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♪ Hush a-bye don't you cry ♪
♪ Go to sleep little baby. ♪
♪♪
Hi, I'm Dr. Rick deShazo.
Thanks for joining me tonight for this second
installment of Premature Parenthood,
our special series looking into Mississippi's
teenage pregnancy crisis.
I'm here again at the Neonatal Intensive Care
Unit at the University of Mississippi Medical Center.
This is the only one like it in the state.
Premature babies from all over the state are flown
here because this is the only place in the state
capable of caring for the smallest and the sickest.
Often, the smallest and the sickest
are children of teen mothers.
That's a fact that's indisputable.
And tonight we hope to give you
a number of facts that will help you
understand teen pregnancy in our state.
We're also looking at the myths
surrounding teen pregnancy.
For so long, many of us have believed
certain things about the girls having these babies.
What's true and what is false?
Hopefully, we'll find the answers.
At the very least, we'll give you real information.
We might as well start this one off
with some good news.
Teen pregnancy is down in Mississippi.
According to the Centers for Disease Control,
Mississippi saw teen pregnancy rates
decline more than 20% between 2007 and 2010.
That is incredible news.
But now for the bad news.
We still have the highest teen pregnancy rate
in the country.
In Mississippi, there are 55 babies born
per 1000 teenage girls.
That equals out to one out of every six babies born
in the state being born to a teen mom.
This just doesn't make sense to the most powerful dad
in the state of Mississippi.
It is not good for a 15 year old girl
to have a baby.
DeShazo: Now this may not seem like such
a strange thing to hear
coming out of Governor Bryant's mouth,
but when you look at it politically,
it's somewhat of a stretch.
In the conservative South, staunchly Republican governors
don't usually take on social issues like teen pregnancy.
But Governor Bryant has a unique way
of looking at the problem.
Bryant: When I was in law enforcement
we would look at accidents and there was a thing
called accident scene reconstruction.
And you would begin with that accident
and you would say that if this one element
had been removed, the entire accident
would not have occurred.
And so I began to use that law enforcement concept
to look at some of the challenges
that we have in Mississippi.
And so much of it began with that teen pregnancy.
DeShazo: A pretty interesting way of looking at it.
But one that can't be solved in ways
that he's become accustomed to.
The legislature can't write laws that can cure this.
DeShazo: So right out of the gate
on the day of his inauguration
Governor Bryant laid out his plan.
He wants to change Mississippi's
teen pregnancy future.
First things first, he has some goals.
Bryant: So our deliverable
is going to be a 15% reduction in teen pregnancy
in the state of Mississippi by 2017.
DeShazo: To meet this goal, Governor Bryant
has created a Teen Pregnancy Task Force whose work
is to come up with ways to solve the problem.
The group meets regularly to work and plan
and then reports back to the governor.
And part of that work includes a second goal.
Bryant: We say we're going to reduce
the number that the second births, the second time.
A lot, this is something that was new to me too,
is a teen mother that has multiple children.
Physicians have told me about patients that they have
between 15 and 19 years old that have 2 or 3 children.
And so we say we're gonna try to reduce that
dramatically by that same time period.
DeShazo: Another huge issue for Governor Bryant
is the men in these equations.
In 2010 on the birth certificates of babies
born to girls aged 12 to 16, 76% of the fathers
were listed as unknown.
Why?
Well we can't say for sure in every case,
but law enforcement often believes this is because
the fathers are far older than the teen mothers
and would be considered *** predators by law.
Although that's not always an easy distinction to make.
Bryant: We've got to target the male.
Primarily the adult male.
In too many of these cases, we've got
adult males who've impregnated teenage girls.
That's a crime.
We should be enforcing that crime.
I have talked to the attorney general,
we're gonna work carefully with district attorneys
across the state to see if we can't enhance penalties
and if we can't clarify the law.
DeShazo: And why does the law need clarifying?
Bryant: You almost have to have a slide rule
to figure out when someone's *** a child.
We can do better than that.
So that's one of the things the legislature can do
is say we're gonna make sure that that *** predator
is classified just as that, that we have to make sure
that they're listed as someone who has been
a *** predator under the current state laws.
We need to make sure that they're held accountable.
DeShazo: Despite his passion
for solving this issue by going after *** predators,
Governor Bryant is, at heart, a family man
and he strongly believes that many
of the messages key to preventing teen pregnancy
must come from the moral center:
the home and the church.
I don't want to get to the point where we say
it doesn't do any good to tell our children
not to have sex.
I just think that's wrong.
