What Pregnant Texas Women Can Do To protect Themselves

The following is part of an article in CourierTexas.com:

“It’s like a knife straight to your stomach,” Dr. Todd Ivey, a Houston-based OB-GYN at an academic hospital, told Courier Texas about a third woman dying in the state during a miscarriage.

“It’s just like, we’ve got to stop this. We’ve got to do something to stop this. Pregnancy is high-risk enough without putting all these complications on top of it.”

The “complications” that Ivey is warning Texas women about are the state’s two abortion bans, which outlaw abortions in Texas from the moment of conception.

The laws impose such harsh penalties on doctors that they are “terrified that they’re going to be criminalized,” said Dr. Austin Dennard, a Dallas-based OB-GYN.

And why wouldn’t they be terrified when they face a sentence of up to 99 years in jail if they perform an abortion that’s considered illegal? They’ll also be stripped of their medical licence, have to pay a $100,000 fine, and can also be sued civilly by anyone who wants to claim a bounty of $10,000 if they can prove a doctor provided an abortion. . . .

Young women who are having complications miscarrying can appear healthy before getting “sick very quickly,” Ivey explained.

How women can protect themselves

“If you are experiencing serious symptoms while miscarrying, you have to move very quickly to prevent (your) organs from failing,” Ivey said. 

And while only three Texas women have been documented to have died from miscarriages since the state’s abortion ban has been in place, the number of Texas women who died from pregnancy or labor complications soared 56% from 2019 to 2022, according to a study by the Gender Equity Policy Institute.

Kaplan said he advises pregnant mothers in Texas to pack a “to go bag” so that “if you need to get out of this state to get the care you need, you’ll be ready to go. Always be thinking — if something were to go wrong, where am I headed outside of Texas.”

But what can a pregnant woman who can’t quickly leave Texas do if local hospitals or urgent care centers don’t appear to be taking the risk to their lives seriously?

“Go to the biggest city near you and go to the downtown-ist hospital and don’t care what it looks like,” Binford said. ”They have the most volumes of deliveries and with volume come pregnancy complications and that means experience in handling them.”

Binford also advised that hospitals affiliated with medical schools will have established ethics committees that will include a lawyer and that committee members will be reachable quickly if a doctor is unsure about whether they can go ahead with a procedure to remove a fetus from a woman’s body.

Texas health lawyer Leah Stewart, who advises doctors and hospitals about the abortion laws, agreed that if a woman thinks she is having a severe miscarriage or another dangerous complication like an ectopic pregnancy or if her water breaks long before viability, then she should go to a large urban hospital.

They see “every single thing that goes wrong … and are better equipped to connect the right provider and give the woman standard care.”

And if you aren’t getting the attention you need quickly, she added, “You have to keep ramping up your fit throwing.”

“You don’t think it’s going to happen to you,” said Ryan Hamilton, a Dallas-area father whose wife nearly died when she miscarried with what would have been their second child at 13 weeks pregnant.

After multiple visits to medical centers over three days and three rounds of treatment with misoprostol, Hamilton’s wife passed out unconscious on the bathroom floor in a pool of blood.

She only survived because Hamilton raced her to a hospital ER for treatment.

“”Women are dying… under the circumstances we went through.. If I wouldn’t have been home to find my wife, she would have been one of those women… I could have lost her….it’s like, ‘oh my God, I really could have.’ That’s reality and that’s hard,” Hamilton added.

The Maternal Death Rate In The U.S. Is Inexcusable

 The following post is by the editorial board of The Washington Post:

Over the past two decades, most countries have made great strides in maternal health, bettering outcomes for mothers and children. The most glaring exception to this trend is, disappointingly, the United States.

In 2021, the most recent year for which data is available, the United States’ maternal mortality rate was 32.9 deaths per 100,000 live births— a stark increase from preceding years. Some of that was no doubt linked to the coronavirus, which posed particular risks for pregnancy. Yet even before the pandemic, the United States saw significantly worse outcomes relative to peer countries — and that pattern shows no signs of changing. A paper published in JAMA in July found that more than twice the number of people in the United States are dying of pregnancy-related causes than 20 years ago.

