Birth control, abortion and unwanted pregnancies.

[Belsnickel]

(08-15-2016, 03:48 PM)bfine32 Wrote: Oh, I thought we were talking about making these things more available; not current policy. 

Well, yeah, but nurses, unless they are a NP, and most school nurses aren't that I have known, don't have the authority to prescribe anything at all, in any setting. So what would make one think that would change?

[*bfine32*]

(08-16-2016, 06:07 AM)Belsnickel Wrote: Well, yeah, but nurses, unless they are a NP, and most school nurses aren't that I have known, don't have the authority to prescribe anything at all, in any setting. So what would make one think that would change?

Once again you are talking current policy. I am pretty sure there are some states where the pharmacist can prescribe birth control pills. I thought the topic of the OP was to make such measures more available to minors. It appears, in typical fashion, that some have gotten wrapped around the axle by the suggestion that a school medical official could make these measures more available. 

Did you really just asked me what makes me think the policy would change with a policy change? But to answer the question: To make birth control more available to minor girls. 

Who do you suggest should be able to prescribe birth control (pills, IUDs, ect...) to minor girls without parental consent, that would make it easier for them to obtain?

[GMDino]

If you don't know your teen is having sex why would you complain that your teen is using proper birth control and has been educated about it?

Wait...you didn't really want an answer except to try and pigeon hole the responder and further divert the thread.  My bad.

Anyway...

http://www.larc4co.com/

Quote:(DENVER, April 27, 2016) – With Governor John Hickenlooper’s signature on the state budget, Colorado will increase funding for a public health program instrumental in reducing teen pregnancy and the teen abortion rates by 48 percent.

The program provides comprehensive contraceptive services, including hormonal implants and IUDs for those who may not be able to access them otherwise.
Since 2008, several foundations provided an increase to the existing program to identify what gains could be made with additional funding devoted to long-acting reversible contraception – and the results were strong.    

The Colorado Department of Health and Environment requested an additional $2.5 million for its existing family planning budget in the 2016 – 2017 fiscal year.
After narrowly rejecting attempts to increase funding in 2015, state lawmakers agreed to allocate additional state funding in this year’s budget. The additional request in 2015 was $5 million, but as more health insurance policies expand access to a broader array of contraceptive options, more individuals get health insurance access through Medicaid, and new and less expensive forms of long-acting contraceptives come onto the market, state officials reduced the budget needed to continue to see the gains made in the state.

“This modest investment marks the next phase in a tremendously successful program that has impacted the entire state of Colorado,” said Lisa VanRaemdonck, executive director of the Colorado Association of Local Public Health Officials and a co-chair of the coalition of 44 organizations supporting funding for the program. “The data is clear. When women have access to the family planning method that works best for themselves and their families, our financial investment is returned through better short and long-term outcomes for women and their families.”

Among the impressive gains the program has supported in Colorado are:

• The birth rate for young women age 15-19 fell 48 percent from 2009 to 2014, and during the same time the birth rate for women age 20 to 24 fell 20 percent. The decline in the teen pregnancy rate over this period was one of the greatest in the country.
• The number of teens giving birth for the second or third time dropped by 58 percent between 2009 and 2014.
• The abortion rate among women ages 15-19 fell by 48 percent and among women ages 20-24 by 18 percent between 2009 and 2014.
  

Publicly funded family planning services have been available in Colorado for more than 45 years. In 2008, funding was awarded to the Department of Public Health and Environment to expand existing family planning services. This initiative included educating providers and increasing access to contraceptive counseling and to the most effective birth control methods, long-acting reversible contraception (LARC). These methods—IUDs and hormonal implants—can work for up to 12 years and are proven to be safe and effective for women, but are expensive on the front-end, creating financial barriers to access.

When given the opportunity to use any contraceptive, more women choose implants or IUDs. Use of these methods by patients in Colorado grew from 4.5 percent before the initiative began to 29.6 percent in 2014. Nationally, only 12 percent of women who use contraception use these most effective methods, often due to their cost.  The increased use of these methods in Colorado is indicative of why our state has had more success than others at reducing birth rates, abortion rates and the number of people using government assistance. To date, more than 36,000 women have received benefits through this program with clear improvements in public health.

“This investment benefits women and their children with both near term and long term impact.  And because teenagers have much higher rates of unintended pregnancies than other women, this initiative benefits two generations of Colorado kids by reducing unintended pregnancies and supporting teenagers’ ability to stay in school. Ensuring women have access to the most effective methods of birth control enables them to create the best future for themselves and support a healthy start for their children,” said Erin Miller, Vice President of Health Initiatives at the Colorado Children’s Campaign and the other co-chair of the coalition supporting funding.

