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The Truth About Abortion, and Why It Matters

Ash Griffith | January 28, 2020

Topics: abortion, Aidy Bryant, contraception, General Assembly 2020, Hulu, Jennifer McClellan, NARAL Virginia, reproductive rights, Shrill

Protecting reproductive rights requires accurate knowledge, and shows like Shrill help shed light on facts about abortion and contraception that are largely absent from political debates around the issue.

In the first episode of the Hulu comedy series Shrill, writer Annie Easton learns that the morning after contraceptive she took didn’t work, and now she has to decide whether to have an abortion. Ultimately she does, and is seen walking into the clinic freely, with her best friend and roommate by her side as her emotional support.

Shrill, which stars Saturday Night Live’s Aidy Bryant, has been applauded not only for its accurate depiction of abortion but for bringing to light little-known facts about contraceptives and the abortion procedure itself. As it seems like every morning these days starts with news about more restrictive laws being placed on the bodies of women, these little beacons of light in media are like a warm blanket in the cold.

However, with so much inaccurate information about abortion spread around our society, I was curious about how accurate Shrill’s depiction of abortion access really was. Who better to call than the experts themselves?

“I think in the media … we are getting to a place where more shows are wanting to destigmatize abortion and lift it up as it is, which is a normal procedure. One in four women within their lifetimes will have [this procedure],” said Michelle Woods, Communications Director for NARAL Virginia. “We hope that people in the media will portray it as a normal healthcare procedure, that it’s a necessity, and how common it is… I think it’s a slow process in terms of lifting up something we don’t talk about, but it’s a conversation that we need to have.”

The biggest battle that those fighting in the healthcare arena are going to face is at its core the simplest — not just for abortion to be legal, but for it to be seen as a normal, routine procedure. However, if abortion and other forms of contraception are to be seen as normal in our society, we’re going to need to have a more accurate understanding of how they actually work.

Photo by Allyson Riggs/Hulu

An alarming moment in that first episode of Shrill is when Annie’s pharmacist points out to her that one of the reasons why the morning after pill did not work is because she exceeds the recommended weight limit for the medication. Apparently this limitation is very real, despite the fact that it is not taught in sexual education courses. Who knew.

“In Annie’s case, despite her readily accessible access to emergency contraception — in this case the brand Plan B — it was ineffective due to a lack of critically necessary medical information,” said Galina Varchena, Policy and Communications Director of NARAL Virginia. “[It was] not presented to her. Annie purchases emergency contraception multiple times, and at no point does the pharmacist mention that emergency contraception is only effective for women of a certain weight, under 175 pounds. Plan B and its generic counterparts are the most readily available form of emergency contraception in the country, but they are also the least effective for women with a high body mass index.”

Varchena notes that there should be an increased responsibility amongst pharmacists and drug companies to clearly explain the product’s effectiveness for different users. At this time, there are effective contraceptives available for women with high BMI; however, they are only available with a prescription.

“A common one is called Ella,” said Woods. “It works up to five days after unprotected sex. It works for women with high BMIs, so women who would not necessarily be protected in that event, but it requires a prescription. At Planned Parenthood, if you get a prescription you can go back at any point in the next calendar year and get it from Planned Parenthood, but you cannot get it over the counter at a pharmacy.”

Media absolutely affects the way we not only view the world but how we interpret and think about laws in our area and across the country. Portrayals through film and television create conversations and in some cases offer the only education many people have about certain issues. Conservative media certainly understands this, and has often pushed anti-abortion talking points regardless of whether or not the information presented is entirely accurate.

“Media coverage helps how people think about certain issues so if media coverage is inaccurate you’re going to have a medically inaccurate understanding of an abortion procedure,” said Katie Buie of NARAL Virginia. “I think we’re seeing that far and wide — people covering and speaking about realities of abortion, and spreading misinformation. It’s definitely an intentional campaign to mislead people on abortion, and I think that’s where we see representation of abortion in less than accurate ways [having] a negative effect on policy.”

