AmyTuteurMD

AmyTuteurMD
Bio
Dr. Amy Tuteur is an obstetrician-gynecologist. She received her undergraduate degree from Harvard College and her medical degree from Boston University School of Medicine. Dr. Tuteur is a former clinical instructor at Harvard Medical School.

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JANUARY 26, 2010 7:43PM

The state with the largest increase in teen pregnancy is ...

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Bristol Palin

 Surprise! It’s Alaska, home of that stalwart supporter of abstinence only education, Sarah Palin, and her daughter Bristol, a teen who became pregnant outside of marriage. That startling bit of information is was included in CDC statistics that formed the basis for a new review calling attention to a worrisome development. After years of dropping steadily, the teen pregnancy rate has plateaued and begun to rise.

According to a report from the Guttmacher Institute, U.S. Teenage Pregnancies, Births and Abortions: National and State Trends and Trends by Race and Ethnicity:

In 2005, the U.S. teenage pregnancy rate reached its lowest point in more than 30 years (69.5), down 41% since its peak in 1990 (116.9). However, in 2006, the rate increased for the first time in more than a decade, rising 3%…

… [F]or the first time since the early 1990s, overall rates of pregnancy and birth—and, to a lesser extent, rates of abortion—among teenagers and young women increased from 2005 to 2006. It is too soon to tell whether this reversal is simply a short-term fluctuation, a more lasting stabilization or the beginning of a longer-term increase. Preliminary data on births for 2007 show a further increase in the birthrate among all women, including teenagers …

Twenty-eight states had statistically significant changes in teen pregnancy rates, 22 states had increases in teen pregnancy rates, while 4 had decreases. Alaska had the largest increase, the teen pregnancy rate rising a startling 19%. It holds the dubious distinction of beating out traditional leader Mississippi, which experienced an increased rate of teen pregnancy of 13%.

Opponents of abstinence only education were quick to suggest that such programs are to blame:

"One of the nation's shining success stories of the past two decades is in danger of unraveling," said Sarah Brown of the National Campaign to Prevent Teen and Unplanned Pregnancy. "Clearly, the nation's collective efforts to convince teens to postpone childbearing must be more creative and more intense, and they must begin today."

But the increase is hardly an endorsement of values neutral, fact based sex education. Even, Heather Boonstra, Guttmacher's senior public policy associate, acknowledges that:

… the reasons for the increase are probably complex and multifold. "We've been seeing declines in contraceptive use," she says, probably at least in part because of complacency about the HIV virus that fueled a rise in condom use among teens in the 1990s. She also says teen pregnancy seems to be more acceptable in many American towns and cities as teens flock to blockbuster movies like Juno (which positively portrays a pregnant teen) and see pregnant peers in their classes, something that was rare several decades ago.

The data indicate that both intended and unintended teen pregnancies rose:

The teenage birthrate in 2006 was 41.9 births per 1,000 women. This was 32% lower than the peak rate of 61.8, reached in 1991, but 4% higher than in 2005.

The 2006 teenage abortion rate was 19.3 abortions per 1,000 women. This figure was 56% lower than its peak in 1988, but 1% higher than the 2005 rate.

From 1986 to 2006, the proportion of teenage pregnancies ending in abortion declined almost one-third, from 46% to 32% of pregnancies among 15–19-year-olds.

The data suggest that teen pregnancy is not a matter of sex education, but rather a lifestyle choice. In that sense, it does reflect the abject failure of abstinence only education. Abstinence only education has had no impact on rates of teen sexual activity, and now rates of both unintended and intended teen pregnancy are rising once again.

But fact based sex education does not appear to be the answer, either. Teens are choosing to get pregnant and choosing to carry pregnancies to term, putting in doubt one of the fundamental assumptions of fact based sex education, that teens who know more will take more precautions to avoid pregnancy.

If we intend to decrease the rate of teen pregnancy, the answer will not lie in either type of sex education alone.

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"If we intend to decrease the rate of teen pregnancy, the answer will not lie in either type of sex education alone."

