OPINION: Pregnancy prevention bill is needed but faces uncertain future

Feb. 20--An enlightened and reasonable measure that could go far in addressing Oklahoma's chronic
teen pregnancy problem -- and many of the other problems teens face growing up -- is before the state
Legislature.

At this point, the legislation's future is uncertain, which is unfortunate, because Oklahoma's young people
need help on these fronts more than ever before.

Two bills -- House Bill 1195 by Rep. Jeannie McDaniel, D-Tulsa, and Senate Bill 535, by Sen. Connie
Johnson, D-Oklahoma City -- would require local school boards to develop courses in human growth and
development that include instruction on "human sexuality, self-esteem, stress management, interpersonal
relationships, domestic abuse, sexually transmitted disease" and HIV/AIDS.

The course materials would have to be "age-appropriate and medically accurate," and instruction would
be provided from grades six through 12.

"These are just common-sense things that are going to help young people make better decisions," said
McDaniel. "For example, if kids are taught early on how to recognize the signs of dating violence, it might
help them to make better decisions later on. So when I look at this bill, it's so much more than just teen
pregnancy."

Chances are many of her fellow lawmakers won't share her enthusiasm for providing teens with the
information they need to make better decisions.

But it's clear McDaniel's got a lot of evidence on her side. Oklahoma's long-running failure to provide
young people with comprehensive,

scientifically sound information about such issues as sexuality has led to epidemics of problems. In fact,
the teen pregnancy problem has shown a startling increase in recent years, and the STD rate among
teens also is alarmingly high -- proof positive that what we've been doing (or not doing) isn't working.

Growing problem

Oklahoma experienced a slow but steady decrease in teen births and birth rates from the early 1990s
through 2005, but that promising trend "reversed itself in a dramatic way starting in 2006," according to a
December report from the Oklahoma Institute for Child Advocacy.

Between 2005 and 2007 the number of births to Oklahoma teens grew by more than 800, an increase of
13 percent. That compares with a growth rate nationally of only 5 percent.

In 2008, there were 7,581 births to females under the age of 20. Nearly a third were to teens ages 17 and
younger, and there were 89 births to girls ages 10 to 14.

More than 20 percent of the births were not the first for the teen mom.

These figures put Oklahoma in sixth place for the highest birth rates to all teens, and in second place for
older teens (ages 18-19).

As experts in the field well know, it doesn't have to be this way. There are evidence-based, well evaluated
course models that "are proven to be effective in reducing risk behaviors for specific youth populations,"
as the OICA report noted. But unfortunately, they are not the norm in most school systems.
One such program, Postponing Sexual Involvement for Young Teens, has shown "strong evidence of
effectiveness, as documented by an independent evaluation from the  University of Oklahoma, for the
past 10 years -- but state agencies are no longer promoting it," according to Sharon Rodine, OICA youth
initiatives director.

Health and accuracy

The two bills pending in legislative committees, both known as the "Adolescent Pregnancy Prevention Act
of 2011," are attempts to set up some standards and guidelines for courses that address not only
sexuality but other developmental issues teens face, such as violence, self-esteem, peer pressure and
abuse.

Materials covered in the classes would be made available to parents wanting to look them over, and
parents could elect to keep their children out of the course if they want.

The course would have to emphasize that the "only completely effective protection" against unwanted
pregnancy and STDs is abstinence, and that abstinence outside of marriage "is the expected social
standard" for unmarried students.

Courses would also provide "accurate information" about contraceptives; encourage discussion with
parents about sexuality; teach students skills to make responsible decisions about sex and how to resist
sexual advances and unwanted peer pressure; and teach teens how alcohol and drugs can affect
responsible decision-making.

A main objective of such courses should be to "explore the components of healthy relationships."

The bills require that all course materials be "medically accurate," a feature that's bound to upset those
who think we ought to stick with the birds-and-the-bees story rather than detailed medical explanations.

The bills incorporate the widely accepted definition of "medically accurate," which, among other things,
means materials that are "relevant to informed decision-making based on the weight of scientific
evidence." Such materials also are "consistent with generally recognized scientific theory."