In 2019, a variety of legislation was proposed with the intent of heavily restricting abortion rights, and some of it passed, including several “heartbeat” bills, which prohibit abortion once a fetal heartbeat can be detected — generally about six weeks after conception.

“I think the louder we are as a movement, and the louder we are speaking out while amplifying the voices of education and doctors to break ground on culture changing projects the better off we are,” said Buie. “We all need to do a much better job in expressing how severely detrimental these bills are, especially the six-week bans in different states. We need to make sure we are listing off the realities of how these bills are harming women.”

Sen. Jennifer McClellan (Photo via jennifermcclellan.com)

In 2019, Virginia voted a record number of women into the General Assembly, and this is already having positive results for abortion rights in the Commonwealth. Bills currently working their way through the state legislature are intended to roll back a variety of restrictions on abortion in Virginia.

“These laws have been about shaming women, stigmatizing abortion, shutting off access, discouraging doctors from providing this care. And we say, we’ve had enough, the voters in Virginia have had enough, and now we’re going to act on it,” NARAL Virginia Executive Director Tarina Keene said at a press conference last week. For Keene, the current moment offers Virginia a chance to become a “safe haven” for women in surrounding states who face more restrictive laws around abortion.

Reacting to the fact that in March, the US Supreme Court will hear its first major abortion case since President Donald Trump appointed two conservative justices to the court, Sen. Jennifer McClellan said, “If ever there is a time to protect a woman’s bodily autonomy, that time is now.” McClellan is the sponsor of the state Senate bill that would roll back several of Virginia’s restrictions on abortion, including a 24-hour waiting period and an ultrasound requirement.

Earlier this month, Virginia also became the 38th state to pass the Equal Rights Amendment, which puts that amendment over the number of individual states that need to ratify it for it to become part of the Constitution. Since there was a deadline placed on its ratification originally, one that has long passed, the fight to add the ERA to the Constitution will continue. Still, it’s an important step, for Virginia and the United States as a whole.

Meanwhile, coincidentally enough, the second season of Shrill was released Friday, January 24 on Hulu. It’s a reminder that we must continue to tell our stories, because despite positive progress, the battle for women’s rights is far from over.

Top Image via Broadway Video/Hulu

Sex Ed Is Key to Reducing Teen Pregnancy, Advocates Say

VCU CNS | January 16, 2020

Topics: abstinence education, Centers for Disease Control and Prevention, contraception, Healthy Teen Network, Martinsville High School Teen Health Clinic, sex education in Virginia, teen pregnancy, teen pregnancy rates in Virginia, Title IX, Virginia Department of Education, Virginia Department of Health, Virginia Physicians For Women, Virginia Standards Of Learning

States requiring schools to teach sex education have lower teen pregnancy rates; some say high teen pregnancy rates in some Virginia localities are a direct result of the lack of a sex ed requirement in the Commonwealth’s schools.

In the early 2000s, Martinsville, a city of about 13,000 near the North Carolina line, had one of the highest teen pregnancy rates in Virginia. In a typical year, nearly 75 of every 1,000 teenage girls got pregnant.

More than a decade ago, the school opened a teen health clinic, which provides birth control and treats sexually transmitted infections. Since then, the city’s teen pregnancy rate has plummeted.

“It’s just been amazing because I’ve seen success,” said Beth Holyfield, the clinic’s health coordinator. “I think everybody was a little nervous about it because it was Bible Belt area, you know, offering birth control for children.”

Under the federal Title IX program, the Martinsville High School Teen Health Clinic can treat STIs and provide birth control without notifying the student’s parents. Holyfield and two nurse practitioners don’t discuss abortion, but they do routine checks on student weight and blood pressure and administer prescriptions.

According to new data from the Virginia Department of Health, among the state’s 133 localities, Martinsville ranked 16th in teen pregnancy rates in 2018. For every 1,000 teen girls, there were about 21 pregnancies.