[Belsnickel]

(08-16-2016, 10:33 AM)bfine32 Wrote: Once again you are talking current policy. I am pretty sure there are some states where the pharmacist can prescribe birth control pills. I thought the topic of the OP was to make such measures more available to minors. It appears, in typical fashion, that some have gotten wrapped around the axle by the suggestion that a school medical official could make these measures more available. 

Did you really just asked me what makes me think the policy would change with a policy change? But to answer the question: To make birth control more available to minor girls. 

I just don't understand why you think that medical professionals currently unable to prescribe drugs would suddenly be able to prescribe drugs. That sort of shift in the medical field goes far deeper than the idea of making contraceptives more accessible. That would be my issue with the logic you are putting on display, here. Especially when it comes to a school nurse who does not have access to medical records, family history, etc. There are many types of oral contraceptives on the market and some medical conditions or family history may be contraindications to being prescribed certain ones. So you're saying a health care professional that has no access to any of this information would suddenly be able to prescribe a medication?

(08-16-2016, 10:33 AM)bfine32 Wrote: Who do you suggest should be able to prescribe birth control (pills, IUDs, ect...) to minor girls without parental consent, that would make it easier for them to obtain?

Hadn't thought about it, mostly because I haven't advocated for teenagers to be on contraceptives without parental consent. I just chimed in on thsi because of the ridiculous assumption that school nurses would be able to prescribe anything.

[oncemoreuntothejimbreech]

(08-16-2016, 10:33 AM)bfine32 Wrote: Once again you are talking current policy. I am pretty sure there are some states where the pharmacist can prescribe birth control pills. I thought the topic of the OP was to make such measures more available to minors. It appears, in typical fashion, that some have gotten wrapped around the axle by the suggestion that a school medical official could make these measures more available. 

Did you really just asked me what makes me think the policy would change with a policy change? But to answer the question: To make birth control more available to minor girls. 

Who do you suggest should be able to prescribe birth control (pills, IUDs, ect...) to minor girls without parental consent, that would make it easier for them to obtain?

Again, maybe you should read the article first before making ridiculous arguments about school nurses prescribing things they aren't allowed to prescribe because they don't have the medical credentials. Then you might know who is prescribing these forms a birth control in Colorado for this program. 

I think we need to start implementing a quiz which people must pass before they are allowed to enter the conversation 

[oncemoreuntothejimbreech]

(08-16-2016, 11:18 AM)Belsnickel Wrote: I just don't understand why you think that medical professionals currently unable to prescribe drugs would suddenly be able to prescribe drugs. That sort of shift in the medical field goes far deeper than the idea of making contraceptives more accessible. That would be my issue with the logic you are putting on display, here. Especially when it comes to a school nurse who does not have access to medical records, family history, etc. There are many types of oral contraceptives on the market and some medical conditions or family history may be contraindications to being prescribed certain ones. So you're saying a health care professional that has no access to any of this information would suddenly be able to prescribe a medication?


Hadn't thought about it, mostly because I haven't advocated for teenagers to be on contraceptives without parental consent. I just chimed in on thsi because of the ridiculous assumption that school nurses would be able to prescribe anything.

He isn't using logic, Matt. He's doing what he always does. 

[*bfine32*]

(08-16-2016, 11:18 AM)Belsnickel Wrote: Hadn't thought about it, mostly because I haven't advocated for teenagers to be on contraceptives without parental consent. I just chimed in on thsi because of the ridiculous assumption that school nurses would be able to prescribe anything.

So you really had nothing constructive to add to the conversation? We get a lot of that around here.

In the OP the article references a child's clinic where IUDs and implants are provided. After reading that and the measures, I shared my view that I thought the program(s) is a good idea; however, the only sticking point would be parental consent to such devices. When some said they would have no issue with their child being prescribed such things, I followed up with what this could mean (a school medical official facilitating access to these devices).

Yet instead of addressing the forest of parental consent for these programs we found a tree that caught our eye.

So allow me to rephrase in a "non-ridiculous" manner (I'm sure you and others will let me know if it ridiculous):

Would folks be OK with whomever is authorized to prescribe pills, IUDs, implants, ect... prescribing these to their minor daughter without consent?

[GMDino]

(08-16-2016, 11:32 AM)bfine32 Wrote: So you really had nothing constructive to add to the conversation? We get a lot of that around here.


In the OP the article references a child's clinic where IUDs and implants are provided. After reading that and the measures, I shared my view that I thought the program(s) is a good idea; however, the only sticking point would be parental consent to such devices. When some said they would have no issue with their child being prescribed such things, I followed up with what this could mean (a school medical official facilitating access to these devices).