The dismal figures, coupled with the tragic death of Olympic sprinter Tori Bowie during childbirth in June, have cast a much-needed spotlight on this brewing crisis. But — because maternal health intersects with myriad other socioeconomic factors and varies dramatically by location — there is no single solution. Still, it’s time for federal, state and local institutions to start thinking creatively about how to better serve mothers.

Most interventions to improve maternal health focus on prenatal care and delivery. To be sure, these are critical periods in pregnancy. The majority of pregnancy-related deaths, however, occur postpartum.

For many American mothers, postpartum care does not functionally exist — a pattern Jessica L. Cohen, an associate professor of global health at Harvard University and an affiliated researcher with the Abdul Latif Jameel Poverty Action Lab (J-PAL), describes as a “chasm of accountability.”

This begins soon after delivery: The average hospital stay after childbirth is about two days, lower than in places such as  Japan and much of Europe. The rush to get birthing parents out of the hospital can make it harder to identify conditions such as postpartum preeclampsia, regarded as a “silent killer.”

Subsequently, an estimated 40 percent of women do not attend a postpartum visit with health-care providers, and the visits that do take place are generally brief. The American College of Obstetricians and Gynecologists recommends a more continuous model of care, with targeted, regular appointments with professionals.

Some of this is, of course, contingent on better family leave policies: Incredibly, a 2012 study found that 23 percent of new mothers in the workforce returned to work within 10 days of delivery. Pregnancy-related Medicaid and Children’s Health Insurance Program coverage can also be expanded to cover more of the postpartum period. The American Rescue Plan offered states the option of extending Medicaid from 60 days after pregnancy to 12 months; 36 states have taken up this option.

Mental health should be central to this approach. Data from the Centers for Disease Control and Prevention suggests that nearly 23 percent of pregnancy-related deaths were linked to mental health. Regular screenings can help more women receive the support they need. A new Food and Drug Administration-approved drug to treat postpartum depression could help, too.

There is another phase to pregnancy that is often overlooked: pre-pregnancy. Many risk factors — such as substance-use disorders or physical comorbidities — can be identified and addressed early. Unintended pregnancies are linked with poorer maternal and child outcomes, so family planning can be a key tool — though restricted abortion access after the Supreme Court’s Dobbs decision has made this more difficult.

According to the CDC’s 2021 data, the maternal mortality rate for Black women was 2.6 times higher than that for White women. Also, American Indian and Alaska Native women are twice as likely to die from pregnancy-related causes than White women.

Some of this discrepancy has to do with the interlocking challenges facing Black women and other women of color — a type of “chronic stress” that University of Michigan professor Arline Geronimus called “weathering.” And it’s true that differences in maternal health outcomes will persist as long as disparities in housing, income, physical safety, health and treatment do.

Yet there is more that can be done in the near term to promote better outcomes. Maternity ward closures during the pandemic were disproportionately concentrated in Black and Hispanic communities. This exacerbated preexisting trends: In the District, for instance, low-income communities in Wards 7 and 8 went without easy access to maternity care centers for years. In addition, hospitals that serve a higher proportion of minority patients tend to be understaffed and under-resourced, resulting in less comprehensive care.

Maternity wards often generate lower profits compared with other health services, and Medicaid reimbursements for births — which pay for more than 40 percent of deliveries nationally — are generally low. Governments could address this market failure by making Medicaid payment rates more competitive and providing grants or incentives to maternity centers that operate in low-income areas. Many minority and low-income women also mistrust the health system; investing in diversifying the medical profession could help build bridges with wary communities.

The United States can also learn from countries — both high- and low-income — that have vastly improved their maternal health outcomes. Most European countries, for example, fare far better on maternal health outcomes by relying more on midwives than obstetrician-gynecologists, allowing doctors to focus their care on women who need it most.

