Adolescent Pregnancy and Abortion Abuse - Case Study Example

 This proposal details a study on the current state of teen pregnancies and abortions in the the county, and presents findings from the literature on best practices to curb the rate of teen pregnancies and better manage the numbers tied to pregnancies and abortions among young people, We believe you will find our proposal to incorporate a comprehensive sex education program into the secondary school curriculum of the county to be optimal, and backed by research. Please find the proposal here attached We will be in touch shortly to arrange a meeting and a presentation, so we may discuss this proposal more fully. Thank you so much, sincerely xxxx. Table of Contents I. Abstract 7 II. Proposal 8 A. Issue 8 B. Data 8 C. Review of the Literature 12 D. Proposal Details 13 III. Conclusion 15 References 17 I. Abstract The paper establishes moral hazards and related issues tied to the easy access to abortions and the reality of unwanted teen pregnancies. Such issues demand immediate and concrete action, hence, this proposal that outlines strategies to deal with the twin problem. This proposal looked at national, state and county data from the past few decades to get a picture of the state o teen pregnancies and abortions in Fairfax, Virginia, and contextualizes that data within national and state averages. The data indicates that Fairfax rates for teen pregnancies and abortions are substantial, even as the sustained drops in those rates through time across all states indicate directions that programmed interventions can pursue to curb those rates. Those efforts include greater education efforts, the greater rates of abstinence from sex, and the greater use of contraceptives among teenagers. These findings and data point to a proposal that builds on what has worked in the past, to incorporate a comprehensive sex education program into the secondary school curriculum of the county. This is to better manage teen pregnancies and abortions (Stranger-Hall and Hall, 2011; Kost and Henshaw, 2013; Northern Virginia Health Foundation, 2013; Partnership for a Healthier Fairfax, 2011) II. Proposal A. Issue The identified issue is adolescent pregnancy and abuse of abortion in Fairfax, Virginia, and this report aims to come up with a proposal to address this issue and to bring down rates of teen pregnancy and to address the problem of abortion abuse in the context of teen pregnancies in the county (Haering, 2014; Partnership for a Healthier Fairfax, 2011). B. Data Data exists that tracks the rate of teen pregnancy in select areas in Virginia, including Fairfax, and while rates for Fairfax have been lower in general in comparison to other places in the state, there is much room for improvement in terms of further bringing down the teen pregnancy rates. The plot above fairly represents the teen pregnancy rates discussed above (Haering, 2013, p. 2): Graph Source: Haering, 2013, p. 2 As can be seen from the plot above, for the past decade leading up to 2011, the rate of teen pregnancy in Fairfax had been somewhat steady, at about 10 per 1,000 (Haering, 2013, p. 2). Going into detail with regard to the data relating to teen pregnancies in Fairfax, we see that the plot above is likewise reflected in other reports In Fairfax City, the teen pregnancy rate is 1.5 percent. The following table details teen pregnancy rates by age and by race (Partnership for a Healthier Fairfax, 2011): Table Source: Partnership for a Healthier Fairfax, 2011, p. 95 We can see from the above data that the bulk of teenage pregnancies in Fairfax are accounted for by teens between the ages of 18 and 19, and the remainder being those between the ages of 15 and 17. In terms of race, while the absolute numbers for Blacks are lower, the teenage pregnancy rates for Black teens are much higher than for Whites, even as the large disparities between rates of pregnancy and rates of live birth suggest that there may be problems in terms of unintended or intended abortions and failed pregnancies from other reasons, which is not available from the data above. We understand that the above data is for 2009 (Partnership for a Healthier Fairfax, 2011, p. 95). The data above is presented in another form in the table below, (Virginia Department of Health, 2009): Table Source: Virginia Department of Health, 2009 In terms of abortion data for teenagers, the data reflects disparities between the rates of teen pregnancies and the rates of teen births, from which data on abortions can be imputed. This data is mixed in with data on spontaneous terminations of pregnancies due