Yet instead of addressing the forest of parental consent for these programs we found a tree that caught our eye.

(08-16-2016, 11:32 AM)bfine32 Wrote: So allow me to rephrase in a "non-ridiculous" manner (I'm sure you and others will let me know if it ridiculous):

Would folks be OK with whomever is authorized to prescribe pills, IUDs, implants, ect... prescribing these to their minor daughter without consent?

I'll repeat:  If you did not know your teen was having sex why would you be upset with them getting proper birth control and education about it?

So the answer is yes, I would be OK with it because in your scenario I don't know what my child is doing anyway.

[*PhilHos*]

(08-16-2016, 04:05 AM)oncemoreuntothejimbreech Wrote: The article did point out some flaws in the study. But, I got the impression the person reviewing the study wasn't being objective in their critique. It's getting late so I don't want to get into all of it maybe tomorrow. 

But I will point out this one thing. . . 


The study claims LARCs are effective at reducing unwanted pregnancies while the critique doubts that claim because of unanswered questions like "it's possible that since LARCs are effective for a number of years, birth rates could increase again in a few years when the devices expire."

Okay, that's not even a question. It is a statement. A statement which claims while the LARCs may actually do what they claim, how will we know they are effective if the unwanted pregnancy rates climb after they stop being effective?

It's not talking about the LARC's being effective in the future, it's talking about if the PROGRAM that provides them will still be effective in the future after the initial LARC's expire.

[oncemoreuntothejimbreech]

(08-16-2016, 11:32 AM)bfine32 Wrote: So you really had nothing constructive to add to the conversation? We get a lot of that around here.

Attack the message, not the messenger. Follow your own advice or stop being a hypocrite. Matt pointed out school nurses don't have prescribing privileges. That's constructive despite your passive aggressive insult.

Quote:In the OP the article references a child's clinic where IUDs and implants are provided. After reading that and the measures, I shared my view that I thought the program(s) is a good idea; however, the only sticking point would be parental consent to such devices. When some said they would have no issue with their child being prescribed such things, I followed up with what this could mean (a school medical official facilitating access to these devices).

You can put lipstick on a pig, but it is still a pig. This program doesn't give prescribing privileges to those that aren't qualified to write prescriptions. Calling a school nurse a "school medical official" doesn't make a school nurse qualified to write prescriptions. And IUDs involve a procedure to insert them. Do school nurses do ob/gyn exams and procedures?

Quote:Yet instead of addressing the forest of parental consent for these programs we found a tree that caught our eye.

The forest is access. Parental consent to obtain access is a tree within the forest of access. 

Quote:So allow me to rephrase in a "non-ridiculous" manner (I'm sure you and others will let me know if it ridiculous):

Would folks be OK with whomever is authorized to prescribe pills, IUDs, implants, ect... prescribing these to their minor daughter without consent?

This question has already been answered on page 1 before you began another passive aggressive hissy fit.

[*PhilHos*]

(08-16-2016, 11:22 AM)oncemoreuntothejimbreech Wrote: I think we need to start implementing a quiz which people must pass before they are allowed to enter the conversation 

But that'll take the fun right out of this forum! 



Plus, that's racist. 

[oncemoreuntothejimbreech]

(08-16-2016, 12:09 PM)PhilHos Wrote: It's not talking about the LARC's being effective in the future, it's talking about if the PROGRAM that provides them will still be effective in the future after the initial LARC's expire.

The program does what? Provides free LARCs to reduce the number of unwanted pregnancies. If they do, the program is effective. 

So Callie Gables is claiming the program is effective. But, how will we know it is effective later after we already know it is effctive?

Well, we know it was effective because the number of unwanted pregnancies decreased. If a woman doesn't go back and get a second LARC after the first expired doesn't change the fact that the number of unwanted pregnancies was already decreased before the LARC expired and needs to be replaced. 


Let's simplify it to one woman. She gets a LARC. She doesn't have an unwanted pregnancy during the shelf life of the LARC. How do we know it was effective?  Because she didn't have an unwanted pregnancy. Now let's say she doesn't get a second LARC after the first expired. Whatever happens from that point forward doesn't change the fact that she didn't become pregnant up to that point. 

[*PhilHos*]

(08-16-2016, 12:30 PM)oncemoreuntothejimbreech Wrote: The program does what? Provides free LARCs to reduce the number of unwanted pregnancies. If they do, the program is effective. 

So Callie Gables is claiming the program is effective. But, how will we know it is effective later after we already know it is effctive?