Home visits have also been key to many nations’ strategies, and a number of developing countries rely on community health workers. The United States does have home-visiting programs, most notably the Nurse-Family Partnership (NFP), which connects nurses to low-income mothers expecting their first child. While the initiative has previously been linked to positive maternal and child indicators over longer time horizons, a recent randomized evaluation in South Carolina, led by Harvard associate professor and J-PAL affiliate Margaret A. McConnell, found it did not have a significant effect on birth outcomes. Another study in South Carolina, led by University of Maryland assistant professor Rebecca A. Gourevitch, likewise found no significant effect on prenatal care.

The NFP, like most home-visit programs, is locally administrated. Its success typically rides on the resources available in the community — a concern amid nationwide shortages in maternity care, mental health services and other support systems. Moreover, initiatives staffed by nurses might struggle to reach people who are disconnected from or uncomfortable with the health-care system.

In time, technology can help address some of these gaps. Organizations are already experimenting with telehealth, apps and digital services that link expecting families with the services they need. These can be particularly useful at identifying warning signs and matching people to specialists or health-care providers with an understanding of their language and culture.

Pregnancy can be an anxious time — and a joyful one. With smart policies and investments, the United States can rebalance the scales so more families can focus on what really matters: ushering new babies into safe, healthy, welcoming homes.

It's Not Safe To Be Pregnant In A Red State

The following post is by Michelle Goldberg in The New York Times:

It’s increasingly clear that it’s not safe to be pregnant in states with total abortion bans. Since the end of Roe v. Wade, there have been a barrage of gutting stories about women in prohibition states denied care for miscarriages or forced to continue nonviable pregnancies. Though some in the anti-abortion movement publicly justify this sort of treatment, others have responded with a combination of denial, deflection and conspiracy theorizing.

Some activists have blamed the pro-choice movement for spooking doctors into not intervening when pregnancies go horribly wrong. “Abortion advocates are spreading the dangerous lie that lifesaving care is not or may not be permitted in these states, leading to provider confusion and poor outcomes for women,” said a report by the anti-abortion Charlotte Lozier Institute.

Others have suggested that doctors are deliberately refusing miscarriage treatment, apparently to make anti-abortion laws look bad. “What we’re seeing, I fear, is doctors with an agenda saying, ‘Well, I don’t know what to do’ when, in fact, they do,” the president of Ohio Right to Life said last year.

A new filing in a Texas lawsuit demolishes these arguments. In March, five women represented by the Center for Reproductive Rights sued Texas after enduring medical nightmares when they were refused abortions for pregnancies that had gone awry. Since then, the Center for Reproductive Rights says it has heard from dozens of women in Texas with similar accounts. And this week, eight more women, each with her own harrowing story, joined the suit, which asks a state district court to clarify the scope of emergency medical exceptions to Texas’ abortion ban.

There’s one woman among the new plaintiffs who recounted terrible mistreatment in a religiously affiliated hospital as she waited to either go into labor or get sick enough to merit an abortion. But in most of these cases, the women described their doctors as struggling to do the right thing. The problem was the law, not the doctors’ misunderstanding of it.

Elizabeth Weller, for example, was hospitalized after her water broke at 19 weeks. She was given antibiotics and, according to the suit, instructed to pray. Her OB/GYN concluded that, without an abortion, she risked an infection and could lose her uterus or even her life. The hospital administration, however, refused to clear the procedure because the antibiotics made such an infection less likely.

“Elizabeth was told that she could either discontinue antibiotics and stay in the hospital to wait to develop an infection and get sicker; or she could go home and look out for signs of infection,” said the filing. She went home. “With every passing day, I felt the state’s intentional cruelty,” Weller said during a news conference on Monday. “My baby would not survive and my life didn’t matter.” Her doctor, she said, called around trying to find another hospital that would treat her. “All of those hospitals told my doctor that they have patients just like me in those situations and they can’t touch them,” she said.

