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Poverty Causes Teen Parenting, Not the Other Way Around

11:56 am in Uncategorized by RH Reality Check

Written by Martha Kempner for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

A teen mother & child

Poverty is a leading factor in teen motherhood.

Like many RH Reality Check readers, I have been closely following New York City’s fear- and shame-based campaign against teen pregnancy. The print ads include pictures of crying babies with captions like “Honestly Mom, chances are he won’t stay with you. What happens to me?” The ads also tell teens that if they have a kid, they will grow up to be poor. But the ads get it all wrong. Teen parenting doesn’t cause poverty; poverty causes teen parenting.

Developed by the New York Human Resources Administration (HRA), the campaign has seen a significant backlash since it was introduced last month. A group of activists in the city created a counter-campaign and demanded the city take the ads down. As Miriam Pérez noted in an article for RH Reality Check, the backlash may have resulted in a few tweaks and improvements, but the ads are still up, and the HRA hasn’t changed the campaign’s underlying tone at all.

I finally saw the ads for myself last week. My subway car was plastered with crying babies telling their potential teen parents not to get pregnant. The ads I saw were focused on money. In one, a curly haired toddler in a bunny rabbit shirt said, “Dad, you’ll be paying to support me for the next 20 years.” Another featured a one-and-a-half-year-old African-American girl with a bow on top of her head and tears streaming down her cheeks, saying, “Got a good job? I cost thousands of dollars a year.”

But the one that got me, the poster that I happened to be standing in front of for my ride on the C train, was one that might almost be seen as encouraging had it not been so completely meaningless. It read, “If you finish high school, get a job, and get married before having children, you have a 98 percent chance of not being in poverty.”

I don’t know whether this statistic is accurate, though it very well might be. Let’s face it: If you graduate from high school and get a job, you are two steps ahead when it comes to not living in poverty, whether or not you get married and have kids.

But these are big “ifs” that are affected by things way out of teenagers’ control, like where they’re born, the quality of the schools in their area, whether their parents are highly educated, whether their parents are employed, the employment rate in their neighborhood, and what the economy is like when they turn 18. And none of that has to do with whether or not they become parents before they get married.

Pérez points out that supporters of the campaign are missing the point — stigmatizing teen parents won’t prevent future teen parents, because that stigma already exists. I would add that the campaign misses another very important point: Teen parenting does not cause poverty. Poverty causes teen parenting.

Cause and Effect

The ads point out that economic outcomes for teen parents and their children tend to be poor. We know that teen mothers are less likely to graduate from high school, that the children of teen mothers are also less likely to graduate from high school (one ad in the campaign points to this statistics), that teen mothers are less likely to marry, and that they are more likely to live in poverty.  It would be easy to assume that these are natural consequences of teen parenting.

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Backlash Against NYC Teen Pregnancy Campaign Brings Tweaks, But Message Remains the Same

6:59 am in Uncategorized by RH Reality Check

Written by Miriam Pérez for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Read more of RHRC’s coverage of the New York City teen pregnancy campaign here and here.

It’s been two weeks since the New York City Human Resources Administration (HRA) launched its teen pregnancy campaign. Though the agency has made some small tweaks to the campaign in response to the significant backlash that has surrounded it, it remains hugely problematic.

The campaign immediately has drawn intense criticism from activists, and that backlash has gotten significant media coverage. For instance, reproductive justice activists in New York launched the No Stigma, No Shame campaign. (View a Storify of the media response to that campaign here.) The Bloomberg administration has yet to admit defeat, but the HRA has made subtle changes to the campaign, seemingly in response to the backlash. According to the Times, the SMS game I wrote about previously for RH Reality Check has been edited. In the exchange about Anaya, the pregnant teen character who is bullied at the prom, she is no longer called a “fat loser”—now she’s just called a “loser.”

