A Healthier Future for West Virginia - Healthy People 2010

9 - Family Planning

Objectives | References

Background

Since 1970, the West Virginia Bureau for Public Health (WVBPH), Office of Maternal, Child & Family Health (OMCFH), Family Planning Program has received Federal Title X funding to support the mission of providing education, medical, social, and referral services to assist individuals in determining the number and spacing of their children. To achieve this mission, the Family Planning Program supports 143 health centers that provide quality comprehensive medical, educational, and contraceptive services to low- income women, men, and adolescents.

A 1998 report from the Alan Guttmacher Institute identified the United States as having one of the highest rates of unintended pregnancies found in Western nations. The legal abortion rate in the U.S. is similar to that of many countries in Latin America where abortion is illegal and contraceptives are not widely available. Additionally, in the United States, 9 in 10 women who are sexually active, fertile, and do not wish to become pregnant report that they use a contraceptive method, yet half of the six million pregnancies in the United States are accidental, unplanned, and often unwanted. Among teenagers, 8 in 10 pregnancies are unintended.

In 1998 West Virginia had 78 pregnancies occur per 1,000 women ages 15-44 compared to 111 per 1,000 in the United States. Of these pregnancies, 62% result in live births, 23% in abortions, and the remaining in miscarriages. Annually, 85 pregnancies occur per every 1,000 women aged 15-19 in West Virginia, compared to 112 pregnancies per 1,000 women of these ages in the United States. Of these 85 pregnancies, 66% result in live births and 19% in abortions. West Virginia ranks 36th in the nation in teenage pregnancies. Thirty-one percent (31%) of total West Virginia births were to unmarried women.

In 1998, 33.2 million women across the nation, including 4.9 million teenagers, are in need of contraceptive services and supplies. In West Virginia, 188,280 women, including 36,300 teenagers, are in need of these services. Of these totals, 15% of the women ages 15-44 in the United States are living in poverty and 17% are without private health insurance or Medicaid; in West Virginia, 19% of the women ages 15-44 are living in poverty and 19% are without health insurance or Medicaid.

West Virginia ranks second in the nation in providing contraceptive services to women in need, serving 73,710 women and 24,310 teenagers in 1998. This, however, represents only 63% of all women and 67% of all teenagers in need of such services. These numbers identify the need to expand state efforts to increase access to contraceptive services and education and to increase funding to avert unintended pregnancies among the young, the unmarried, and the poor.

The Adolescent Pregnancy Prevention Initiative is a focus area of the Family Planning Program, targeted to reduce the number of pregnancies among adolescents through improved decision making skills, abstinence, or access to contraceptive services.

Separate from contraceptive issues is the focus on increased efforts to support Abstinence Only educational programs. The purpose of these programs is to support education and activities designed to encourage self-esteem building and decision-making, with the goal of postponing sexual activities among teenagers. According to the 1999 Youth Risk Behavior Survey, in the United States, 47.6% of female students and 52.2% of male students in grades 9-12 reported having engaged in sexual intercourse; in West Virginia, 51.3% of females and 57.9% of males reported having engaged in sexual intercourse. Besides the risk of unintended pregnancies is the risk of STD's, sexual abuse, loss of educational opportunities to teen parents, and increased numbers of families in poverty.

The Healthy People 2010 Family Planning objectives identified for West Virginia support ongoing national efforts to improve the health and future for families by assuring their ability to avoid unintended pregnancies.

The Objectives

FLAGSHIP OBJECTIVE
OBJECTIVE 9.1. Increase to at least 70% the proportion of all pregnancies among women 15-44 that are planned (i.e., intended). (Baseline: 54.8% in 1995)

Data Source: West Virginia Bureau for Public Health (WVBPH), Office of Maternal, Child & Family Health (OMCFH), Pregnancy Risk Monitoring System (PRAMS)

In 1995, approximately 45% of all pregnancies in WV were unintended (women wanting to be pregnant later or not at all). By providing confidential information, services, and contraceptive methods, women, men, and adolescents are able to determine the timing and spacing of their children. Unintended pregnancy is associated with insufficient participation in prenatal care, smoking and substance abuse during pregnancy, and low birthweight infants.

OBJECTIVE 9.2. Reduce pregnancies among females ages 15-17 to no more than 40 per 1,000 adolescents. (Baseline: 43 in 1996)

Data Source: National Campaign to Prevent Teen Pregnancy

The vast majority (85%) of pregnancies among teens are not fully planned or intended. Rather, they result from accidents or the teen's ambivalence about pregnancy, confusion about preventing it, and sometimes failure to make any clear decisions about abstinence, sexual activity, or contraception. Adolescent pregnancy occurs as a result of a number of combined factors, including family background and values, low self-esteem, pressures to have sex, lack of communication skills, lack of perceived risk, lack of a supportive environment to delay sex, and lack of strong intentions to avoid pregnancy.

OBJECTIVE 9.3. Reduce to no more than 12% the proportion of individuals aged 15-19 who have engaged in sexual intercourse before the age of 15. (Baseline: 15.3% in 1997)

Data Sources: Kids Count, Special Report, When Teens Have Sex: Issues and Trends; WV Department of Education (WVDOE), Office of Healthy Schools (OHS), Youth Risk Behavior Survey (YRBS); West Virginia Kids Count

Early sexual activity is directly related to adolescent birth rates and sexually transmitted infections. The younger the teen, the less likely he or she will be to use contraception or to use it effectively. Sexual activity has risen slightly among those younger than 15, the group least likely to use contraception.

OBJECTIVE 9.4. Increase the number of schools doing surveys and reporting data related to abstinence and contraception. (Baseline: 29 schools in 1999)

Data Source: WVDOE

Additional information pertaining to important health-risk behaviors could be collected if additional questions related to abstinence and contraceptive use were added to surveys and if the number of high schools surveyed was expanded.