Two of the women in the original suit, Lauren Miller and Ashley Brandt, had been pregnant with twins. Each discovered that one of her twins had severe abnormalities and wouldn’t survive. In both cases, only by aborting the doomed twin could they protect the life of the viable one, as well as their own health.

Texas doctors can do little for women in this excruciating situation. Given a state law that lets people sue anyone who “aids or abets” an abortion, many are fearful even to counsel their patients about out-of-state options. “In every interaction with their medical team in Texas, Lauren M. and her husband felt confused and frustrated and could not get direct answers,” says the lawsuit. Both Miller and her doctors were afraid to even utter the word “abortion.”

Now Miller’s obstetrician, Austin Dennard, has joined the lawsuit, not as a doctor but as a patient. Shortly before Miller’s devastating diagnosis, Dennard had been pregnant with what she hoped would be her third child when she learned that the fetus had anencephaly, giving it no chance of survival. She left the state for an abortion, as Miller would later do. Seeing Miller endure the same ordeal that she had, and then watching her go public about it, inspired Dennard to do so as well, despite fears about what it could mean for her career.

“This is not some isolated incident of one doctor misunderstanding the law,” said Molly Duane of the Center for Reproductive Rights. “This is a widespread, pervasive fear throughout the medical community.”

If the anti-abortion movement were interested in allaying this fear, it might consider joining this suit, or filing one of its own. Perhaps needless to say, that hasn’t happened.

One of the new plaintiffs in the suit, a mother of four named Samantha Casiano, was forced to carry to term a fetus that she knew would not survive after birth, spending months fund-raising for the inevitable funeral. Reporting on Casiano’s case in April, NPR spoke to Amy O’Donnell of Texas Alliance for Life. O’Donnell was at least honest. She doesn’t believe in exemptions for cases like Casiano’s. “I do believe the Texas laws are working as designed,” she said. 

There's A Reason For Texas' High Teen Pregnancy Rate

Texas ranks third in the nation for having a high teen pregnancy rate (73 out of every 1000), behind New Mexico (80) and Mississippi (76). And it leads the nation in the rate of second teen pregnancies. Obviously, the state leaders are doing something wrong.

The charts above are from a new report from the Texas Freedom Network. They give us a good idea of why the teen pregnancy rate is so high in Texas. Texas schools are failing to teach real sex education. About 83.4% of Texas schools teach abstinence only (58.3%) or nothing at all (25.1%).

This is because the Republicans have a stranglehold on state government, and they support abstinence only (or no sex education at all) in an effort to pander to the large number of fundamentalist christians in their base. These fundamentalists have the silly notion that if sex is not mentioned, then teens will not learn of it and have premarital sex.

The truth is far different. Teens are not stupid. They know sex exists, and just telling them not to engage in it is futile. What teens need is the knowledge that comes with real sex education -- knowledge that can prevent teen pregnancies and sexually-transmitted diseases. By not providing them with that knowledge, schools (and political leaders) are failing the youth of Texas.

As the bottom chart shows, things have improved slightly from eight years ago -- with the percentage getting abstinence only or nothing falling from 96.3% in 2007-08 to the current level of 83.4%. That is primarily because the Obama administration removed abstinence only requirements mandated by the Bush administration.

But with the national government now controlled completely by right-wing Republicans, and the same being true of Texas state government, I wouldn't expect anymore improvement in the teaching of real sex education. If anything, there will probably be a return to the failed policies of the past.

Teen Pregnancy Rate Drops (But Not Due To Abstinence)

The chart above is from a report in The Journal of Adolescent Health. It shows that since 2007 the rate of both teen pregnancies and teen births have been dropping. That's a good thing, but what's is causing the drop?

Were the "abstinence only" folks right? Is their message finally starting to sink in with teens? NO. The study also found that the percentage of teens having sex has remained constant. The percentage of teens having sex is the same as it was in 2007.