I think we have got to have our responsibility
as parents to say you are a child.
I don't want you drinking when you're driving.
I don't want you staying out at 2:00 in the morning
on a school night.
I don't want you having sex.
And I don't think it's anything wrong for fathers
to set down with their young son and say
and I don't want you fathering a child
and if you do, there's gonna be
some bad consequences for it,
and I'm gonna hold you accountable for it.
Fathers need to start having that conversation.
DeShazo: From Governor Bryant
to another of Mississippi's influential leaders,
Dr. Mary Currier.
When she talks of teen moms,
instead of looking at the legal side of things,
she sees the the public health perspective.
The problems with teen pregnancy are that
it's bad for the mom and bad for the baby.
The outcomes are worse when you have children
and you're a teenager,
you're a child yourself having children.
The kids are more likely to end up
on public assistance, more likely to end up in jail
and they themselves are less likely
to graduate from high school.
The moms are less likely to graduate from high school,
less likely to have a job that can support them.
So not only is it an issue of good health outcomes
for the mom and the baby, but it's an issue of good
economic outcomes for the family and for the state.
DeShazo: This sentiment was echoed almost exactly
by Jamie Bardwell, the Program Director
for the Women's Fund of Mississippi.
This non-profit group is making it their mission
to find a way to stop teenage pregnancy in Mississippi.
We know that children of teen mothers
are more likely to end up in prison.
We know that children of teen mothers are more
likely to also become teen moms themselves.
And we know that the educational outcomes
for teen moms and their children
are not very good at all.
We know that only 30% of teen moms actually graduate
from high school and that the number one reason
for drop out for teen girls is teen pregnancy.
So clearly it's an economic issue,
it's a health issue, and it's an issue
that really affects the workforce development.
What businesses are going to come to Mississippi
and set up shop if they can't find
a well-educated, healthy workforce?
DeShazo: And that's if the pregnancy goes well
to begin with which all to often is NOT the case.
Children that are born to teen moms
are more likely to be born too early.
About 15-16% of our births in the state
are to teen moms, but they account for more
than 20% of our infant mortality.
So there's a higher rate of infant mortality
among those infants born to teen moms.
DeShazo: Then there's the issue of race.
Long a touchy issue in Mississippi,
we wanted to know what the experts think.
What about the race myth?
Is this a black issue?
Because that's what people seem to think.
The numbers are very clear.
No way to argue with them.
In 2010, there were 6,185 babies born to teen moms.
2579 were to white mothers,
and 3606 of those to non-whites, mostly black,
but with a few Hispanic mothers as well.
When broken down into percentages,
that means that 41% of the teen mothers in 2010
were white, 59% of the teen mothers were not.
Clearly not as, pardon the pun,
black or white as one might have previously thought.
So we asked both Dr. Currier and the experts
at the Women's Fund what they thought
about the controversy.
Is this a black problem or a white problem
or a hispanic, whose or what?
We have high rates of teen pregnancy
across the board in the state.
There is more teen pregnancy among
African-Americans, but we're still high
across all racial groups.
DeShazo: Carol Penick, Executive Director
of the Women's Fund of Mississippi
put it even more clearly.
This is not a black or a white issue,
this is a black and a white issue.
We broke down our statistics by county.
Some counties, it's equal black
and white teen births.
Some there are more black children born,
some there are more white children born.
But the important thing here is that this
is not somebody else's problem.
This is everybody's problem.
DeShazo: So there is that myth
completely blown out of the water.
Mississippi's teen pregnancy crisis is NOT
a bunch of African American girls
having babies right and left.
One myth down, plenty more to go.
How about Medicaid and the many myths
surrounding it and teen pregnancy?
Many people believe that a lot of girls
get pregnant over and over merely
to make money off of the system.
Is that so?
Well we went straight to the horse's mouth:
Dr. David Dzielak, the Executive Director
of the Mississippi Division of Medicaid.
He filled us in on what Medicaid is,
what it is designed to do and who it serves.
Medicaid is designed to take care
of the most vulnerable people that we have in this state.
56% of our enrollees, and we have 640,000+ enrollees,
56% of those are children.
And 24% are the elderly and disabled,
the supplemental security income people.
So if you put those two together,
that's 80% of the people that we serve
are the most vulnerable people that we have in the state.
DeShazo: So what about the teen moms?
How do they fit in?
If you're a teenager and you're pregnant,
you're eligible for Medicaid without a means test.
So that means you don't have to beat
the federal poverty level measures.
You're just eligible.