Well, we know it was effective because the number of unwanted pregnancies decreased. If a woman doesn't go back and get a second LARC after the first expired doesn't change the fact that the number of unwanted pregnancies was already decreased before the LARC expired and needs to be replaced. 


Let's simplify it to one woman. She gets a LARC. She doesn't have an unwanted pregnancy during the shelf life of the LARC. How do we know it was effective?  Because she didn't have an unwanted pregnancy. Now let's say she doesn't get a second LARC after the first expired. Whatever happens from that point forward doesn't change the fact that she didn't become pregnant up to that point. 

What if said person does NOT get a LARC yet still does not have an unwanted pregnancy during the same time period? How effective would you say the LARC program was then?

LARC's certainly are effective at preventing pregnancy. But that's not the question. The question is did this program have a positive effect on decreasing something that was already in decline and declined in places this program was not present? I think it's safe to say it had SOME effect, but to the point where it should be implemented at tax payer expense? That's a different story. (I'm not saying it does or it doesn't; just that more research is needed.)

[Rotobeast]

(08-16-2016, 12:37 PM)PhilHos Wrote: What if said person does NOT get a LARC yet still does not have an unwanted pregnancy during the same time period? How effective would you say the LARC program was then?

LARC's certainly are effective at preventing pregnancy. But that's not the question. The question is did this program have a positive effect on decreasing something that was already in decline and declined in places this program was not present? I think it's safe to say it had SOME effect, but to the point where it should be implemented at tax payer expense? That's a different story. (I'm not saying it does or it doesn't; just that more research is needed.)

I can't trust any of the data in any of the studies presented.
I need more information.
How attractive were these women ?

All subjects should be referred to me, for thorough evaluation.


Sent from my SM-S820L using Tapatalk

[oncemoreuntothejimbreech]

(08-16-2016, 12:37 PM)PhilHos Wrote: What if said person does NOT get a LARC yet still does not have an unwanted pregnancy during the same time period? How effective would you say the LARC program was then?

That is one of the fair criticism of the paper. But, when Callie Gable analyzed the data she was guilty of blatant conformational bias by accepting data which supported her opinion while rejected data which didn't.

Quote:LARC's certainly are effective at preventing pregnancy.

Seems the researchers, Callie Gable, and you agree they are effective at reducing unwanted pregnancies.

Quote:But that's not the question. The question is did this program have a positive effect on decreasing something that was already in decline and declined in places this program was not present? I think it's safe to say it had SOME effect, but to the point where it should be implemented at tax payer expense? That's a different story. (I'm not saying it does or it doesn't; just that more research is needed.)

How many abortions need to be prevented for a program like this to be deserving of tax payers dollars?

[*PhilHos*]

(08-16-2016, 12:53 PM)oncemoreuntothejimbreech Wrote: That is one of the fair criticism of the paper. But, when Callie Gable analyzed the data she was guilty of blatant conformational bias by accepting data which supported her opinion while rejected data which didn't.

She may be analyzing the data through a filter of bias, but I didn't see her reject data that didn't support her opinion. I saw her question data and gave reasons for why it should be called into question and acknolwedged the data that supported the claims that she was critiquing, but I don't recall reading her rejecting any data because of her biases.

oncemoreuntothejimbreech Wrote:Seems the researchers, Callie Gable, and you agree they are effective at reducing unwanted pregnancies.

So do condoms. So does abstinence. The question is if making the more expensive LARCs available to more people will it have the effect on a societal problem to the point that it justifies its cost.  If the problem is already declining at the same rate without this program, then I would say the cost is NOT justified. 

That's why I'd like to see a more comprehensive study done.

oncemoreuntothejimbreech Wrote:How many abortions need to be prevented for a program like this to be deserving of tax payers dollars?

That's a good question. Off the top of my head, I'd say that if it lowers the abortion rate by, at least, 10-15% I'd probably be okay with some tax payer dollars going towards this.

[oncemoreuntothejimbreech]

Quote:So how could one attribute the 34 percent decline in abortion rates to the CFPI? Almost the same reduction — about 85 percent of the reduction we saw in CFPI counties — still happened in places where the program wasn’t available. This makes sense because abortion rates have been dropping steadily for years (including among younger women):

Quote:It’s more curious that the abortion rate for women 20–24 rose slightly in the non-CFPI counties while that statistic dropped noticeably where the program was available. But with the very limited evidence the study presents, we have no idea if this is just due to random variation.

Here she is analyzing data from a single chart. The data from the first qoute "makes sense" because it confirms her bias. The data from the second quote is dismissed because it doesn't confirm her bias citing "very limited data" and we have no idea if this is just "random variation."

