained more wisdom from them than I could possibly teach in our short time together.

Last week's workshops focused on communication--specifically, how we can talk about what we do in a way that resonates with the communities we're trying to reach and, well...doesn't tick anybody off. After hours of training and exercises and simulating interviews and chart paper, a really smart colleague raised this point:

The language we have at our disposal stinks.

It's true. We work in a field where we say stuff like:

  • Evidence-based teenage pregnancy prevention programs (I fell asleep typing that)
  • Adolescent sexual and reproductive health services (umm...what?) sometimes shortened to the hip and cool 'ASRH'
  • Opportunity costs/deficits/insert noun that implies a connection to financial ledgers here

And the list goes on.

Nothing is wrong with using these phrases. In fact, if you work in this field, using this jargon is second nature. Not to mention, really smart people researched for years to develop the important concepts behind these terms. The problem is that they don't do a good enough job of capturing our values--put another way, you can't tell why we do what we do if you listen to the way we speak.

Let's pick on the Campaign for a moment and our decision to frame much of what we advocate for as "pregnancy prevention." Sounds kind of medical, kind of blah. Some would even argue that it implies an inappropriate singular focus on a particular reproductive health outcome (add the phrase "reproductive health outcome" to the list above) rather than giving weight to the full range of issues and circumstances that youth are facing when they make decisions about sex, relationships, and contraception.

But here's what we believe:

  • Addressing high rates of teen pregnancy is an important issue to work on, including in communities where stark disparities exist for racial/ethnic groups, and even considering that in some situations the issue is complicated by poverty, a lack opportunity and resources for young people, and spotty access to information and services.
  • We approach our work in communities with great consideration of these circumstances (also known as social determinants of health...LIST ALERT), and do our best to address all barriers that inhibit progress on this health issue and others.
  • Our messages and actions about prevention should never, EVER alienate or stigmatize teen parents. They also must acknowledge that every single teen who becomes pregnant ALWAYS has a right to choose to parent, and that in a small number of cases, teens become pregnant intentionally.

We act on these values by supporting community-based organizations that provide services and programs to youth while addressing barriers to access within those communities, constantly asking teens what they want for themselves and how we can best support them, and by exploring data and important research questions about the circumstances in which teen and unplanned pregnancy occur, which provides important context about young people's lives for the work we do. But saying all of that takes too long. The language we have is imperfect, but it's what we have.

Here is what I propose. If we can acknowledge that our terminology leaves something to be desired, then you can assume when we say we work on "teen pregnancy prevention" that it entails much more than just going into communities and blindly telling teens not to get pregnant.

Language matters, but not as much as our values do.

Mar 19 2012

starsLooks Like Men Care About Birth Control Access Too

I wrote a column for CNN recently asking why, as conservative GOP men attack insurance coverage of contraception, we don't hear more from men who support such coverage. I expected only a few men would respond saying something like, "Hey, lady, we're out there!"

The response both surprised and sobered me. I was surprised by the number of men who wrote to the CNN website and my email address, showing a keen understanding of how important accessible, affordable birth control is for women and society. I was sobered by how many felt powerless to do any more than support contraception in their private lives.

"I'm writing because I want you to know that there are older men who are quite vociferous on this and other women's issues," said Ray, 61. "I've been able to convince my 59-year-old girlfriend, her 36-year-old daughter and her 19- and 20-year-old granddaughters to vote for Barack Obama over issues just like this. I am quite out of place in a very conservative part of North Carolina, and this was no small feat. My point is I believe there are many more like me, and I want you to know we are out here!"

A writer named Robert said he talks to his children about condoms and diaphragms and defends his girlfriend's right to make her own choices. He wants to offer better advice to his children, he said, than did his father, whose guidance amounted to "Don't do anything stupid."

Jeremy, a 36-year-old single father of a nine-year-old daughter, said that he had had a vasectomy in order to "take charge of my own reproductive situation." Other men revealed that they had had the same procedure, and wished there were birth control options for men in addition to surgery, condoms, and abstinence.

For years, those of us in the baby boom generation, women as well as men, have considered birth control primarily a women's issue. Jeremy was one of several male correspondents who bemoaned this, saying it prevents men from sharing the obligation.

"Men have been kicked out of the sexual reproduction manager's office!" he wrote. "They know it's politically incorrect, at worst a rocky coast that will smash their hopes if they dare to interject themselves. Women have developed a hair trigger to the topic when it comes out of man's mouth, and no male with any self respect, or hope of bedding said woman, will risk such hari kari."

Mike, "a sterilized father of two college students," wrote, "even having an opinion about a woman's body produces the ire of someone on either side. It's safer to keep our mouths shut lest we be interpreted as having a say in a woman's choice."

Neoconservative lawmakers, of course, have no such qualms. As R.A. Heinz observed, their attitude "plays out like a woman does not own her own reproductive system. It is on loan and needs to be administered by the state, the church, her parents and her husband....They have no concept of reason and no talent for tolerance. "

For years, I've thought of contraception and abortion as primarily the concern of women. But recently I've come to believe that strategically at least, as the number of anti-contraception, anti-abortion bills increases, women can no longer afford to think of those issues as only ours.

We need men to join us in large numbers to support the concept that children deserve to be born into a family that has the means to provide for them. As many have already noted, making birth control less affordable and less accessible will result in some women having babies they say they are not ready for and can't afford to support. This was noted by several men, including a CNN writer who huffed:

The economy is in the gutter and the Republicans' main concern is banning abortion (and) contraception....? Seriously? Yeah, because nothing will boost the economy like having more kids so they can live with their jobless, homeless parents in their cars!"

Bruce, who emailed me, took this thought one step further, suggesting a kind of conspiracy on the part of political conservatives. Make contraception expensive and less accessible, and outlaw abortion, and it's not only poor women who will be having babies, he wrote. So will young women and middle- and upper-income women whose professional ambitions will be thwarted or at least slowed down. Who might benefit from that? Men seeking those same jobs.

Perhaps he's right, although I suspect a majority of men know that for most families these days, both partners' incomes are essential.

In her column, "Women Will Remember in November," the Baltimore Sun's Susan Reimer suggests that this fall, the female electorate will throw out of office or hold back support for GOP candidates who have withheld support for contraception and abortion.

She could be right, especially if women recognize and enlist the support of their men.

Mar 09 2012

starsThe Transformative Role of Contraception

Sarah Brown is my boss. She's been working in the area of birth control and pregnancy planning for nearly 45 years. She's also really smart. Not surprisingly, she has some really smart stuff to say about contraception in a new video.

I don't want to spoil the ending, but Sarah has a simple thought for us all. It goes like this: Whatever the proposition of the day regarding contraception, ask yourself a simple question: Does it improve women's access to good contraceptive care? If the answer is no, oppose it.

Simple.

Watch for yourself and please share with others if you are so moved.

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