As U.S. teen birthrate reaches 70-year low, Ky. still 7th highest

The teenage birth rate nationwide is the lowest in nearly 70 years, but Kentucky's rate is much higher than the national average — 46.2 births per 1,000 compared to 34.3 across the U.S.

That ranks it seventh highest in the nation, but the figure is down from 53.1 per 1,000 in 2007. Nationwide, the number is down from 61.8 per 1,000 in 1991. "Young people are being more careful," Sarah Brown, CEO of the National Campaign to Prevent Teen and Unplanned Pregnancy, told Sharon Jayson of USA Today.

In 2010, a total of 367,752 infants were born to mothers ages 15 to 19. Mississippi had the highest rate, with 55 teen births per 1,000 and New Hampshire had the lowest with 15.7, according to the National Center for Health Statistics.

Girls who are having sex for the first time are much more likely to use contraception than their predecessors, notes Laura Lindberg, a senior research associate with the non-profit Guttmacher Institute in New York. She credited the lower teen-birth rate to "the elimination of pelvic exams before receiving prescriptions for hormonal methods, as well as use of long-acting methods such as IUDs." (Read more)

Will birth-control mandate cost more or less? Yet to be seen

Will requiring insurance companies to provide contraception be cost-neutral, as the Obama administration claims? It is unclear, and so is whether insurance companies will make Catholic institutions pay more. These were the findings of FactCheck.org, a nonpartisan, nonprofit, consumer-advocate project funded by the Annenberg Public Policy Center of the University of Pennsylvania.

In support of its claim, the administration cites data from Hawaii's birth-control mandate, which shows health insurance premiums "did not appear" to increase. The study also found the number of pregnancies increased after contraception coverage was required.

But when Pennsylvania considered imposing a similar mandate, a state agency found "the amount of possible savings relative to the cost of the legislation is unclear." Findings were also unclear in Connecticut when officials there looked at whether or not insurance plans saved enough because there were fewer pregnancies to offset the cost of providing coverage. A Texas study found insurance companies would not save enough because women would buy contraception on their own.

A recent survey of 15 insurance companies found six thought costs would increase and another three felt the move would be neutral in cost. None felt they would save money because of the mandate.

"Until better data are available, we're unable to conclude whether the Obama birth-control mandate is likely to result in a net cost increase or not," FactCheck reports.

A couple's journey with infertility; similar tale likely in your town

Laura Ungar of The Courier-Journal follows the story of Kelly and James Durst, who turned to in vitro fertilization when they had trouble conceiving a child.

The Dursts are "among the 12 percent of reproductive-age couples in the United States who couldn't conceive without help," Ungar reports.

In April 2010, they gave birth to son Cooper, one of more than 675,000 babies born in the U.S. through assisted reproduction techniques since 1985. "He is literally the light of our lives," Kelly said. "He's why we try to make things better each day."

Ungar follows the Dursts' journey to have a second child, this time using the frozen embryos that were created at the time of Cooper's conception. The embryos will be placed in Kelly's womb.

Given the growing prevalence of assisted reproduction techniques, stories like the Dursts' can likely be found in nearly every community and make for a compelling read. (Read more)

Critics, proponents debate Louisville hospital merger

Questions regarding ectopic pregnancy, end-of-life care and funding for indigent care were addressed Wednesday by proponents and critics of a proposed merger between University Hospital, Jewish Hospital & St. Mary's HealthCare and St. Joseph Health System. The issues were discussed at a meeting of the Louisville Forum.

The merger, which still needs approval by Gov. Steve Beshear, would give St. Joseph majority control over the three systems. Because St. Joseph is owned by Catholic Health Initiatives, University Hospital and Jewish and St. Mary's would have to adhere to Catholic health directives.

As such, "The other merger partners have agreed not to perform certain services forbidden by those directives: elective abortions; sterilizations; contraceptive dispensing for the purpose of contraception only (except in cases of sexual assault when the victim isn't already pregnant); artificial insemination and in-vitro fertilizations; and euthanasia," reports Laura Ungar of The Courier-Journal.

Altogether, there are 72 Catholic health directives, but David Laird, president and chief executive officer of Jewish and St. Mary's, said his organization and University Hospital have not agreed to abide by all of them. "We are not a Catholic hospital," said Laird, left. "University will not become a Catholic hospital," he said. (Photo by Frankie Steele)

Merger critic Beverly Glascock, a Louisville attorney and former nurse, broached the issue of ectopic pregnancies, which occur in the fallopian tube rather than in the womb. In all cases, the fetus cannot survive and there is danger to the mother if the tube bursts.