Martinsville’s increased access to sex education and contraception coincided with the drop in the city’s teen pregnancy rate. Experts say preaching abstinence over other methods — Virginia’s official policy — has been ineffective. States with more schools teaching contraceptive methods tend to have lower teen pregnancy rates.

Localities vary widely in teen pregnancy rates

Virginia’s teen pregnancy rate in 2017 was 15 pregnancies for every 1,000 teenage girls, according to the U.S. Centers for Disease Control and Prevention. Thirteen states had a lower teen pregnancy rate than Virginia’s. Massachusetts, New Hampshire, and Connecticut all had fewer than nine pregnancies per 1,000 teenage girls.

Within Virginia, the rates vary widely, according to data obtained by Capital News Service from the Virginia Department of Health through a Freedom of Information Act request.

The data showed the number of pregnancies for every 1,000 adolescent girls in each city and county of Virginia. That way, it’s possible to compare localities regardless of population.

Petersburg, 30 miles south of Richmond, had the highest teen pregnancy rate in the state in 2018: about 44 pregnancies for every 1,000 teenage girls.

Norton, a city at the southwest tip of Virginia, was second with 35 pregnancies per 1,000 teenage girls. Lancaster County, along the Chesapeake Bay, followed at about 30 pregnancies per 1,000 adolescent girls.

The cities of Roanoke, Richmond, and Hopewell all had rates around 25 pregnancies for every 1,000 teen girls.

Sex education is optional in Virginia

Under the Virginia Standards of Learning, the state’s public school curriculum, schools in the commonwealth may teach sex education but are not required to do so. State law requires an emphasis on abstinence, but the SOL curriculum also includes recommendations for teaching about contraception and condom usage.

More than 90 percent of Virginia schools teach abstinence. Fewer than 40 percent of the state’s high schools teach contraceptive methods recommended by the CDC, according to the Sexuality Information and Education Council of the United States, or SIECUS.

Virginia Department of Education spokesperson Charles Pyle says the curriculum is designed to promote parental involvement and help students cope with peer pressure during developing stages.

Pyle said classes “include age-appropriate instruction in family living and community relationships, abstinence education, the value of postponing sexual activity, the benefits of adoption as a positive choice in the event of an unwanted pregnancy, human sexuality, and human reproduction.”

Dr. Samuel Campbell, an obstetrician-gynecologist at the Virginia Physicians for Women health-care service, says pregnant teens need more than that.

Pregnant teenagers encounter a specific set of problems because of limited resources and support, Campbell said.

“They have difficulty with transportation. They frequently will seek care later because they are afraid to tell their parents (or) family. They have to continue with their schooling,” Campbell said. “And they have to deal with the social stigma of being a teen mom.”

Most states require sex ed

Thirty-two states require schools to teach sex education, according to the most recent statistics from SIECUS. Eighteen states — including Virginia — do not.

There are seven types of recommended contraception: the birth control pill, patch, ring and shot; implants; intrauterine devices; and emergency contraception. In 2017, no states reported that all of their schools were teaching about all seven methods as well as how to properly use a condom.

According to SIECUS, 19 states reported more than half of school districts teaching students about a variety of contraceptive methods. Fifteen of those states had teen pregnancy rates below the national average of 18 pregnancies per every 1,000 adolescent girls.

Of the 10 states with the lowest teen pregnancy rates, eight required sex ed in all school districts. They include New Hampshire, Wisconsin, and Minnesota, which had pregnancy rates under 15 per 1,000 teenage girls.

The six states with the lowest teen pregnancy rates — Massachusetts, New Hampshire, Connecticut, Vermont, New Jersey, and Rhode Island — reported that three quarters of their schools taught students how to use a condom.

On the other hand, of the 10 states with the highest teen pregnancy rate, seven do not require sex ed in schools. Those states include Arkansas, Texas, and Alabama.

Nationwide, 89 percent of school districts teach abstinence, which recommends that teens put off having sex until marriage. Many schools teach both abstinence and contraceptive methods. That is the case in New Jersey and New Hampshire, where teen pregnancy is below the national average.