If she is going to reject the data because it is limited and random variation, she has to reject all the data for the same reason. You can't accept the data you like and reject the data you don't like. If she is going to ignore the limitations she cited when analyzing the data she liked she has to do the same with the data she didn't like. She isn't objective at all. It's blatant conformational bias and while she has some valid criticism on the limitations of the study, ultimately she undermines her credibility so severely her overall critique can't be taken seriously. If you have doubts about the study, you should have bigger doubts about her critique. 

[*PhilHos*]

(08-16-2016, 03:00 PM)oncemoreuntothejimbreech Wrote: Here she is analyzing data from a single chart. The data from the first qoute "makes sense" because it confirms her bias. The data from the second quote is dismissed because it doesn't confirm her bias citing "very limited data" and we have no idea if this is just "random variation."

If she is going to reject the data because it is limited and random variation, she has to reject all the data for the same reason. You can't accept the data you like and reject the data you don't like. If she is going to ignore the limitations she cited when analyzing the data she liked she has to do the same with the data she didn't like. She isn't objective at all. It's blatant conformational bias and while she has some valid criticism on the limitations of the study, ultimately she undermines her credibility so severely her overall critique can't be taken seriously. If you have doubts about the study, you should have bigger doubts about her critique. 

I don't see it as her rejecting data, though. She mentions it and while she tries to explain it away as a "we don't know why", I don't see it as a total rejection.

In any event, if one little thing like this is enough to throw her whole critique out, then shouldn't you be doing the same for the study she's critiquing? She may be biased, but as you even admitted, she has some valid criticism. So if you're standard is "one problem=throw the whole hting out" shouldn't you be doing that for the original study as well?

[oncemoreuntothejimbreech]

(08-16-2016, 08:35 PM)PhilHos Wrote: I don't see it as her rejecting data, though. She mentions it and while she tries to explain it away as a "we don't know why", I don't see it as a total rejection.

The alternative explanation for the increase in unwanted pregnancies in the counties the program wasn't available and a decrease in unwanted pregnancies in the counties where the program was available would be the program was effective. That is the conclusion she should have reached if she accepted the data for the other age group. But, she didn't and then cited reasons she didn't apply to the other age group.

Quote:In any event, if one little thing like this is enough to throw her whole critique out, then shouldn't you be doing the same for the study she's critiquing? She may be biased, but as you even admitted, she has some valid criticism. So if you're standard is "one problem=throw the whole hting out" shouldn't you be doing that for the original study as well?

You told me you didn't see where she rejected data based upon confirmational bias. I showed you an example. That doesn't mean it is the only time she did it. I'm not going to go through it point for point because even when I show where she rejected the data you deny she did when even you state she "tried to explain it away."  If she is tried to explain it away that is because she rejected it. You don't explain away data or conclusions you accept. I'm not dismissing her critique based upon "one little thing."  It is based upon a pattern of a lack of objectivity, confirmational bias, a repeated inability to analyze the data, a disregard for the scientific method, and the single most ignorant comment I've ever read criticizing a study's findings weighed against her valid criticism of the studies limitation which leads me to conclude she has almost zero credibility. Again, she does have some valid criticism regarding the studies limitations, but as a whole that critique is a farce.

A valid critique is to the original Ghostbusters as her critique is to the remake.

[*PhilHos*]

(08-16-2016, 09:20 PM)oncemoreuntothejimbreech Wrote: The alternative explanation for the increase in unwanted pregnancies in the counties the program wasn't available and a decrease in unwanted pregnancies in the counties where the program was available would be the program was effective. That is the conclusion she should have reached if she accepted the data for the other age group. But, she didn't and then cited reasons she didn't apply to the other age group.


You told me you didn't see where she rejected data based upon confirmational bias. I showed you an example. That doesn't mean it is the only time she did it. I'm not going to go through it point for point because even when I show where she rejected the data you deny she did when even you state she "tried to explain it away."  If she is tried to explain it away that is because she rejected it. You don't explain away data or conclusions you accept. I'm not dismissing her critique based upon "one little thing."  It is based upon a pattern of a lack of objectivity, confirmational bias, a repeated inability to analyze the data, a disregard for the scientific method, and the single most ignorant comment I've ever read criticizing a study's findings weighed against her valid criticism of the studies limitation which leads me to conclude she has almost zero credibility. Again, she does have some valid criticism regarding the studies limitations, but as a whole that critique is a farce.

A valid critique is to the original Ghostbusters as her critique is to the remake.

Look, I openly admitted at the beginning that I posted this mainly to spur discussion - which I think it has, to some degree, but at this point, I think we're at the point where neither of our viewpoints are going to change and any further discussion is going to involve rehashing the same arguments over and over.

So let's just agree to disagree, okay?