And you propose?

Shouldn't your extensive quotes have linked sources? Just asking.
Excuse me Amy... your links are there. Interesting. Well, not really.
Anybody who has ever lived in Alaska knows that this is part of a constellation of "behaviors" that made Alaska the "last frontier" ... decliningly so but still more so that anywhere else in the US.

Alcohol abuse, gun violence and suicide are all WAAAAY up there in Alaska.

Two years ago I was in Barrow, not having been there in 20 years. It's very different ... really weird to see a Burger King in Barrow if you remember the place from 20 years ago.

But a lot of things haven't changed really.
The increased acceptance of teen pregnancy is a victory of sorts for the right wing. As a liberal, I admire many of the features of the right-wing campaign. Admit that humans are sexual beings. Do not shun a pregnant teen. Keep the grandchildren close. Somehow these three kindly attitudes have made teen pregnancy acceptable, rather than accidental and avoidable. I'm not sure where the disconnect between the intent and the actuality arises.
"Anybody who has ever lived in Alaska knows that this is part of a constellation of "behaviors" that made Alaska the "last frontier" ... decliningly so but still more so that anywhere else in the US."

Interesting observation. I hadn't considered that.
"Somehow these three kindly attitudes have made teen pregnancy acceptable"

How do you figure that? Has the Right really been welcoming of teen pregnancy?
in my Mom's day abstinence only worked
because society supported it
I applaud Bristol's decision
To understand Alaska's "startling increase" in teen pregnancy, the first thing I'd want to look at is the demographics of who is getting pregnant and where. Alaska is one of the least culturally homogenous places in the US today. An overwhelming fraction of the non-native people live in or near Anchorage, Juneau, Fairbanks ... particularly teenagers.

"Modern" Alaska is a culture shock to me, because it is wildly different than the Alaska I knew from 20 years ago, but it remains wildly different from any place else in the US.
"I applaud Bristol's decision"

Which decision? The decision to get pregnant without being married and without having any means of supporting a child?
"Go figure. I would have thought it was Utah"

Actually, Utah has one of the lowest rates of teen pregnancy. It is ranked 45th out of the 50 states.
If I'm not mistaken, though it has the second-smallest total population, Alaska has one of the largest percentages of Native Americans of all the states. It's been a well-known fact for decades that teenage and out-of-wedlock pregnancy rates are much higher "on the rez" than elsewhere.

There's also, from what I've heard, a culture of "football, fishing, and fucking" (maybe hockey instead of football, but you get the point.) There's not much else to do up there. Nearly all the well-paying jobs that require a college degree entail leaving your home and family and moving a thousand miles south, and nearly all the well-paying jobs that DON'T require a college degree are traditionally men's jobs.

Having a baby at 17 or 18 isn't going to derail future plans quite as much when you don't really have any.
Amy,

When you say Alaska has an 19% increase, does that mean 13 more teens per thousand base on the average of 69 per thousand or is it a 13% increase or 1.9 teens per thousand?

Also, you said "value neutral, fact based"are you implying that abstinence programs are not fact based? Do not want to assume something that you are not saying. From my understanding the abstinent based programs that I have seen teach the facts including birth control, but encourage teens to wait because it also teaches all the consequences of early sexual activity. No birth control is totally effective and condoms are lowest on the list for preventing pregnancy and STDs. But, even the best birth control will not protect against the emotional scares of forming and destroying emotional intimacy between teens engaging in early sexual activity without the maturity needed to process relationships.

This Christmas my 19 year old nephew announced he may be one of three possible fathers of a child. It turned out he is not the father. The sad part is this young girl (whom we met over family Christmas) had sex with three different men in less than a month and had no idea who got her pregnant. She was just an average kid, not evil or stupid, but no one every told her she had options to not be used by men. Instead she has been told all teens are having sex and hooking up is no big deal.