Dr. Elizabeth Broderick, a pediatrician in Newport News, calls abstinence education “insufficient information.”

“Abstinence is an excellent way to prevent pregnancy and sexually transmitted infections,” Broderick said. “But eventually, many people choose to become sexually active, and they should have accurate and complete information so they can make the best decision that fits their beliefs and values.”

Broderick says long-acting and reversible contraceptives are generally best for adolescents, but they can be hard to get.

“Access to contraception is difficult for most teenagers,” Broderick said. “Education about anatomy, physiology, contraception, sexually transmitted infections, and consent is appropriate at school and at home.”

‘Educate them on the facts’ to make good decisions

The CDC’s teen pregnancy prevention guidelines say implants and intrauterine devices, or IUDs, are the most effective and reversible birth control methods. Broderick says these are more difficult to obtain than condoms or spermicide because they require a trip to the doctor and a prescription.

Dr. Natalie Dogal, an OB-GYN with Virginia Physicians for Women, said talking about contraception is important for preventing teen pregnancy. She said she discusses contraceptive options with all her teen patients.

“They tend to have heard good or bad stories from friends, parents, or from reading online, and I like to educate them on the facts to help them make good contraceptive decisions,” Dogal said.

According to SIECUS, about 40 percent of male and female high school students nationwide report having had sexual intercourse.

Nationally, the teen pregnancy rate has decreased in recent decades. According to data from the CDC, the rates dropped by 50 percent from 2005 to 2017.

Nearly a third of teen moms reported not using contraceptives because they didn’t think they could get pregnant. Another quarter of teen moms reported that their partners did not want to use contraception.

“Many teenagers think they are invincible,” Dogal said. “That includes thinking they will never be the one who gets pregnant or gets an STI.”

Resources for Teen Mothers in Virginia

The Virginia Department of Health has resources for first-time teen mothers. In the “Resource Mothers” program, a community health worker develops a supportive mentoring relationship with the teen and her family. The free resources include information about prenatal care and health care, assistance finishing school, and tools to avoid drugs and alcohol. Mothers can also sign up for free text messages on prenatal and infant care.

The Healthy Teen Network has a variety of resources for teen parents across the country, including #NoTeenShame, “Mom, Dad — I’m Pregnant,” and Healthy Families America.

To find a health assistance program near you, call 1-800-311-BABY. This will connect you to the nearest health department. For information in Spanish, call 1-800-504-7081.

The U.S. Bureau of Maternal and Child Health has resources for women nationwide. The programs and initiatives include home visiting, which provides at-risk pregnant women tools for mother and child health, raising children, and preventing neglect. The bureau seeks to promote child development and encourage positive parenting.

Planned Parenthood has a webpage for teens to get information about sex, puberty, pregnancy, and birth control, as well as a private chat function for additional questions.

Planned Parenthood has health centers in Charlottesville, Richmond, Hampton, and Virginia Beach. There are also two health centers in the Washington, D.C., area.

How We Got and Crunched the Data

For this report, we downloaded teen pregnancy rates for each state from the U.S. Centers for Disease Control and Prevention.

In addition, we needed the teen pregnancy rates for each city and county in Virginia. The Virginia Department of Health posts such data on its website; however, at the time, the most recent statistics available were for 2017.

We filed a Freedom of Information Act request with the VDH, asking for the 2018 data. The department emailed us the file we requested and then posted it online.

The VDH provided the data as PDFs. We exported the data as an Excel file and cleaned up column headings and other formatting. We have posted all of the data we obtained from the VDH and CDC.

One question we wanted to explore was whether there was a relationship between teen pregnancy rates and the sexual education curriculum taught in schools. To examine this on the national level, we used 2017 data from the Sexuality Information and Education Council of the United States.

We compared the council’s data, which explains how comprehensive sex ed is in each state, with the pregnancy rates from the CDC.

Written by Hannah Eason and Emma North, Capital News Service. Top Photo by kyo azuma on Unsplash.

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