In July, the National Association for City and County Health Officials named the health department in Gaston County one of the three best county departments in the U.S.
One of the reasons cited for the award was the way the Gaston County Department of Health and Human Services aggressively treats women who come in seeking reproductive care.
A new report from the Guttmacher Institute, a national organization that studies issues around reproductive health, indicates Gaston County is wise in its aggressive emphasis on birth control.
The report finds that even though more women overall are planning when to have children, more than half of pregnancies in North Carolina are still unplanned. And data also show that many women lack consistent access to contraceptives that could help them plan the timing of their childrens births.
In the most recent Guttmacher data from 2008, which compares all states to one another, North Carolina ranked 31st in the rate of unintended pregnancies with 52 percent, about the same as Texas but lower than most states in the South.
In our county, anyone can come to us and get any kind of birth control, said Gaston Health Director Velma Taormina.
Taormina also said every doctor, nurse and nurse practitioner in the department has extensive training in up-to-date contraceptive technology.
She also said the county clinics are open every day, with someone who knows about birth control on duty at all times. Taormina said all of this is because county officials were looking for a way to address a persistent problem: unintended pregnancy.
Young, sexually active and unprotected
Many of the people in those studies are young women who want to get pregnant someday, said Elizabeth Finley of the Adolescent Pregnancy Prevention Campaign of North Carolina.
Finley said focus groups conducted by her organization and the National Campaign to Prevent Teen Pregnancy show many women in their late teens and 20s underestimate the benefits of contraceptives and overestimate the negatives.
Finley said that younger women also tend to be concerned about the side effects they hear listed at the end of commercials and therefore stay away from contraceptives.
The result is that young women use contraceptives less consistently than they could, and many end up with pregnancies that they werent planning. According to the Guttmacher data, that was about 99,000 pregnancies in North Carolina in 2008.
Of those pregnancies, 58 percent of women went on to have the babies, about 14 percent had miscarriages, and about 28 percent had abortions.
More recent data from the N.C. Pregnancy Assessment Monitoring System, a survey sponsored and led by the Centers for Disease Control and Prevention, gives additional insight about unintended pregnancies. In 2011, for women younger than 20, 80.6 percent said their pregnancies were unintended; for women between 20 and 24, 58.1 percent of pregnancies were unintended.
While unintended pregnancies can be the result of young womens ambivalence about birth control, many unintended pregnancies are the result of women being unable to get contraception, said Taormina.
She said a lot of general practitioners might not be up on the latest in contraceptive technologies and will only offer older methods.
For poorer women who rely on health departments, there are other barriers.
In a lot of health departments, they set aside a certain time for reproductive health visits, because thats when a provider is available, Taormina said. But what if the woman isnt available?
She said thats why her clinic has people available every day to help women with reproductive health care.
Then there are financial issues, from insurance not covering contraceptives for some people to others who have high-deductible policies with high out-of-pocket costs.
Taormina said data her department collected about Gaston County women on Medicaid found that 55 percent of them didnt plan their pregnancies. And that ends up costing the Medicaid program money.
According to a separate study by the Guttmacher Institute, researchers found that every dollar invested in providing publicly funded contraceptive services in 2010 saved $5.68 in Medicaid costs for pregnancy and infant care, higher than prior estimates.
But Taorminas biggest concern is the teens she sees.
I know one pediatrician who said that in her four-doctor group, shes the only one offering contraception to teens in her practice. She gives them all pills.
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