I do not believe peer pressure is the problem. Teens do not run TV networks, movie and music companies. You mentioned Juno, which is total Hollywood fantasy and almost makes teen pregnancy some sort of conscience raising experience. The reality is teen pregnancy, single parent child raising, and young adults engaging in high levels of sexual activity is taking it's toll on an entire generation and leaving emotional scares that can last a lifetime.

There is no such thing as value neutral. The question is what values do we teach our teens? The current program of more and more sexual information at younger and younger ages does not seem to be working.
"Also, you said "value neutral, fact based"are you implying that abstinence programs are not fact based?"

Of course. They have nothing to do with facts. They're just a stealth way to introduce the values of religious conservatives into schools.
Amy, so you are saying that you cannot teach facts if you include values? Would that mean teaching business ethics are worthless because they have no fact? Or maybe there are no morals or values at all? If that is the case then all sexual behavior is acceptable.

If we are honest with ourselves there is no such thing as natural values, some ideology will be taught regardless of the subject and especially human sexuality.

I do not see how giving a teens all the options including not having sex as any less factual than just giving just birth control methods. Every choice has its consequences and its problems.
"so you are saying that you cannot teach facts if you include values?"

No, I'm saying that the goal of abstinence only sex education is NOT to teach facts but ONLY to teach values. Simply put, it is a way for religious conservatives to smuggle their ideology into the public schools, facts be damned.

I personally find the values of religious conservatives to be repugnant, so I certainly don't want my children to be exposed to them under the guise of "sex education." And I have no interest in my children being exposed to the mishmash of half truths and deliberate omissions of relevant facts that masquerade as abstinence only sex "education."
I guess it would depend on which program was being taught, I don't think there is just one abstinence program out there. I guess you would have to sight a specific program in question. The blanket idea that abstinent programs are full of half truths and false logic is more of a generality based on your ideology not fact.

It is impossible to teach any subject void of some worldview or ideology. Every group and individual has it's agenda, and what it considers moral behavior. You find one group repugnant, but to be fair they may find your views just as repugnant and could make the same claims about masquerading personal values as facts.

If we are honest with ourselves (myself included) we filter all our facts through our worldview and are never totally objective.
"I don't think there is just one abstinence program out there."

But all are based on the same premise: that the goal is to convince teens to abstain. If the goal is to educate teens to avoid pregnancy and sexual transmitted disease, abstinence is just one method among many.

Imagine if a group wanted the schools to teach "condom only" sex education. Simply including it in the name betrays that there is an agenda besides educating teens. The same thing applies to "abstinence only" sex education.

Inevitably, when the goal is to promote one method over all others, facts take second place or may be omitted altogether.
Hay, give them a break. It gets very cold in Alaska:):)
Alaska starts to make sense if you think of it as a third world country. The state's source of revenue comes from a combination of plundering its natural resources and relying on the largess of the US government. All of the wealth and consumer goods are concentrated in the urban areas. Some outer villages don't have basic sanitation. There is a distinct two tiered standard of living known as the urban/rural divide.

Most salon readers would feel right at home in Anchorage. You would recognize all of the big box stores and chain restaurants. Anchorage has a multicultural population (94 different languages are spoken in the Anchorage School District), and all of the specialty grocery stores, restaurants, and cultural events that come along with that. It has decent urban amenities. You can watch Avatar on an enormous XD 3D screen or catch a Broadway show. Compare that to a rural village where people run out of food and fuel. Seriously. No food. No heat. No plumbing. That's why books about this state have titles like Going To Extremes.

There is a lot more to this teen pregnancy and alcoholism thing than a bunch of so called rednecks living in Wasilla.
I trust the human race to provide the fodder necessary to serve the needs of industrial capitalism in whatever mysterious ways it must.
Well, I don't know if it's "one of the worst" catastrophes on earth, but I know teen pregnancy starts girls out with a tough situation. In general I agree that the trend is a reason for concern.
As a person under 20, I just think people should leave Bristol alone and stop harrassing her.
I think the young generation must be educated to be very careful at this chapter. This is just another stage but must be very well understood. polita rca ieftin
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