By: Callie AdamApproximately fifty percent of pregnancies are unintended in Iowa
and across the nation. An unplanned pregnancy can place a heavy burden
on parents, grandparents, and taxpayers alike. The Iowa Initiative to
Reduce Unintended Pregnancies is a five-year research program that aims
to reduce this high rate of unintended pregnancies among women in Iowa
ages 18-30. The Initiative is using research, ne  tworking,
public outreach, and collaboration with established providers around
the state to increase access to family planning services and
information. Further information can be found at the Iowa Initiative
website http://www.iowainitiative.org/.Headed by former Iowa first lady, Christie Vilsack, the program was launched in January of 2008. With a background in journalism education, Vilsack says, “I’m now educating in a different way; I’m educating about the issues we are facing.” She travels across the state speaking to schools, families, and communities to start the conversation about the Initiative. Women ages 18-30 are the target for the message the Iowa Initiative sends. “We’ve managed to reduce teen pregnancies,” Vilsack said, “but we haven’t been able to put a dent in the number of unintended pregnancies for the 18-30 age range.” These are the years women are trying to get an education and do well in a first job and a mistimed pregnancy could prevent them from advancing to another level. “Women should feel empowered to control their fertility and plan when they are ready to have children,” Vilsack said. According to the website, http://www.iowainitiativeresearch.org/, the Iowa Initiative Research Program was developed to educate women on contraceptive options and resources, motivate responsible behavior, and as a result, prevent unintended pregnancies. Five different research studies are being done within the Iowa Initiative: the salon project, pharmacy project, radio serials, and two social marketing campaigns; one aimed at a college setting, the other being a statewide effort. The salon project utilizes the relationships already established between stylists and their clients to get reproductive health and contraception information out to women. Stylists are trained about the messages and are provided with resources to give their clients. The Initiative is also using pharmacies as a resource to provide answers, advice and encouragement about contraception to women. Unlike doctors, pharmacists are the most accessible healthcare providers for many Iowans, being available in rural and urban areas. Two radio series – one geared towards Latino women, the other towards African American women – will be used to educate women about unintended pregnancies in an entertaining way. Family planning issues are addressed in the episodes, providing information to audiences less likely to get health information from traditional channels. Two social marketing campaigns were developed. One campaign will focus on college settings such as local events, bars, dorms, Facebook, My Space, and student activities. The other will target a general audience through radio, TV, print, and electronic media. With these campaigns in place, the Iowa Initiative hopes to change attitudes about contraception use. Northeast Iowa Community Action Health Services Clinic headquartered in Decorah has utilized funding from the Iowa Initiative. The clinic is able to offer their clients free long-acting reversible contraceptives (LARCs) such as Implanon, Mirena, and ParaGard. There may be a fee for insertion of these products, but the product itself is free to the client. Jane*, a clinician at NEICAC says that clients have so many forms of birth control to choose from now, and they listen more carefully when being educated about the different kinds. “They especially like the idea of the LARCs because you don’t have to think about them and best of all, they are extremely reliable.” But she notes, “With LARCs, you either like them or you don’t. There are pros and cons to all forms of birth control; you just have to figure out how long and what you’ll put up with.” NEICAC Health Services has also been able to increase access to their services making it more convenient to their clients. Director of Health Programs Lori Egan said, “As part of the Initiative, we have been able to open four new clinics to provide reproductive health services to women of child bearing age.” These clinics are located in Fayette, New Hampton, Elkader, and Postville. Having these clinics and services available throughout the northeast Iowa area has reached over 450 new clients and clients no longer have to travel sixty miles on average in the rural area to receive family planning and reproductive health services. Egan says they have promoted their clinic and the Iowa Initiative by putting ads in newspapers and on the radio, distributing  posters, developing a Facebook page “Get A Plan”, and adding a lot of information to their redesigned website http://www.neicac.org/health.html. They are also finishing up a YouTube video that can be viewed from their website and Facebook page.NEICAC Health Services has encountered a few obstacles in their efforts to increase awareness and availability of services. Egan mentions that the attitudes towards talking about sex and reproductive health are very conservative; which is one barrier the Iowa Initiative is trying to break through. Community members have also expressed mixed feelings with the opening of the clinics and these services becoming more available. According to Vilsack, “The topic of abortion is not the issue the Iowa Initiative addresses, we are just educating about preventions.” The most recent statistic she was able to give is that due to state and federal funding for programs like the Initiative, 20,000 unintended pregnancies and 8,000 abortions have been prevented. Despite these issues, Jane* said, “Most often we hear nothing but wonderful support and encouragement from the town.” NEICAC’s goals to lower the number of unintended pregnancies are to increase the number of unduplicated clients they serve and increase the percentage of clients that use a LARC method. “I think this is a great opportunity for Iowa,” Egan said. “I believe it is every woman’s right and responsibility to reproduce when she is best prepared to do that - financially, physically, and emotionally. It will take some time and effort to educate our young and old that sex is a very normal part of life and it can be a very wonderful part of our lives.” “I am very excited to be a part of such a wonderful research project,” Jane* said, “and I foresee only that it will be extremely effective and thus will expand and continue in Iowa and all over the country.” Allen Women’s Health in Waterloo is another clinic that has benefitte  d from the Iowa Initiative. They were able to open three new clinics in Cedar Falls, Waverly, and Independence.“Our main office is able to reach out to patients and make our services more accessible to those in need,” A.R.N.P. Sara Douglas said. “Our clinic in Independence has been really beneficial for young women, especially teens, since they did not have any other resources available in their area,” Long-acting reversible contraceptives are also available at Allen Women’s Health at no charge. These products typically come at a steep cost. The intrauterine devices Paragard and Mirena cost $311and $524, respectively. Implanon costs $450. “The most our patients pay out of pocket is about $100,” Kristy Strom, R.N. said. “The Iowa Initiative grant money covers what insurance cannot cover for the LARCs.” The Initiative has also created employment. “Our jobs would not exist if it were not for this grant,” Douglas said, as she and Strom were both hired under the Initiative. Douglas mentioned that one barrier for their clinic is that the public is not simply aware of Title X clinics and that there is state funding for birth control. Allen Women’s Health has done radio, newspaper, and television ads to market their new clinics and the contraception options that are available. An Allen representative travels to middle schools and high schools in Black Hawk, Buchanan, and Bremer counties to educate students about reproductive and sexual health. The Independence, Waverly, and Cedar Falls clinics collectively provide services to nearly 300 women, 80 of them being new patients since January of 2009. Information for their clinic can be found at http://www.allenhospital.org/body.cfm?id=50. UNI student Katie* said, “Clinics like Allen Women’s Health and NEICAC Health Services are great resources. Girls who are uncomfortable talking to their parents about sexual health but still want to be protected can get educated about birth control options.” The Iowa Initiative hopes to overcome the barrier of people being uncomfortable talking about sex and contraception. Vilsack said, “The topic should become main stream conversation – in schools and families, not just the media – because it is empowering for women to have options for controlling her fertility.” She mentions that Oprah Winfrey’s website has tips on talking to teens about sex and getting over the “eew factor” at http://www.oprah.com/subtopic/relationships/sex “Sex is not just about procreation,” Vilsack said, “it’s fun and a way to have a relationship with someone.” In five years the Iowa Initiative research data will be evaluated. The hope is that Iowa will create a national model in preventing unintended pregnancies. *Names have been changed |