A medically accurate curriculum, for example, would include data about the effectiveness of using
condoms for preventing pregnancy and STDs.

The legislation may be controversial with some, but McDaniel believes that, given the scope of the
challenges and problems young people face growing up today, schools should be required to address
these issues. "These are the things we proclaim that we are working on -- teen pregnancy, bullying,
domestic violence -- and this would be a message from the Legislature saying we want these issues
covered in our schools."

McClatchy - Tribune Business News. Washington: Feb 20, 2011. 

 Better birthing

Jan. 10--I OWA CITY Belly dancing might not be on every expectant mother's radar, but the activity as a
form of birth preparation is an example of the variety of ways women approach labor and delivery. Many
of those options will be discussed during the Conscious Birth Summit 2011, scheduled for 10 a.m.

to 7:30 p.m. Saturday at the Iowa City Public Library. The event is in its fifth year. 'It's really growing every
year,' says organizer Kristin Bergman, a massage therapist who also assists women during labor as a
doula. From seven couples at the inaugural event, the summit has grown to attract about 200 people last
year.

This year's program features more than a dozen presentations, including a screening of the film 'Guerrilla
Midwife' at 5 p.m. The documentary follows an Indonesian midwife and her experiences with disaster
relief clinics.

Bergman notes that while donations for the summit -- which is free to attend -- support the work of Friends
of Iowa Midwives, the topics extend beyond midwifery. 'This is much more about educating expectant
parents and offering a place for people who work in maternal health to share their experiences,' she says.

'How to give birth in the safest, healthiest way.' Ways to promote optimal mental and physical health
during pregnancy; using positions, the squat bar, birth sling and birth ball for hospital births; pregnancy
loss; fatherhood and adoptions are among discussion topics.

Most sessions are at the library, but some of the movement classes will be across the Pedestrian Mall at
Heart land Yoga. That's where the 'Bellydance for Birth' class will be led by Melanie Moore.

Advocates note that belly dancing is the 'original and best' exercise for pregnancy because it strengthens
control of pelvic muscles and encourages optimal fetal positioning.

Bergman says all of the summit presenters are from the Iowa City area. One session on hospital births
will feature certified nurse midwives.

Under Iowa law, parents can choose to have an at-home birth, but lay midwives -- those who have not
attended an accredited nursemidwifery program but instead enter the field through apprenticeships --
cannot legally attend those births, says Kathy Weinberg of the Iowa Board of Nursing.

Lay midwives who do could be charged with practicing medicine without a license.

Efforts have been under way for years to change the law. Attempts will be made again this legislative
session, Bergman says.

Midwives are becoming an increasingly popular choice, says Elizabeth Cook, a certified nurse-midwife
and a women's health nurse practitioner.

Certified nursemidwives are allowed under Iowa law to attend at-home births, but most, like Cook,
practice in hospitals.

Cook, who joined the University of Iowa Hospitals and Clinics in Iowa City in 2010, is one of four certified-
nurse midwives to practice at there.
Certified-nurse midwives are registered nurses who have also graduated from a nurse-midwifery
program. The World Health Organization recommends that all midwives have at least a bachelor's degree
before entry into practice.

Many, including the four women who practice at the UI, have mas ters and postmasters as well.

'Consumers need to consider this when choosing a midwife because some home birth lay midwives do
not,' Cook says.

Nationally, about 10 percent of births are attended by a midwife, she says, with just more than 7 percent
in Iowa.

Cook and other certified nurse-midwives provide primary care during deliveries. By practicing in a
hospital, she says she can offer her patients 'the best of both worlds.' 'If complications arise, we have any
medical equipment we might need right at our fingertips,' Cook says.

Bergman says parents should be comfortable with whatever choice they make.

'Then rather than being a traumatic experience, it's a positive experience,' she says.

'That then prepares you for parenthood.'

McClatchy - Tribune Business News. Washington: Jan 10, 2011.