Since my first article on the campaign was published, I’ve received a few additional text messages from the SMS bot. A few days into the firestorm, I received this:

 

A week later, I received another random text from the SMS bot, this time about premature ejaculation. The texts seemed strangely timed, and I got the impression that these new texts were sent out in response to media pressure about the campaign. Sending out a few relevant facts about pregnancy prevention is nice—but it does not negate the fact that the campaign is rooted in shame and stigma.

Meanwhile, the campaign’s ads can be seen all over public transportation in New York City.

Brookings Institute Senior Fellow Richard Reeves was one of the few self-identified liberals to publicly defend the campaign. In an op-ed for the New York Times, Reeves argued that shame is a necessary tool: “[L]iberals should think twice: shame is an essential ingredient of a healthy society, particularly a liberal one. It acts as a form of moral regulation, or social ‘nudge,’ encouraging good behavior while guarding individual freedom.” He goes on to cite examples of how shame can be used to discourage drunk driving or smoking. “Teenage pregnancy qualifies for some ‘moral disapprobation.’ It is a bad choice, for the parents, children and society,” he wrote, quoting John Stuart Mill.

It’s abhorrent to compare the decision to become a teen parent to drunk driving, which is not only illegal, but also directly puts the lives of innocent bystanders at risk. Shame has been used to address both issues, but they are not morally equivalent. At least Reeves is honest in one way: He acknowledges that shame tactics have negative consequences on teen parents.

But there’s an assumption in Reeves’ op-ed—and in the campaign—that teen parenthood isn’t already incredibly stigmatized. Teen parenthood is not like smoking, which has been glorified and glamorized through decades of cigarette ads and popular culture. Gloria Malone, a teen mom and blogger who was brave enough to go on The O’Reilly Factor to talk about the campaign and wrote pieces about it for RHRC and the New York Times, is one of many teen moms who’ve spoken out about the stigma and lack of support they faced. “Some people argue that these ads are a fresh approach to dealing with the problem of teenage pregnancy. But I can tell you that there’s nothing innovative about them. All they do is take the insults and stereotypes directed at teenage parents every day, and post them up around the city,” she wrote in the Times.

And that’s where we really must question the city’s decision to spend $400,000 on this campaign. Even if we believe, as Reeves does, that stigma is an effective or legitimate method of prevention, where’s the evidence that teens aren’t already getting that message?

Obviously I don’t think stigma works, nor do I even think prevention is the right goal, when it comes to teen parenting. Helping teens avoid unwanted pregnancy? Sure. But when it comes to teen parents, I think we should be investing money in making sure they have the resources they need to thrive. Further promoting stigma only makes those resources harder to reach, as Malone points out in her Times article: “[A]fter I had my daughter, my high school guidance counselor refused to see me and help me with my applications. She never expected me to graduate. Most people, even within my family, assumed I wouldn’t amount to anything and would be dependent on government assistance for the rest of my life.”

Teen parents don’t have to end up in poverty, and there’s nothing inherently immoral about parenting at any age. The problem isn’t teen parents, it’s the social and economic conditions that make it impossible to juggle parenting and a career. Those are things we as a society have control over, and improving them will help everyone, including parents of any age.

Paid Sick Leave Pays for Itself: So Why Is NYC’s Mayoral Hopeful Blocking It?

12:58 pm in Uncategorized by RH Reality Check

Written by Sarah Jaffe for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Rosa* lost her mother just a few weeks ago.

Guy in a face mask

New York City companies want to keep sick people working, despite the costs.

Her elderly parents lived at home in New York. A home health-care aide helped Rosa’s father with the burden of caring for her mother, who had Parkinson’s disease and had suffered a major stroke just over two years ago.

“We didn’t want to keep her in a nursing home, for financial reasons, for germs. They basically told us to take her home,” Rosa told RH Reality Check.

The home health-care aide didn’t have paid sick days, so she came to work sick one day, and Rosa’s parents both wound up with the flu. Her 88-year-old father recovered; her mother did not.

“My dad lives with guilt that he allowed the person to stay,” Rosa said. “I’m living with guilt because I came to work that day to make a few pennies.”