to miscarriages and the like. (Council on Virginia's Future, 2014; Virginia Department of Health, 2009; Partnership for a Healthier Fairfax, 2011). The data below adds to the data on birth and pregnancy rates for teens (Northern Virginia Health Foundation, 2013): Table source: Northern Virginia Health Foundation, 2013 On the other hand, another set of data paints a different picture with regard to teen pregnancy, teen births, and teen abortion rates for Fairfax and for Virginia in general. Data from 2008, for instance, states that Virginia ranks 37th among all states in terms of teen pregnancy rates, 37th in terms of teen birth rates, and 20th in the US in terms of teen abortion rates, with an abortion ratio of 32 per 1,000 women between the ages of 15 and 19 years of age. The rate of abortion is highest between the ages of 18 and 19, and lowest for the ages 15-17. By ethnicity, the highest rates of teen pregnancy in the state occur among Hispanics at 60 per 1,000 women between 15 and 19 years, followed by Blacks at 49 per 1,000 teenagers. The abortion rate among Black teenagers in the state is about 28 per 1,000, with no data breakdown for other races. (Kost and Henshaw, 2013). The actual figures on abortion notwithstanding, there is a need specified in the literature with regard to addressing the hidden emotional and social costs of abortion abuse among teenagers and in the general population. The problems are identified and explored in the available literature in debates surrounding legislation that addresses abortion access and abortion abuse. The take is that even as abortion has found traction as a legal remedy for those who become pregnant but are not ready or willing to go ahead with the pregnancy for various reasons, such as rape, there are social and legal concerns about the mechanics of access to legal abortion. The reality is more complex too, from the point of view of how access to abortion for instance presents a kind of moral hazard on the part of teenagers having sex knowing that if their methods fail, there is always abortion as a recourse. The data on abortions in the US in general suggest that over time, the ease in which women are able to get access to abortion has improved, meaning that access has improved. Again, this poses concerns rightfully about abusing this mode of preventing pregnancies, which is an extreme measure that is not without its own set of physical and moral risks (Henshaw and Finer, 2001). C. Review of the Literature From a subjective, moral perspective, one can make an argument for a closer scrutiny of the data on teen abortions from the perspective that any teen abortion is a cause for concern, given that teenagers are at a time in their lives when they are still unable to make mature decisions about raising another human life or terminating those unintended pregnancies. First the thinking is that any teen pregnancy is unintended and out of place in the natural life programming of young people. Second, as discussed above, the moral hazard problem translates to young people who are still experimenting with the boundaries of their freedom being given easy access to abortions. Such easy access can be abused. The reality is that teenagers have and will continue to get pregnant, and that many have and will continue to resort to abortions. This is the bigger and indeed more problem that needs to be addressed, and prompts us to urgent action (Ferree et al., 2002). That said, data across decades has shown that there has been an overall sustained drop in rates of teen pregnancies all over the United States from the 1980's all the way to the present time, and the decrease in the rates of teen pregnancies translated naturally to lower rates of abortion among this age demographic again in terms of absolute numbers of abortion going down and as a proportion of teenagers, due to lower rates of pregnancies and lower absolute numbers of young people getting pregnant. The underlying causes for this include to a small extent the reductions in the numbers of young people having sex at these ages, and also that contraceptives use has generally gone up substantially among teenagers. This latter reason, the rise in the use of contraceptives, is by far the single biggest reason for the drop in the teen pregnancy rates for all states in the United States. Moreover, not only have teenagers increased use, but also that teenagers have come to resort to contraceptive methods that have been deemed more efficacious at preventing pregnancies. Among these more effective methods include the use of contraceptive methods that were of longer effect, or