Tuesday, May 09, 2006

The headline screams at me from the monitor. “U.S. has second worst newborn death rate in modern world, report says.” (CNN) I click to MSNBC. The news there isn’t much better: “U.S. gets poor grades for newborns’ survival. Nation ranks near bottom among modern nations, better only than Latvia.”

World wide, four million babies die every year. Two million in their first day of life, two million more in their first month.

Four MILLION. That is almost 110,000 a day. Most who die are in third world countries, 99% according to research done by the Save the Children organization. Melinda Gates wrote in a forward to the Save the Children report, “It’s tragic that millions of newborns die every year, especially when those deaths are so easily preventable. Three out of four deaths could be avoided with simple, low-cost tools that already exist, such as antibiotics for pneumonia, sterile blades to cut umbilical cords and knit caps to keep babies warm.” (CNN)

Simple. If we could stop trying to kill each other and start trying to help each other. The poorest outcomes for both mothers and babies are in countries in which there is war or civil strife.

The statistics for America are that for every 1,000 babies born, five will die in their first month of life. We are tied with Hungary, Malta, Poland and Slovakia on this. It is even worse if you are an African-American mother: nine babies die for every 1,000 born.

Why? Lack of preventative health care. Poverty. Our abysmal teenage pregnancy rates. Poor maternal health.

Emory University health policy expert Kenneth Thorpe: “Our health care system focuses on providing high-tech services for complicated cases. We do this very well. What we do not do is provide basic primary and preventative health care services. We do not pay for these services, and do not have a delivery system that is designed to provide either primary prevention, or adequately treat patients with chronic diseases.” (MSNBC)

What to do about it? That’s the problem. Sex education works. No it doesn’t; it promotes promiscuity. Abstinence works. No it doesn’t, it keeps teens ignorant of birth control options. We are as confused about the solution as we are about sex itself.

From the American Medical Student Association 1998-1999 National Initiative on Teen Pregnancy:

“Even with decreases in the birth rate over the past several decades, the birth rate to teenagers in the United States is considerably higher than in most other industrialized countries. The birth rate to teenagers in the United States is twice that of Great Britain; more than four times that of Sweden and Spain; seven times that of Denmark and the Netherlands; and 15 times greater than the birth rate in Japan. However, teenage sexual activity in the United States and these other countries does not vary significantly. There are several possible explanations for the higher birth rate in the United States. In the United States, society identifies teenage sexuality, not just teen pregnancy, as a social problem. According to one article, this negative focus on teen sexuality causes adolescents to feel greater embarrassment about obtaining contraceptives. Other reasons for the higher teen pregnancy rate in the United States are less access to contraceptives and health care for adolescents and a larger poverty class.”

I call this the “good girls don’t plan sex” problem. Despite the constant in-your-face sex in movies, songs, music videos, television programs, magazines, despite every hormone in a teen’s body screaming for sex, it is still thought of as "being bad”. So therefore, if a girl goes out and gets contraception before she has sex, then she perceives herself as being “bad”. So what does she do? She “lets” herself get “swept away” in the moment. Then it was just an accident and she isn’t a wanton slut who wanted to have sex.

And sex education in high school, whether abstinence-only or the full blown deal isn’t going to help much. Studies prove that these programs work, each in their own way. But our (U.S) age at first sexual intercourse still one of the lowest (15.8 years)

The problem is that like most social problems, Americans want it to be simple. This is the problem, this is the solution. Be solved.

But it doesn’t work like that. Teen pregnancy, teen sex is a complex problem. Girls get pregnant for a whole lot of reasons and for many of them, a course in Understanding Your Body isn't going to help much. Especially since we tend to wait until high school to provide sex ed and by then, the danger group is already having sex, if not their first babies.

In all the conflicting data out there on this subject, a few truths stand out. Girls who delay sexual intercourse and/or use contraceptives for birth control and STD protection: come from intact functional families or have an involved, caring parent who supports and encourages them; have a good relationship with their father; have been encouraged to excel at school; have high self esteem.

I’d go on, but you get the point. Girls who have been sexually molested, girls who grow up feeling unloved, girls who perceive they have no future, girls who are looking for a way out of an abusive family situation, girls who have given up on themselves are much more likely to engage in sexual activity and less likely to use contraceptive.

Sex education needs to start early, in infancy. From birth to three years of age, a child’s brain is still growing, still laying down pathways and developing a core personality. From elementary school, a child is learning who they are and how they fit in to the world. They are learning what they can become.

Sex education does not have to mean body parts and hormone cycles. It means self esteem and confidence.

And I know I left out the boys who are 50% responsible for this problem. But the facts are that boys do not get pregnant and give birth. Girls still bear the brunt of responsibility in child rearing. Girls have to learn to protect themselves and their futures. Whether that means knowing how to say “no” or knowing how to obtain and use contraceptives without fear or shame, that depends on the girl.

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