Rosa takes unpaid leave from her job in order to care for her parents — her father still struggles with heart troubles and a bad back that makes it hard for him to get around. When Rosa is sick, she goes to the office. She uses her personal days to stay home with her family. (Rosa is also a breast cancer survivor.)

“It’s basically women who are the caregivers,” she noted. “I realize these corporations, they don’t want to do paid family leave. But they’re just eating themselves because the workers come to work exhausted.

“If it’s between work and my parents, my parents must come first.”

Rosa’s home health-care aide was just one of the 44 million workers nationwide who don’t have even a single paid sick day, according to Ellen Bravo, executive director of the Family Values at Work Consortium. A 2010 report from the Public Welfare Foundation and the National Opinion Research Center at the University of Chicago found that 55 percent of workers without paid sick days have gone to work with a contagious illness like the flu. “Thus, not having paid sick days is associated with an 18 percentage point increase in ill employees spreading diseases at work,” the report said. And 24 percent of parents without paid sick days have sent a sick child to school or daycare.

New York’s city council has a bill that would require paid sick days for more than 1.2 million workers. Calling for its passage, the New York Times editorial page noted that it is “a normal benefit for workers in at least 145 countries.” The bill’s been stalled, though, for more than 1,000 days, since its introduction in 2010, even as a natural disaster and flu epidemic hit the city. Christine Quinn, the powerful council speaker, has refused to bring the bill up for a vote, as Mayor Bloomberg and the business community are strongly opposed. Quinn has said that she’s in favor of the policy, but not while the economy remains weak.

Now, the bill is shaping up to be an issue in the 2013 mayor’s race, as a coalition of well-known and politically powerful women have declared they won’t support Quinn in her historic run for mayor unless she allows a vote on the bill, and there are hints that there’s a compromise afoot.

On February 25, a group of women elected officials from Congress, the state legislature, and the city council held a press conference calling for passage of the bill. Rep. Carolyn Maloney (D-NY) said, “…[R]ight here in New York, we can bypass congressional gridlock, enact paid sick leave, and make the Big Apple a national leader in protecting the health of our citizens and guaranteeing elementary fairness to all the working women and men who make our great city tick.”

“I think it’s pretty much a no-brainer,” said Pat Kane, an operating room nurse at Staten Island University Hospital and treasurer at the New York State Nurses Association. “When public health emergencies have to be declared during flu season, when every recommendation from every government agency involved in health says you have to stay home, I don’t see how you can have no requirement that people have to have this benefit when they’re working.”

Kane noted that at the end of January, the Center for Disease Control and Prevention released a new study on a new strain of norovirus, causing gastrointestinal illness, spread by people handling and preparing food. “A lot of those workers don’t have paid sick days,” she pointed out. “When you think about all the requirements to certify a restaurant, to me this should be one of those requirements.”

Paid sick leave is good reproductive health policy as well, Bravo pointed out. “From whatever angle, whether it’s prenatal visits, well baby visits or being able to have an abortion, people need time to take care of themselves without being forced either to forgo the treatment or forgo the pay or even worse, the job.”

“When they say ‘everyone’s free to stay home when they’re sick, they’re just not free to keep their paycheck or their job,’ that’s not freedom,” she continued.

Sick Leave Boosts Women’s Finances

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Empire State Stupidity: New York’s Condom Policies Undermine Public Health and Human Rights

9:58 am in Uncategorized by RH Reality Check

Written by Martha Kempner for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Photobucket

When Julia Roberts pulled a strip of colorful condoms out of her boot in her break-out roll as a prostitute in 1990’s Pretty Woman and declared “I’m a safety girl,” I breathed a sigh of relief.  While I was waiting for her inevitable happy ending (and forgetting to be outraged by the offensive messages of this modern fairytale), I was glad to see that she was protecting herself and her future by avoiding STDs (and pimps and kissing on the mouth). Turns out that my reaction to her condoms is one of the many things about the lives of sex workers that wasn’t exactly on-target in this star-making movie. Rather than being considered a sign of good protective behavior, in New York City carrying condoms can be used as evidence of prostitution, and therefore a crime.