that acted for longer periods of time. This included the use of contraceptives that were injected into the body and had sustained effect for longer periods of time, in comparison to one-use methods of birth control that were of lesser efficacy at preventing pregnancies, such as the pill and the condom. As early as the turn of the century, moreover, teenagers have come to resort more to emergency contraception methods as well. The overall take is that the the data point to the effectiveness of abstinence and the greater proliferation of contraceptive options in pushing down pregnancy and abortion rates among teenagers (Boonstra, 2002; Santelli et al., 2004; Kaufmann, 1998; Klein, 2005; McKay and Barrett, 2010). On the other hand, literature also exists with regard to sex education and the impact of sex education on teen pregnancy rates and rates of contraction of sexually transmitted diseases among this age group, together with rates of abortion. The debate in America at present is related to what kind of sex education is best suited to the interests of young people and the communities that they belong to in general. The findings from the research are that where states put an emphasis on sex education that is solely focused on abstinence, the result is that the rates of teen pregnancies correlate positively with greater emphasis on abstinence. Put another way, the more states emphasize abstinence solely in a sex education curriculum, the higher the rate of pregnancies in those states are. In states meanwhile that emphasize comprehensive sex education, or education on sex that includes not just abstinence but the use of other contraceptive methods such as the use of condoms, the result is that the rate of teen pregnancies in those states go down significantly. There is a case therefore to be made, based on these research findings, for the use of comprehensive education in sex that includes the whole gamut of options for contraception that teenagers can avail of, rather than just focus on abstinence. On the other hand, this is clearly tinged with religious and moral issues, and states populations do differ in terms of what they deem morally and religiously acceptable when it comes to contraceptive methods. That said, the data clearly suggests that relying on abstinence only when teaching sex to young people is ineffective, and will only result in the elevation of teen pregnancies (Stranger-Hall and Hall, 2011). D. Proposal Details From the available data we see that proper interventions that build on what works can help to address issues relating to the abuse of abortions among young people, and to mitigate the rates of abortion and of pregnancies among teens in Fairfax. It is important that any interventions must build on rather than destroy the gains that have been made in the county. Clearly the county is doing some things right in terms of pushing down pregnancy rates, but the bigger and more pressing concern relates to the persistent potential abuse of abortions among those who do get pregnant. Teen pregnancy is a reality that will not go away, and with access to abortions increasing in facility, then too will abortions not go away unless we act. The literature tells us that there are interventions that emphasize both abstinence and the greater and more effective use of contraceptives to bring down teen pregnancy rates, and therefore also abortion rates. Both have been deemed effective and responsible for the sustained drops in teen pregnancy rates in the US. It goes without saying that the way to manage high abortion rates is to quell the rates of teen pregnancies, which comes prior. The former flows from the latter. Therefore, the point of focus should be on lowering and managing the rate of teen pregnancies and to make sure that any interventions will be sustainable and will not destroy the prior successes and gains of the county in this regard (Stranger-Hall and Hall, 2011; Kost and Henshaw, 2013; Northern Virginia Health Foundation, 2013; Partnership for a Healthier Fairfax, 2011). Given too that comprehensive sex education works where abstinence-only education does not work, the proposed solution to improve the teen pregnancy and abortion rates in Fairfax and bring them even lower is to incorporate sex education into more aspects of the secondary school curriculum, and to make sure that education is comprehensive and has a well-developed curriculum that takes off from best practices in the state and in other parts of the US (Stranger-Hall and Hall, 2011; Kost and Henshaw, 2013; Northern Virginia Health Foundation, 2013; Partnership for a Healthier