Wednesday, November 12, 2008

U.S. 29th in Infant Mortality?

On Sunday, October 18, a New York Times editorial called “shameful” how poorly the United States compares with other industrialized countries in its infant mortality rate. The Times reports that in l960 we were 12th and now we’re 29th. The editorial says it’s difficult to pinpoint the causes because infant mortality is linked with health and economic status of the mother, her race or ethnicity, access to quality medical care as well as obesity and drug use.

While we’re overhauling the health care system maybe we could take a look at where we can integrate age-appropriate sexuality education from kindergarten through college.

If we can help women learn to prepare their bodies for pregnancy, educate them about contraceptive methods that will allow them to plan their pregnancies and space them with enough time to recover, we can reduce the mortality rate.

The Guttmacher Institute numbers show that the mortality rate goes up when women have babies too close together for their bodies to heal and strengthen. At the family level, the school level, the community level, in faith-based organizations and among elected decision makers, we must make women’s reproductive healthcare a higher priority than polarizing ideologies.

Ads Help Make Family Planning Mainstream

I remember seeing the first ads for feminine hygiene products on television and wincing. “Is there nothing private any longer,” I wondered. We now have ads for Viagra and “happy periods.” For someone like me who grew up in a family where we didn’t talk about any body parts we can’t see, this was unsettling. But the more I think about it, the more I think it’s a good thing, because advertising is helping us get over our sexual taboos.

In my job with the Iowa Initiative, I am working with family planning clinics which are starting to advertise their services and the new long-acting reversible contraceptives (LARC), which not too many women yet know exist. As a result, I think these ads will help us get used to the fact that family planning clinics are as Main Street as the local doctor’s office or the local pharmacy.

In Cedar Rapids, for instance, at all the local theaters, viewers see the Coke and popcorn ads, but they also see the ad for a local family planning clinic. In Ottumwa, the local clinic advertises on billboards and park benches at busy intersections. In Harlan, there’s a banner on the local hospital. In Des Moines, you can learn about long-acting reversible contraceptives on local buses.

At a clinic in Council Bluffs, the phone at the clinic starts ringing right after the staff hears the popular Planned Parenthood “bunny” ad airing on local TV.

These ads are part of a public conversation we need to be having about health care options which includes preventing unintended pregnancies among adult women.

Family Planning Clinic Openings

Now the young woman is living with her fiancé who is a medical student. When they first became sexually active, she decided to go to the Planned Parenthood in her community, but she kept putting it off. She knew she needed to take responsibility for averting an unintended pregnancy, but somehow she felt guilty about going to the clinic to get birth control. She found it ironic that she felt bad about doing something responsible.

For this reason it’s important that we make family planning clinics so mainstream, so Main Street that there is no stigma attached to walking in the front door.

Earlier this year, when I opened one of the first family planning clinics funded by the Iowa Initiative in Cedar Rapids, Waverly and Independence, I was surprised to find the Chamber of Commerce ambassadors, the mayors, city council members and county supervisors in attendance.

The family planning clinic in small town Waverly is on Main Street near a dance studio. It struck me that in Waverly little girls will learn to be physically and emotionally strong as they learn the power of their bodies, and when they’re young adults they’ll go next door to assure that they continue to be physically and emotionally healthy and strong as they learn the power of their adult bodies.

In small town Independence the new family planning clinic is located in the local hospital between the wellness center and the nursing home. Again, local leaders were there to welcome this small business to the community.

Recently in Postville, a local early childhood teacher brought her high school class to the family planning clinic opening. One of her students was pregnant. They all learned about the services the clinic offers, including yearly exams and testing for sexually transmitted diseases as well as birth control counseling.

Earlier that day we opened a clinic in New Hampton, where a local reporter in her 40’s was visibly pregnant. She and her husband already have several children. She laughed about the fact that she had made an appointment to get one of the new, long-acting IUD’s, but when she went for the insertion, they discovered she is pregnant. She and her husband are anticipating the arrival of their baby and she’s comfortable telling her story to strangers.