Is the drop in teen births due to more use of abortion? Again NO. It seems that the abortion rate has also been falling.

So, what is causing the drop in teen pregnancies and births? It's exactly what public health officials have been saying for years. It's a wider availability of effective contraceptive methods. If you provide effective contraceptive and teach teens how to use them, the rate of teen pregnancies and teen births will go down.

We shouldn't have needed a study to show us that, since common sense will say the same thing. But for those hard-headed people among us, we now have a scientific study to prove it.

NOTE -- And in a back-handed way the study also shoots down the notion that the wider availability of contraceptive methods will cause more teens to have sex. As reported above, the percentage of teens having sex has remained constant.

FDA Makes "Plan B" Contraception Cheaper To Buy

The United States is slowly but surely beginning to adopt a more reasonable position on making contraception available to all women in this country. The Affordable Care Act mandates that all insurance policies provide contraception to women free of charge.

That was a good first step, but it did not help women without insurance, or teenagers who need some kind of contraception (but have parents who refuse to provide it). Last April, a federal judge helped to remedy this by ordering that Plan B (commonly called the "morning after" pill) contraceptives be made available over-the-counter at pharmacies -- with no prescription from a doctor needed and no age restrictions on who could buy it.

The Obama administration initially appealed the decision, wanting to restrict those who could buy the contraceptive to those at least 16 years old. But seeing this was a battle he would probably lose in court (and that the position had angered those on both sides of the contraception issue), President Obama changed his position in June of 2013 and agreed to the judge's order.

That was a big step in making contraception easy and accessible for all women. And now the FDA has taken another step -- this time making the easily accessible Plan B contraceptive less expensive to buy. They did this by approving the sale of generic alternatives to the brand name drug. While the brand name Plan B drug costs around $50, the generics will cost between $20 and $35. That may not sound like a big difference to those with plenty of money, but to a poor person or a teenager it is a significant difference.

Now the FDA needs to take the next logical step in making contraceptives easily accessible to all women. They need to make all contraceptives (even oral contraceptives) available over-the-counter (without the need for a doctor's prescription). That is the position of the American College of Obstetricians and Gynecologists, who say these drugs are very safe. There is simply no need to have to pay for an expensive doctor's visit to get contraceptives.

Most Americans, regardless of their position on a woman's right to choose what happens to her own body, would like to see the number of abortions reduced significantly in the United States. That won't be done by trying to ban abortions -- since that will just drive the procedure underground and put women's lives in danger. The only way to do it is to prevent unwanted pregnancies -- and the best way to do that is to make all contraceptives free (or very cheap) and easily & widely accessible to all women who want them. That's not only reasonable, but it's the way a free society should operate.

Medically-Accurate Sex Education Works

(This chart was made using CDC figures from their latest report on births in U.S.)

There is more evidence now that real medical-accurate sex education works to prevent teen pregnancies -- and works far better than the religiously-driven abstinence-only programs. The U.S. Center for Disease Control (CDC) has released its report of births in the United States (2011). And the information about teen pregnancies is particularly interesting.

The teen pregnancy rate for the country as a whole dropped from 34.2 in 2010 (per 1,000 girls) to a rate of 31.3 in 2011. The rate dropped in nearly every state, but it has dropped the most (and remains the lowest) in those states that provide real sex education to students.

An excellent example of this is what has been accomplished in California. That state has seen its teen pregnancy rate drop about 60% -- from a high in 1991 of 70.9, to a current rate of 28.7 (below the national average). State officials and public health officials give credit to state laws mandating comprehensive sex education with medically-accurate information on birth control, and community-based family planning programs providing resources to teens. California is definitely moving in the right direction.

That's still not as low as some other states (like New Hampshire, Massachusetts, Connecticut, and Vermont -- who have the lowest rates in the nation), but it is a remarkable accomplishment for such a large state -- and it shows what can be done with some reasonable state effort. I expect the rate will continue to drop there.

