It's a good thing to learn about reproductive health -- about STIs, HIV/AIDS, birth control, mammograms, abortions -- the list seems endless. Be sure you visit sites that will give you the truth, the medically accurate, science-based truth. Visit our links page for a list of various websites that offer unbiased information. Below you'll find information about some reproductive topics currently in the news.

Public Health and Education

Unplanned pregnancies in states reach 4 in 10
By Sharon Jayson, USA TODAY May 19,2011

At least 4 in 10 pregnancies in every state were unwanted or mistimed, according to the first-ever state-level analysis of unintended pregnancies.

Mississippi had the highest rate of unplanned pregnancies.

According to the analysis released today, more than half of pregnancies in 29 states and the District of Columbia were unintended; 38% to 50% were unintended in the remaining states.

Using another measure that calculates frequency of unintended pregnancies, the analysis by the nonprofit Guttmacher Institute found the highest rates of unintended pregnancy were in the South, Southwest and in states with large urban populations. Highest was Mississippi with 69 per 1,000 women ages 15-44; lowest was New Hampshire, with 36 per 1,000.

"There are many, many reasons why people don't plan ahead, even when it's such a crucial decision," says Claire Brindis, director of the Bixby Center for Global Reproductive Health at the University of California-San Francisco, who was not involved in the analysis.

Brindis says difficulty in finding family-planning services and lack of access to birth control contribute to the high numbers of unintended pregnancies. There is "a very strong denial factor (people think) 'this won't happen to me,'" she says.

The analysis, based on 2006 data, the most recent available, used national and state surveys on pregnancy intentions, births, abortions and miscarriages, including data from 86,000 women who gave birth and 9,000 women who had abortions. It is published online in the journal Perspectives on Sexual and Reproductive Health.

Guttmacher will release more details about unintended pregnancy in reports later this year, including nationally representative numbers based on a different set of data. The data in today's report "were designed to produce state-level data estimates, not a national estimate," says lead author Lawrence Finer.

In nearly every state, about 65% to 75% of unintended pregnancies were considered mistimed and 25% to 35% unwanted, according to Guttmacher, which studies reproductive issues.

"We know we have very high levels of unintended pregnancy in the U.S., much higher than in most places around the developed world," says Kelly Musick, a sociologist at Cornell University in Ithaca, N.Y., who was not involved in the analysis.

The state breakdown was possible because additional state data became available in 2006, Finer says. Six states and the District of Columbia had no surveys; estimates were used.

Among the 34 states that had data for 2002 and 2006, rates of unintended pregnancies increased in 23 states and decreased in eight; three had little or no change.

"We do a better job of planning to buy tickets to see Lady Gaga than we do about being careful in planning for when we're going to have children, how many children and when in our lives we're going to have them," Brindis says.

Mammograms
Did you know that The Clinic! has mammogram referrals? And those mammograms could be free or low-cost. Visit The Clinic! Mondays 10:30 to 5 or Wednesdays 12 to 6, 120 Richardson St, Grass Valley. Here are guidelines from The Women's Health Specialists, who staff The Clinic!:

Women under age 40 The Clinic! offers women a clinical breast exam and risk evaluation with the WHS clinician. The clinician will discuss with the woman her risk and her screening concerns, together they will come up with a plan the client is comfortable with that is also in her best medical interest (per American College of Obstetricians and Gynecologists, ACOG, recommendations). If the woman has a medical indication for a mammogram, she will be referred.

Women over age 40 WHS offers annual clinical breast exams and offers annual screening mammograms. Women are not denied exams based on the new recommendations from the US Prevention Task Force, which recommends routine screening mammography begin at age 50 and be done every two years. We provide information about the changes in recommendations and the risks and benefits of mammography.

Payment In the State of California there are different payment methods available to women who have no insurance or are underinsured. Please call Women’s Health Specialists at 800.714.8151 to check funding guidelines for a mammogram under those programs.

Further reading: the National Cancer Institute’s explanation of mammograms http://www.cancer.gov/cancertopics/factsheet/Detection/mammograms

New emergency contraceptive ella
Last summer, the FDA approved a new emergency contraception, ella. It’s similar to Plan B (“morning-after pill,” “emergency contraception”) but instead of working up to 3 days after unprotected sex, ella is affective up to 5 days.

This good news is the result of two things - solid research done by the National Institutes of Health and an FDA review process that was guided by science.With this approval we're celebrating not only the approval of Ella (ulipristal); we're also celebrating the return of an FDA where science, not politics, guides decisions about women's health. We also hope that the FDA will finally finish a process that has taken too long to remove the unjustified age limits on over-the-counter access to Plan B One-Step and Next Choice, after-the-fact contraceptives already on the market. Currently Plan B is available without a prescription to those 17 and older (K-Mart in Grass Valley)..

How does it work?
ella contains 30mg of ulipristal acetate and is a selective progesterone receptor modulator (SPRM). A daily low dose regimen of ulipristal acetate is also showing promise in late stage clinical trials as a treatment for uterine fibroids.  ella is effective at preventing pregnancy by inhibiting or delaying ovulation. Studies show it is particularly effective during the time when women have the highest chance of getting pregnant and are most likely to be having sex, immediately prior to when the egg is released by the ovary. Since ella may delay ovulation, a woman is not protected from unintended pregnancy if she has sex even a few days after taking ella. It is recommended that women do not use ella more than once within the same menstrual cycle. Ella may lower the effectiveness of hormonal contraception, such as birth control pills, so couples should use another method, like condoms, until a woman’s next menstruation to prevent pregnancy. It does not protect from STIs or HIV.

Is ella the “abortion pill”?
No. Emergency contraceptives should not be confused with mifepristone (brand name: Mifeprex®), also referred to as RU-486 or the “abortion pill.” While ulipristal acetate and mifepristone are chemically similar, the formulations for ella and Mifeprex work differently. Emergency contraception works to prevent pregnancy by inhibiting or delaying ovulation, while Mifeprex terminates an early pregnancy.

Availability and Cost
ella should be available by the end of the year by prescription. Experts recommend that women obtain emergency contraception in advance of needing it, and have it on hand in case a contraceptive fails or an accident happens. Until the product is officially on the market, we will not know what ella’s price and insurance coverage status. ella could be eligible for reimbursement under insurance plans and Medicaid. Current OTC EC products typically retail between $39-$60.

Click here for Facts on American teens’ sexual and reproductive health.

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The Clinic! has mammogram referrals, and they could be free or low-cost!

Info on mammograms.

Teens, visit Coalition for Positive Sexuality. Visit our links page for the description.

Read the review for Carole Joffe's book, Dispatches from the Abortion Wars.

Fake clinics, or "crisis pregnancy centers" give you one choice - theirs. NARAL has just completed a two-year study on CPCs, Unmasking Fake Clinics. You really need to read this.

Read about our local CPC

Comprehensive Sex Education California law says it's mandatory that schools teach HIV/AIDS classes twice and if they choose to teach sex education, it must be comprehensive and must follow the guidelines in the California Education Code. How is Nevada County holding up to this legal requirement?

.Are you pregnant and need a ride to your counseling or abortion appointment? ACCESS Women's Health Justice can help!

Questions about HPV (human papillomavirus)? This Nantional Cancer Institute Fact Sheet is a good source!

Abstinence-only education still doesn't work.