Apparently, New York Police officers use possession of condoms (especially more than one condom) as one of the factors in determining whether there is probable cause to arrest someone for prostitution or loitering for the purposes of prostitution.

One judge told the New York Times that he would not be swayed by condoms as evidence:

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New York’s Universal Comprehensive Sex Ed Mandate: The Radical Notion Our Kids Might Learn Facts

10:33 am in Uncategorized by RH Reality Check

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Written by Andrea Miller for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Monica has it good. A junior at Bard High School Early College on the Lower East Side, she has a twice-weekly health class this semester that includes one unit each on sex education and on HIV and AIDS. Two-hundred blocks north at Aerospace High School in the Bronx, eighteen-year-old Tamara has never been taught sex education, and it doesn’t appear on the syllabus for this semester’s health class. Somewhere in between, metaphorically anyway, eighteen-year-old Brandon at New Design High School has the option of choosing sex education as a one-week elective, alongside other options like sports, LGBTQ Alliance, and poetry. “It’s a shame you have to pick it,” Brandon said, because so many students don’t.

New York City’s universal standard for sex education, announced by schools Chancellor Dennis Walcott in a letter to middle school and high school principals on August 9, 2011, seeks to put an end to this loose patchwork of sex ed programs across the city. For decades, students’ likelihood of receiving sex ed has come down to the luck of the draw, depending on whether principals have considered it a priority, teachers have the training to teach it, or parents are informed enough to demand it.

The new policy will ensure that middle schools and high schools teach at least one semester each of sex ed, beginning in the Spring semester of 2012. The Department of Education is encouraging schools to use two vetted, evidence-based, age-appropriate, comprehensive sex ed curricula: HealthSmart and Reducing the Risk. They are providing the curricula for free, and offering training and technical assistance to schools on the implementation process.

Those of us who care about and have been working for years to improve the health of our youth couldn’t be more excited. But as with any attempt to keep our youth healthy and safe by ensuring their access to comprehensive sex ed, a few detractors are raising their voices in opposition. Most notably, the Catholic Archdiocese has rejected the universal standard, and the vehemently anti-choice Chiaroscuro Foundation has rallied to promote abstinence-only education instead. Last week, an op-ed ran in The New York Times claiming that sex ed will usurp parents’ rights to educate their children as they see fit. And on Monday, New York Congress members Bob Turner and Michael Grimm led an anti-sex education rally outside a Brooklyn public school.

In response to these few but vociferous critics, I want to set the record straight.

First, opponents claim that the decision to set these standards was a sudden one, made solely by school administrators without input from a broad spectrum of constituents across the five boroughs.

In reality, it has been years in the making.

New York State has required general health education for all public schools since 1967, and HIV and AIDS education since 1987, but sex education was not required and was by no means universal. In fact, as of 2004, 75 percent of New York City schools failed to even meet state requirements for basic health education.

The city began to ramp up its commitment to sex education under Mayor Michael Bloomberg. In 2007, based on advisory board recommendations, the DOE began recommending the HealthSmart curriculum, supplemented by the Reducing the Risk curriculum for high schools. Both curricula were made available to schools for free, but without a mandate, fewer than half of all schools offered some form of sex ed. Currently, 43 percent of high schools report having used the high school version of HealthSmart and 38 percent report using Reducing the Risk. Sixty-four percent of middle schools report using HealthSmart.

The DOE first tested the waters for implementing a universal standard by piloting a program of evidence-based sex education in ten South Bronx middle and high schools in 2007-2008, using HealthSmart and Reducing the Risk. The South Bronx was chosen for its high rates of teen sexual activity and teen pregnancy. At the end of the school year, seven of the 10 schools successfully implemented the program. Findings showed that students entering the classroom lacked a basic understanding of reproductive anatomy, but were eager to receive that knowledge. The program was wildly popular, garnering support from students, parents, teachers, and principals. All principals involved said they would use the curricula again, with one reporting, “Sex ed is needed throughout the city – not just in the South Bronx. It should be mandatory.”