Meanwhile, the states mandating abstinence-only religious programs continue to have the highest rates of teen pregnancy in the nation -- states like Texas, Oklahoma, New Mexico, Mississippi, and Arkansas. There is no reason these states couldn't do as well (or better) than California. But they will never do it by preaching abstinence-only instead of teaching real medical-accurate sex education.

We can do even better in this country. But we'll never do much better until we stop replacing science with religion in too many of our schools. We need to trust our young people enough to teach them the truth.

Teen Pregnancy Down (In Some States)

It looks like Texas no longer leads the nation in the number of teen pregnancies (although I think it still is number one in the number of second pregnancies among teens). The state with the most teen pregnancies per capita is Texas' western neighbor, New Mexico. But New Mexico is followed closely by Mississippi, Texas, Nevada, Arkansas, and Arizona.

Teen pregnancy has actually fallen in the United States as a whole, but the states listed above have not helped the national average. Why is this? Because these states either don't mandate sex education programs at all, or they don't require those programs to be medically accurate. Too often, if programs are offered at all in those states, they either are just "abstinence only" programs or contain anti-contraceptive propaganda instead of medically accurate information.

According to the Guttmacher Institute, the drop in teen pregnancies is almost exclusively due to increased use of contraceptives by teenagers. The rate of use of contraceptives nationally is 75%. That's the highest it's ever been, but sadly, it means that 25% of teens nationwide still don't use contraceptives when having sex. And in the states with the leading pregnancy rates, the use of contraceptives is lower (only 60.5% in New Mexico).

The truth, whether right-wing fundamentalists want to admit it or not, is that good medically accurate sex education programs do work to reduce teen pregnancies. Abstinence only programs and programs that provide anti-contraceptive propaganda instead of medically accurate information just lead to higher rates of teen pregnancies. It may make fundamentalists feel good to teach religion instead of contraception, but it just puts teens in danger of unwanted pregnancies (and sexually-transmitted diseases).

Note -- The above maps are from Think Progress.

U.S. Sex Education Is A Miserable Failure

We are failing our younger generation by refusing to teach them the truth about human sexuality and contraception. It's not that we don't have the knowledge, or don't know how to teach it. It's just that far too many school systems would rather teach religion instead of scientific fact, resulting in the preaching of "abstinence only" instead of the teaching of sex education.

In many of these "abstinence only" programs there is no teaching about contraception at all, and in many others the students are taught lies about contraception -- like condoms are subject to a breakage rate of 31%, that the pill will cause women to contract cancer or to gain weight, that the pill is not as effective as advertised, and that pregnancy can result from the touching of genital areas among other lies. This is doing nothing but producing a generation of young people who are not equipped with the knowledge to prevent unnecessary pregnancies or prevent the spread of sexually-transmitted diseases.

This is verified by a new survey done by the Guttmacher Institute. They surveyed a random sample of young people between the ages of 18 and 29, and their findings were rather discouraging. More than half of all young men and more than a quarter of all young women received a "D" or an "F" on the test -- they flunked it! Even more depressing was that 60% of all the youth underestimated the effectiveness of the birth control pill (which is effective for 999 out of 1,000 women).

But worst of all, 40% of those surveyed said that birth control really doesn't matter because "when it is your time to get pregnant it will happen". With a belief like that, that 40% are very unlikely to use any kind of contraceptive when having sex -- putting themselves at risk for both unwanted pregnancies and sexually-transmitted disease.

I have no problem with any religion teaching their beliefs in their church, temple, or mosque -- but this does not remove the need for real fact-based sex education in our schools. Failing to teach fact-based sex education simply sets too many young people up for a life-altering failure. The religionists seem to think that teaching youngsters about safe sex will make them want to run out and have irresponsible sex (which is odd, since most of these same people don't believe teaching gun safety will make youngsters want to go out and misuse firearms).