Fairfax, 2011). Prospectively, the impact of this proposal can be depicted in a chart, where we can foresee from the above discussion that employing an abstinence-only sex education program in Fairfax can lead to a rise in teen pregnancy rates, from the current baseline of about 10 per 1,000 young women. In the proposed case where integrated sex education is incorporated into the secondary school curriculum, on the other hand, the projection is for a further reduction in the teen pregnancy rates. This is depicted in the original graphic below, which is a projection plot of teen pregnancy rates through time, with baseline at 10 per 1,000, and the rates for two options for sex education on the y-axis and properly labeled ((Stranger-Hall and Hall, 2011; Kost and Henshaw, 2013; Haering, 2013): Original graph, with data from Haering, 2013; Stranger-Hall and Hall, 2011 III. Conclusion There is a pressing need to do something about the ever-present possibility of the abuse of abortions by teenagers in Fairfax, as well as the reality of teen pregnancies. Human nature dictates that where there are easy ways out, people will take those easy ways out rather than take more mature, cautious decisions about their actions. This goes for sex and for its unintended consequences, especially among teenagers. The problem is persistent and the threat of abortion abuse and teenage pregnancies will not go away. In this regard long-term interventions are key to addressing the problem. The proposed solution incorporates both abstinence and the use of contraceptives in a curriculum for sex education among teenagers that takes off from best practices in the US and makes sure to preserve and build on the gains already made by the county in managing the rates of teen pregnancies and abortions (Stranger-Hall and Hall, 2011; Kost and Henshaw, 2013; Northern Virginia Health Foundation, 2013; Partnership for a Healthier Fairfax, 2011). References Boonstra, H. (2002). Teen Pregnancy: Trends and Lessons Learned. The Guttmacher Report on Public Policy 5 (1). Retrieved from http://www.guttmacher.org/pubs/tgr/05/1/gr050107.html Ferree, M. et al. (2002). Shaping Abortion Discourse: Democracy and the Public Sphere in Germany and the United States. Cambridge University Press. Retrieved from http://catdir.loc.gov/catdir/samples/cam031/2001037366.pdf Haering, S. (2013). Memorandum. Alexandria Health Department. Retrieved from http://alexandriava.gov/uploadedFiles/Memo%20-%20TPR%20-%202013-01-08.pdf Henshaw, S. and Finer, L. (2001). The Accessibility of Abortion Services in the United States. Perspectives on Sexual and Reproductive Health 35 (1). Retrieved from http://sparky.guttmacher.org/pubs/journals/3501603.html Kaufmann, R. et al. (1998). The Decline in US Teen Pregnancy Rates, 1990-1995. Pediatrics 102 (5). Retrieved from http://pediatrics.aappublications.org/content/102/5/1141.full.html Klein, J. (2005). Adolescent Pregnancy: Current Trends and Issues. Pediatrics 116 (1). Retrieved from http://pediatrics.aappublications.org/content/116/1/281.full Kost K. and Henshaw, S. (2013). US Teenage Pregnancies, Births, and Abortions, 2008: State Trends by Age, Race and Ethnicity. Guttmacher Institute. Retrieved from http://www.guttmacher.org/pubs/USTPtrendsState08.pdf McKay, A. and Barrett, M. (2010). Trends in teen pregnancy rates from 1996-2006: a comparison of Canada, Sweden, USA and England/Wales. The Canadian Journal of Human Sexuality 19 (1-2). Retrieved from http://www.biomedsearch.com/article/Trends-in-teen-pregnancy-rates/229542649.html Northern Virginia Health Foundation (2013). How Healthy is Northern Virginia? Northern Virginia Health Foundation. Retrieved from http://burnesscommunications.com/sites/default/files/upl-ps/NVHF_Report_FINAL.pdf Partnership for a Healthier Fairfax (2011). Community Health Status Assessment Technical Report. FairfaxCounty.gov. Retrieved from http://www.fairfaxcounty.gov/hd/mapp/pdf/comm-health-assess-tech-rpt-02.pdf Santelli, J. et al. (2004). Can changes in sexual behaviors among high school students explain the decline in teen pregnancy rates in the 1990s? Journal of Adolescent Health 35 (2). Retrieved from http://www.jahonline.org/article/S1054-139X%2804%2900134-X/abstract Stranger-Hall, K. and Hall, D. (2011). Abstinence-Only Education and Teen Pregnancy Rates: Why We Need Comprehensive Sex Education in the U.S . PLOS ONE. Retrieved from http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0024658 Virginia Department of Health (2009). Health Profile, Fairfax County, 2009. VDH. Retrieved from http://www.vdh.state.va.us/healthstats/FairfaxCo09.htm Read More