Our thoughts exactly.

Second, let me be clear that opponents to sex education represent not the concerns of actual parents of public school students, but first and foremost their own conservative agenda to shame and stigmatize sexual activity and push dangerous, useless abstinence-only education. The chief group opposed to the New York City mandate, the NYC Parents Choice Coalition, is a project of the anti-choice Chiaroscuro Foundation – a conservative anti-choice organization that describes itself as a grant-making organization that funds anti-choice initiatives, religious liberty, Christian evangelization and Catholic formation, and humanitarian efforts.

In reality, the vast majority of New York City parents support their children learning comprehensive sex education in school. When the new standard was piloted in the South Bronx in 2007-2008, parents overwhelmingly supported the new program. Only a few parents (zero to three per school) opted their children out for religious reasons, as was – and should be – their right. Similarly, the city-wide mandate has a provision allowing those few parents who do not want their children to learn about prevention and birth control to opt their children out of those lessons.

But more than merely supporting sex education, parents tend to have a widespread expectation that schools have a responsibility to teach the vital, potentially life-saving information that students need to stay healthy and safe. A 2009 poll showed that 85 percent of New York State voters supported comprehensive sex education, and 77 percent of voters mistakenly assumed that it was already being taught.

Third, opponents of comprehensive sex education would have us think that providing comprehensive, age-appropriate sex education is somehow a radical idea. A consistent pattern of fear-mongering has arisen, complete with unfounded and disproven claims that the recommended curricula will increase teen sexual activity. The anti-sex ed crowd repeatedly trots out red herrings in the curricula that obfuscate the truly comprehensive nature of the recommended curricula.

In reality, HealthSmart is medically accurate and abstinence-based, containing materials such as a worksheet students should complete with a parent about how to abstain from sex. And Reducing the Risk has been found to increase parent-child communication about abstinence and contraception, delay initiation of intercourse; and both reduce the incidence of unprotected sex while increasing use of contraception.

Where opponents of sex education see a radical idea, the rest of us see common sense. In 2009, 35 percent of female high school students and 45 percent of male high school students report having had sex. Teens currently make up more than one in four diagnosed STI cases in New York City. Over the past decade, New York City’s teen pregnancy rate has consistently exceeded the national rate, and in 2005 it was 21 percent higher than the national rate. Teens in under-resourced neighborhoods are three times more likely to become pregnant than teens in more affluent neighborhoods. The disparity in access to sex education has been yet another of the disparities plaguing New York City teens, leading to large gaping inequalities in reproductive health outcomes. And, as if that weren’t enough, parenthood significantly increases the dropout rates for teen mothers and teen fathers – about 51 percent of teen moms have a high school diploma, and the graduation rate for teen fathers is around 64 percent.

Universal, comprehensive sex education is not a radical notion. But for students who have not yet received that knowledge, it just might make a radical difference.

As the largest public school district in the country, serving 1.1 million students, New York City’s universal standard should serve as a catalyst for other localities interested in moving forward with a sex ed policy. First and foremost, it levels the playing field for students in the city by ensuring they have equal access to quality sex education across the board. In modeling not only good policy, but also solid implementation guidelines, this move has the potential to reach beyond New York City to inspire other large school districts, localities or even states to implement similar initiatives. With the New York City universal standard for sex education, we just might be one step closer to ensuring that access to sex education is not an accident of geography.

How HIV-Positive Women Drove a Grassroots Campaign for NYC’s Sex-Ed Mandate

7:56 am in Uncategorized by RH Reality Check

"Teach/Learn"

"Teach/Learn" by duane.schoon on flickr

Written by Alison Yager for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Earlier this week, New York City announced that all public middle and high schools must provide a semester of sex education in 6th or 7th grade, and again in 9th or 10th grade. This is a tremendous achievement for the many individuals and agencies who have worked toward this goal for many years.  The Sex Education Alliance of New York City (SEANYC), a broad-based coalition, has provided a large tent under which advocates gathered with the shared mission of improving comprehensive sexuality and health education in the NYC public schools.  Participating agencies each bring something different to the table.  HIV Law Project, where I work, is an active SEANYC member.