We have already failed one generation. How many more will we fail before we wake up and teach the truth?

Teen Pregnancy Drops In U.S. (But Not Nearly Enough)

CNN was trumpeting recently that the teen pregnancy rate in the United States has dropped again. It now rests at about 34.3 births for every 1,000 teenage girls. That is the lowest rate for the United States since 1946 (66 years ago). Great news. Right?

Well, it's great news if your standard for great news is pretty low. That 34.3 birth rate is still among the highest for all developed nations. Our neighbor to the north, Canada, has a rate of only 14 per 1,000. Many of the European countries, like France, the Netherlands, and all of the Nordic countries have a much smaller rate than even Canada. Japan was also down into single digits.

The truth is that even though the rate has fallen in this country, it is still far too high. And one reason for it is because far too many states still refuse to teach sex education -- relying on "abstinence-only" preaching instead. And those states naturally have the highest teen pregnancy rates.

There is no reason why the United States should have a higher rate than other developed nations. The only reason it's happening is because too many Americans believe that teaching real sex education in the schools will make teenagers want to have sex (and that offends their religious beliefs). It's a ridiculous belief. Too many teens are going to have sex whether sex education is taught or not. That's just a part of what happens in the teen years. But educated teens can at least avoid getting pregnant or catching an STD. All we have to do is look at the success of the other developed nations to see that.

I'm glad the rate has fallen. But it is time we really get serious about this problem. And it's not going to be solved by preaching and burying our heads in the sand.

Half Of Pregnancies In U.S. Are "Unintended"

About a week ago, Rhode Island Rep. Edith H. Ajello and State Sen. Rhoda A. Perry wrote a commentary for the Providence Journal on preventive medicine, including reproductive healthcare. In that article they made the claim that nearly half of all pregnancies in the United States are unintended. That was a pretty shocking claim, and I think most people, including myself, would find it hard to believe. The folks over at PolitiFact also found it hard to believe, so they decided to do some checking and find out if it could possibly be true.

They found two studies on the subject done by the Guttmacher Institute. The first compared statistics from 2001 with statistics from 1994. The second was published in 2011, but was derived from 2006 statistics. Figures for all three years were taken from Center for Disease Control (CDC) studies. The studies showed a remarkable consistency. They showed that 49% of all the pregnancies in 1994, 2001, and 2006 were unintended (or unwanted).

And since this statistic was so consistent from 1994 through 2006, there is little doubt that it is probably true in 2011 also -- especially in light of the fact that right-wing fundamentalists have prohibited the teaching of anything but "abstinence only" in our schools for the last few years. They seem to think that refusing to teach young people about contraception will somehow keep them from having sex.

That, of course, is a ridiculous assumption and several studies have shown that "abstinence only" education simply does not work. Sex is a natural bodily function like eating, and asking people to not have sex, even young people, makes about as much sense as asking people not to eat. But that does not mean unintended pregnancies could not be prevented. There are numerous safe and very effective methods of contraception. And a massive public information campaign, coupled with easy (or even free) access to those methods, could significantly reduce the number of unintended pregnancies.

One would think that those who are opposed to legal abortion would be in favor of educating people about contraceptives and providing easy access to them, but that is not true. It seems that many of the same people who oppose legal abortion are also opposed to preventing unintended pregnancies. That makes no sense to me. Preventing unintended pregnancies is the best (and probably only) way to prevent abortions.

We need to make a choice in this country. Do we want to continue having a massive amount of unintended pregnancies -- about 3.2 million in 2006 out of 6.7 million total pregnancies -- or do we want to stop them. And abortion is not the only negative consequence of unintended pregnancies. These pregnancies are associated with "a number of adverse maternal behaviors and child health outcomes, including inadequate or delayed initiation of prenatal care, smoking and drinking during pregnancy, premature birth and lack of breastfeeding, as well as negative physical and mental health effects on children".

We could do a lot better in this country, and it's time we started doing it.