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Is Everything Up To Date in Kansas
The hospital joins the growing ranks of private fertility clinics in Kansas and Missouri that for varying ethical and legal reasons have excluded single women from their practice.
Some local health care officials and fertility experts are worried that a disturbing trend is developing, one that threatens women's reproductive choices.
"I find it frustrating for women that they don't have choices," said Valerie Montgomery Rice, a physician who is head of the fertility clinic at University of Kansas Hospital. "I respect everyone's policies, but I have some issues with that."
About 15 percent of U.S. women of childbearing age have received infertility services, according to a 1999 national report by the Centers for Disease Control and Prevention. Comparable statistics were unavailable for Kansas and Missouri.
While private physicians perform some reproductive services, such as artificial insemination, only fertility clinics are equipped to carry out the more sophisticated assisted reproductive technology procedures. Such procedures involve the handling of eggs and sperm, as with in vitro fertilization.
Shawnee Mission's program and Reproductive Resource Center of Greater Kansas City in Overland Park serve only heterosexual married couples. No clinic in Kansas other than the University of Kansas Hospital serves single women.
Shawnee Mission officials turned down interview requests. In a statement, Chief Executive Officer Sam Turner said he changed the fertility clinic's policy to align with the Seventh-day Adventist Church's stance on assisted reproduction. The hospital is affiliated with the church.
The church's position: "The ideal is for children to have the benefits of an intact family with a mother and father. For this reason, reproductive services should only be provided within the bounds of the fidelity and permanence of marriage."
Shawnee Mission's clinic is the second Kansas clinic in as many years to opt out of treating single women.
The Center for Reproductive Medicine in Wichita stopped providing similar services to single women in December 2000. Officials there would only say that the physician in charge of the program decided to alter the policy.
At other Kansas and Missouri clinics, various officials said the decision to exclude single women was based on the ethical and legal questions spawned by the technology. (Editor: What "ethical" question?)
That so many Kansas and Missouri clinics do not serve single women
disturbs Rice. "Should the decision be made for women that they
shouldn't become a single mom? Or that a single parent should not be
considered an intact household?" she said. "I think the question has
to be raised as to who should make these judgments." (Editor: We
wonder if a fetus is allowed to come to term if the couple separates
or divorces first. Or, if the mother is allowed to come to term and
then the child in removed and placed in a household of a married
couple. Far fetched? If you can get out, just don't go back to
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Women Are Having More Children
U.S. births hit 30-year high, but
teenage fertility rate drops to all-time low
For the first time since 1971, women are producing enough children to offset deaths in the United States, the National Center for Health Statistics (NCHS) said.
The center reported 4,058,814 births in 2000, the latest year for which figures were available - up 2.5 percent from 1999. It was the first time since 1993 - when the number of women in their childbearing years was higher - that births topped 4 million.
The report showed increases in the fertility rate in 2000 among women of all age groups except teenagers. Births to 15- to 19-year-olds dropped to an all-time low.
Researchers said the roaring economy of the 1990s was probably a major factor, helping potential parents feel more comfortable about supporting a family.
"When people's prospects are better off than what they were accustomed to, they are more likely to have children. Things in 1999 and 2000 were pretty good," said Brady Hamilton, an NCHS statistician.
The strong economy also likely played a role in the lower teen birth rate.
"They could see they should be spending time improving their education and occupational skills, and postponing marriage and childbearing," NCHS demographer Stephanie Ventura said.
The economic downturn in 2001 could return the nation's fertility rate to around 2 births per woman, roughly where it has been since 1989.
It will take several years to tell whether the jump in 2000 was a temporary blip on the fertility-rate screen or the start of a return to the 1940s and '50s, when big families were the rule and the average fertility rate was 3.5 children per woman, Hamilton said.
The national birth total breaks down to an average of 2.13 children for every woman through her childbearing years of 15 to 49. The government uses 2.1 as the figure necessary for a population to fully replace itself.
Births to 15- to 19-year-olds dropped to 48.5 for every 1,000 women, a record low and down from 49.6 in 1999. Over the decade, teen births dropped 22 percent.
"The credit goes to the teens themselves," said Sarah Brown, director of the National Campaign to Prevent Teen Pregnancy. "There are only two ways these rates can go down: less sex and more contraception. There's evidence that these teens are doing both."
The report also found that smoking among pregnant women declined for most age groups, down to 12.2 percent in 2000. That rate has fallen steadily since 1989. The report found 12 percent of babies born to smokers had low birth weights, compared with just 7 percent of babies born to nonsmokers.
Twin births up
The rate of twins rose slightly, extending a two-decadelong trend.
"Older moms are more likely to have multiple births," said Joyce Martin, an NCHS epidemiologist. "And you have the added whammy of fertility-enhancing therapy, both the drugs and the techniques."
But sets of triplets and higher-order births are on the decline, the report found. Health officials hope that decline means women might be heeding their warnings about fertility procedures, which often produce multiple births that put the children at risk.
Overall, the fertility rate of 2.1 places the United States at the high end of developed nations. The rate is 1.8 in Australia, 1.7 in Britain and 1.2 in Spain.
Source: Erin McClam, The Associated Press.
Ask the Experts
What to do when a condom tears
1. Wash immediately. Share the news and hit the shower. "Wash yourself with soap and water," says James Trussell, Ph.D, expert on emergency contraception at Princeton University. No studies have shown that soap destroys STDs, "but it won't do any harm, and it might do some good."
2. Be and show concern. Gently ask her to (a) inspect herself for condom bits, (b) refrain from douching, as that can push in microbes, and (c) use emergency contraception pills. If taken fewer than 72 hours after intercourse, they can prevent pregnancy. She can get them from her doctor or call Planned Parenthood at 1-800-230-PLAN. Visit www.teenwire.com for more information.
3. Talk about history. Before you even consider having sex with a girl, you should talk about history -- not "War of 1812" kind of history, but how many sexual partners she has been with. If she is infected, and the condom breaks, your risk for getting a sexually transmitted disease ranges from 50 percent for gonorrhea to 0.2 percent for HIV.
Should your condom break, have another chat with her about previous sex partners and diseases. "If you're concerned about STDs, see your doctor and get tested within a few days," says Jonathan Zenilman, M.D., of the Johns Hopkins University STD Research Group.
If you know you were exposed to HIV, ask your doctor about a combination anti-HIV drug treatment. This measure is expensive, controversial and unproven, but it may be your only recourse.
4. Troubleshoot. Did you use an expired condom or an oil-based lubricant? Maybe you nicked the condom with a fingernail while putting it on. Whatever the cause, eliminate it.
A study published in the American Journal of Public Health showed that men who experienced a condom break or slip were twice as likely to do so again. Be sure you know how to put one on!
Pregnant women, during the time they are with child, must tell the
child they're carrying everything they see when they're walking
through the woods. - Rigoberta Menchu