In 2006 HIV Law Project invited a group of women living with HIV and AIDS to develop an advocacy campaign around a yet-to-be-determined issue.  They considered various issues of importance to them, and sex education was at the top of the list.  They knew that HIV continued to spread unabated through their communities, and they saw that their children and their neighbors’ children were not getting the information they needed to stay safe.  Many of the women had already stepped into this breach themselves: they gave condoms to the youth in their apartment buildings, they hosted impromptu living room chats for their teenagers’ friends about safe sex, and they routinely dispelled myths about HIV transmission.  Read the rest of this entry →

House Bill Would Decimate Women’s Health Care in Cities and Rural Areas, Governors and Mayor Say

9:16 am in Uncategorized by RH Reality Check

Written by Jodi Jacobson for RHRealityCheck.org - News, commentary and community for reproductive health and justice.

In a conference call today, the Governors of Connecticut and Vermont and the Mayor of New York City described the devastating effects the GOP’s cuts to Title X and Planned Parenthood would have on women in their states as well as on the fiscal health of their region.

Juxtaposing the needs of women in one of the nation’s largest cities (New York City) and in Vermont, one of the nation’s most rural states, the Mayor of New York City, Michael Bloomberg and the Governor of Vermont, Peter Shumlin spoke today about how cuts to both Title X and to Planned Parenthood would undermine the health of the populations they represent. Each of their concerns were echoed by Connecticut Governor Dan Malloy.

Last week, the GOP/Tea-Party-dominated House of Representatives passed both a Continuing Resolution (CR) that effectively eliminates funding for Title X programs, and the Pence Amendment to the CR that specifically targets Planned Parenthood Federation of America (PPFA), prohibiting federal funding of preventive health care services provided by the organization.

Over 90 percent of services provided by Planned Parenthood clinics are made up of preventive care, including breast and cervical exams, testing and treatment of sexually transmitted infections, and contraceptive supplies.  PPFA clinics serve more than 5 million clients across the country each year. If the House budget and the Pence Amendment are passed by the Senate and signed into law by President Obama, literally millions of women and men will lose their only source of health care.

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My Patients Deserve Complete Care: Why I Support New York City’s Crisis Pregnancy Center Bill

6:50 am in Uncategorized by RH Reality Check

Written by Dr. Lynette Leighton for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

As a family physician, I provide comprehensive health care for all of my patients, including safe abortions for women who decide to end a pregnancy. I’ve cared for many women who came to me in crisis when they learned they were pregnant. The last thing my patients need is to be misled by anti-abortion organizations masquerading as health clinics. I’m strongly in favor of the New York City bill requiring crisis pregnancy centers to disclose that they do not provide abortions or contraception, or offer referrals for these services.

I recently treated Michelle, a 16-year-old who came to my clinic for an abortion. Michelle received counseling from our social worker, and she was quiet when she entered the exam room—not unusual for a woman going through a difficult time. However, as I began to counsel her about what to expect during the procedure, she started to sob.

“Are you sure this is the right decision for you?” I asked.

She exclaimed through her tears, “I can’t have a baby right now!”

We sat down together and discussed the pros and cons. She was not ready to be a mother, or to be pregnant. She wanted to go to college. Michelle felt suicidal at the thought of carrying out the pregnancy. Her mother was opposed to abortion, but Michelle still concluded that it was right for her.

On the way to the clinic, however, Michelle saw a nearby building with a large sign: “Unintended Pregnancy?” Thinking it was our clinic, she went in. She was surprised that instead of taking her medical history, the staff asked her about her relationship with God. They told her that ending a pregnancy is murder, and if she followed through with her abortion, the baby would feel pain during the procedure. They showed her pictures of fetuses from much later in pregnancy. “I can’t get them out of my head,” she said. Read more