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Adolescent PregnancyFrom: Zach Newton (zbnewton@atl.mindspring.com)Sat Mar 29 12:19:59 1997
List member Harrison Sheld has an opinion letter publsihed in the Ob.Gyn. News (Vol 32, No. 5. 3/1/97) on the topic of adolescent pregnancy. It is a stirring piece with anguish and hope. In essence, Dr. Sheld addresses the miserable failure of government policy to reduce adolescent pregancy. He offers outcome data to demonstrate the deterioration of the social condition in spite of the consumption of gargantuan public funds. To break the poverty cycle in a broad sense and to reduce illegitimate adolescent pregnancy in particular, Dr. Sheld proposes the dire need for personal responsibility derived from a societal value-system, currently lacking. Fortuitously, I read back-to-back the letter of Dr. Sheld together with a JAMA article entitled "The Effect of Monetary Incentives and Peer Support Groups on Repeat Adolescnet Pregnancies:..." (Vol 277, No. 12. 3/26/97). The results of this study give clear evidence that current public policy toward reduction of repeat adolescent is dismally failing. What to do? In the U.S. major welfare reform legislation at the Federal and State levels has been passed and more is on the way. No telling what will come of this. Sex behavior is relatively fixed. The variable that is most conducive to public policy is the use of contraception. Passive contraception in the form of IUD's, progestin implants and sterilization has the greatest impact on the reduction of unplanned pregnancy. On a wide scale basis, these measures will be chosen voluntarily by the affected target group of welfare recipients only by the force of economic incentive. Would a program of a monthly stipend for welfare recipients monitored for use of passive contraception be ethically and economically sensible?
-- Zach Newton Z. B. Newton, III, M.D. Atlanta/Gyn
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