But, in a merger document released earlier this week, one of the banned procedures includes "elective (direct) abortions." "In the case of extra-uterine pregnancy, no direct abortion will be performed," the document reads.

Dr. Dan Varga, chief medical officer for St. Joseph Health System, addressed the issue, saying "a direct abortion is the termination of a viable pregnancy, and ectopic pregnancies are, by definition, not viable," Ungar reports.

The issue of indigent care was also discussed. Since CHI has said it will invest $320 million in the deal and commit $200 million to improve University and Jewish hospitals, one audience member asked how much of that would be used for indigent care. Laird said a combined $270 million in indigent care is already being spent. As for whether the CHI funds will increase that sum, Laird said he could not say. "How much will these hundreds of millions of dollars will go to help the indigent?" Glasscock asked. "Not one dollar, not a cent."

As for end-of-life care, merger partners said they have "agreed only not to perform euthanasia, which they do now," Ungar said. Continuing to provide food to someone in a vegetative state and honoring living wills should not be a concern. (Read more) To view a video of part of the hospital merger discussion, click here.

Writer weighs in on morning-after pill decision in provocative way, looking at both sides but ultimately saying it protects girls

Freelancer Mariam Williams writes a provocative piece in The Courier-Journal about a federal official's recent rejection of a proposal to allow girls 16 and under to obtain the morning-after pill without a prescription.

Williams speaks to girls who fall in this age group and highlights the advantages and disadvantages of the decision, which was made last week by Health and Human Services Secretary Kathleen Sebelius, despite a recommendation to the contrary by the U.S. Food and Drug Administration.

"Her decision will come at a cost to me and every other adult woman of child-bearing age," Williams writes. "It will set a precedent for every time someone wants to ignore science and embrace an ideology that not everyone else believes. Her actions will tell them that's OK, and when a pharmacist denies a grown woman's request for the morning-after pill, or when people who believe a fertilized egg is a person can't give any scientific reason for the laws they want to pass, they'll point to Kathleen Sebelius.

"But I believe you and girls younger than you are worth the danger her decision put all of us in. She did this to protect you where the adults in your life have failed you, to push you to talk to an adult if you're having sex or if you've been sexually assaulted so that you can get the information you need to be as safe as possible. So I hope you take your behavior seriously. We women do." (Read more)

Ky. premature births declining, but still above national average

Giving birth to a baby before it has been brought to full term has become less common in the U.S. and Kentucky, but the nation still only received a C, and the state a D, in the 2011 Premature Birth Report Cards compiled by the March of Dimes. Each year, nearly half a million babies are born prematurely.

In Kentucky, 13.6 percent of women gave birth to babies prematurely in 2009, down by 0.4 percentage points over 2008. Only Vermont was given an A, with a pre-term birth rate of 9.3 percent, reports Bonnie Rochman of Time Healthland. Three states and Puerto Rico got Fs; 19 got Cs and 11, as well as the District of Columbia, got a D.

Data from 2006 to 2009 were analyzed. In 2009, the preliminary preterm birth rate was 12.2 percent, compared to 12.8 percent in 2006. The March of Dimes wants that number to drop to 9.6 percent by 2020. Pre-term birth is the leading cause of newborn death in the U.S.

The study analyzed three factors that can contribute to pre-term birth, including the percentage of uninsured women in each state and the percentage of women who smoke. Late pre-term birth, which occurs when a baby is born between 34 to 36 weeks gestation, was also considered, as it "has been linked to rising rates of early induction of labor and C-sections," the study says.

In Kentucky, the percentage of uninsured women has remained the same at 22.8 percent from 2006 to 2009. The smoking rate has dropped from 30.5 percent to 27.3 percent, as has the late pre-term birth rate, down to 9.7 percent from 10.2 percent. (For other states, click on the map above, then click on the state in the larger image.)

The pre-term birth rate was calculated by looking at the percentage of all live births in which the babies had reached 37 weeks gestation or less.

March of Dimes President Dr. Jennifer Howse called the study results positive, "given that for the past 30 years, the rate of preterm birth has been increasing."

"It's not a lot, and the rate is still too high, but the good news is some things are starting to work," she said. (Read more)