The results of the YRBS administrated to West Virginia students in grades 9-12 was designed to monitor priority health-risk behaviors that contribute to the leading causes of disease, death, and social problems among youth. These behaviors fall into six categories:

1. behaviors that result in unintentional and intentional injuries
2. tobacco use
3. alcohol and other drug use
4. sexual behaviors that result in HIV infection, other sexually transmitted diseases (STDs), and unintended pregnancy
5. dietary behaviors
6. physical activity

OBJECTIVE 9.5. Increase by 5% the proportion of sexually active, unmarried individuals aged 15-19 who use contraception that both effectively prevents pregnancy and provides barrier protection against disease:
9.5 Use condom (Baseline: 58.9% in 1997)
9.5b. Use contraception (Baseline: 41.3% in 1997)

Data Sources: Kids Count, Special Report, When Teens Have Sex: Issues and Trends; NSFG Family Planning data

Sexual intercourse without contraception puts a teen at risk of unintended pregnancy and of contracting STDs, including HIV/AIDS. Being a successful user of contraception is difficult, even for adults. It requires motivation, attention to detail, a clear understanding of consequences, and an eye on the future – qualities not always associated with adolescents. A sexually active teen who does not use contraception at all has a 90% chance of pregnancy within one year. All teens should be educated about contraception even if they are firmly committed to abstinence. Teens who are sexually active should have access to and use contraception.

OBJECTIVE 9.6. Decrease number of teens aged 15-19 who report being sexually active. (Baseline: 40.4% in 1999)

Data Sources: Kids Count, Special Report, When Teens Have Sex: Issues and Trends; WVDOE, OHS, YRBS; Kids Count Special Report

Teens lack the developmental maturity to consider and act upon the possible consequences of their actions, for themselves or others. Instead, they are prone to be risk-takers who perceive themselves as operating behind a shield of assumed invulnerability. Teens need factual information and detailed instructions on how to avoid pregnancy and sexually transmitted disease through contraception. Teens must have more education about human sexuality that includes a basic acceptance of self-worth, a greater sense of dignity and future.

Meeting the Objectives

Health Promotion Channels for Achieving Objectives:

• Worksites
• Schools
• Public Health Programs
• Networks
• Health Care System
• Higher Education

Some of the organizations that will be leading the initiatives to reach the 2010 objectives include:

WV Family Planning Program/Office of Maternal, Child & Family Health (OMCFH)
WV Adolescent Pregnancy Prevention Initiative/OMCFH
WV Department of Education, Office of Healthy Schools
West Virginia State Task Force on Adolescent Pregnancy and Parenting
WV Abstinence Only Education/OMCFH
Adolescent Health Initiative/OMCFH
Right From The Start/OMCFH

Work Group Members

Denise Smith, MS, Work Group Leader, CHES, Family Planning Program Specialist, OMCFH
Ann Williams, BSN, MS-HCA Director, Family Planning Program, OMCFH
Patty Pearson, BS, Family Planning Program Specialist, OMCFH
Judy McGill, MSN, Director, Division of Perinatal and Women's Health, OMCFH
Diane Kopcial, MSN, Former Director, Women's Services, OMCFH
Savolia Spottswood, Director of Minority Health Program, Racial/Ethnic Populations, Rural Healthy Policy, Office of Community and Rural Health Services
Sharon Lewis, LSW, Executive Director, Women's Health Center of WV, Inc.
Susan Thompson, Executive Director, Girl Scouts Black Diamond Council
Brenda Isaac, RN, Kanawha County Schools
Martha Cook Carter, RN, CNW, Director, WomenCare
Ken Selbe, Director, Perinatal Programs- Maternity Services, OMCFH
Karen Merriman, RN, MSN, Vice President for Academic Life, University of Charleston
Patricia Kelly, MD, Professor, Adolescent Medicine, Marshall University
Donna Bolden, Marshall University
Ann Dacey, RNC-NP, Department ofOB/GYN, West Virginia University
Felice Joseph, PharmD, PEIA
Brenda Donithan, RN, Mercer County Board of Health
Gary Gunnoe, Charleston Police Department, DARE Unit
Charlotte Flanagan, Director of Program Services, March of Dimes
Trina Bartlett, MSW, Adolescent Health Coordinator, Community Council of Kanawha Valley, Inc.
Elizabeth Carr, RN, Braxton County Health Department
DeeAnn Price, RN, Women's Services, BCCSP, OMCFH

References/Resources

Baker M and Lutifyya N. "Some significant factors determining the trends of intendedness of pregnancy in West Virginia, 1991-1995." PRAMS Statistics (April 1998): 1-4.

Hutchins J. "The next best thing: helping sexually active teens avoid pregnancy." National Campaign to Prevent Teen Pregnancy.

Hutchins J et al., eds. "Get organized: a guide to preventing teen pregnancy. Focusing on the Kids. Vol. 1.

National Campaign to Prevent Teen
Pregnancy. "Whatever happened to childhood?" The Problem of Teen Pregnancy in the United States. 4, 6-12.

West Virginia Office of Healthy Schools. West Virginia Youth Risk Behavior Survey. Charleston, WV: West Virginia Department of Education, 1999.

For More Information

Family Planning Program
Office of Maternal, Child, & Family Health
Room 427
350 Capitol Street,
Charleston, WV 25301-3714
Phone: (304) 558-5388; Fax: (304) 558-2183

This page was last updated June 13, 2001.
For additional information about HP2010, contact Chuck Thayer at (304) 558-0644 or Chuck.E.Thayer@wv.gov