DeShazo: Okay now what about the costs.
Surely these teens are costing taxpayers
of Mississippi a fortune, right?
Well, not exactly.
Mississippi has a pretty sweet deal when it
comes to Medicaid, the best in the nation actually.
Because of the federal match,
for every 25 cents that Mississippi taxpayers
put in the pot, the federal government pays 75 cents.
So keep that in mind.
Now, not every pregnant teenager comes and enrolls
in Medicaid, but last year, we covered
about 1100 pregnant teenagers.
And for each pregnancy, normal pregnancy,
it costs about $4300 for the Medicaid program.
And you gotta remember, the federal match rate,
so it really only 1/3 of that costs is actually
the cost to Mississippi itself.
But if you have a low birth weight baby,
which teen moms are very susceptible to having,
that changes the game completely.
The average cost for a low birth weight baby
is much higher than the cost for a normal pregnancy
because you have to then spend time in the NICU,
there's a lot more medical need depending
on how low of a birth weight baby you actually have.
So the average low birth weight baby
costs Medicaid about $63,000.
DeShazo: As we learned on our last program,
when you have one low birth weight baby,
odds are you'll have another.
But why are teens more likely to have them?
And is it ALL teen mothers?
Teenage mothers do have a higher risk
of having low birth weight babies.
Teenage mothers who are also in a low income
situation have an even greater chance
of having a low birth weight baby.
So the risk for- and there are several factors
that go into that.
Prenatal care may not be as good as it would be
in a higher income bracket, so there is
a significant risk for the Medicaid population
to have low birth weight babies.
DeShazo: But just for a little perspective,
these numbers should help.
For the six month period from October 2011 through
March of 2012, Medicaid paid for 890 teen births.
The total bill over those six months
came to a whopping $3.27 million.
So we now know that Medicaid will pay
for delivering the babies.
What else?
We also cover family planning services
for those individuals that are eligible
who meet the means test.
Now, family planning has a much better match rate
than the state match rate for other medical services.
It's a 90% match rate.
So for every 10 cents we put in as a state,
we get 90 cents from the federal government
to support those services.
Last year we spent about $20 million
on family planning services, so if you do the math correctly,
it's about $2 million in state money for family planning.
DeShazo: So between the deliveries
and the family planning alone, that's a lot of cash
out of Mississippi pockets albeit, thanks
to the federal match, it could have ben much, much more.
What are we leaving out?
Medicaid will pay for doctor's visits during the pregnancy.
They will pay for the mother's medical expenses
related to the pregnancy for two months after birth.
And they will pay for the child expenses for up to one year.
So until the child is one year old.
DeShazo: But wait, this is what everyone says
is why so many girls get pregnant.
There's money in this, right?
Are there direct cash payments to mothers
who have these babies out of wedlock?
Not from Medicaid.
There are no direct cash payments.
The only thing Medicaid is allowed to pay for
are medical services or those services
that are surrounding medical services,
so transportation to the doctor would be one,
but there are no direct payments to the enrollees.
DeShazo: So there's another
myth cleared up, right?
Teens can't make money off a baby.
Well, not so fast.
We couldn't get anyone to really agree
on this one way or another.
Take a look at some of these sound bites
from interviews of other people you'll see
from other shows this week.
Are you aware of the economic benefits
to teenage mothers, to get pregnant
in the medicaid incentives in that regard?
Because you haven't mentioned anything about
the financial incentives women have to get pregnant
and stay pregnant if they're in poverty.
We don't think that's true.
We've never met a single young woman
or older woman who has decided to get pregnant
because she wants an extra $50.
The cap on money you can get from,
say, welfare is less than $150 a month,
and it's time limited to, I believe,
15 months, so you can't become wealthy
off public benefits.
And we've never encountered anyone
who has said, I wanted to have a baby to make money
because you don't make money,
you lose money.
Here you are, you're a teenager,
and you have a baby and what do you do?
You have no way to take care of them and then there
are programs that you can apply for and get help
with raising your child and who wouldn't do that?
They're available right?
And some of them do get caught into that system of...welfare.
We've got maybe about 5 who wanted to go back to school
but they kept coming up with excuses not to go to school.
These are the ones who are caught up in the system.
I want a job, I want money, I want an apartment,
but because you're in the system,
you've got an apartment that you pay a dollar
or five dollars or ten dollars a month.
You want a job, but you've got this little money
coming in, so you're not trying really to find a job.
I've gone out and I have found jobs for several
women and they didn't take them.
I don't understand that.
When you need a job, you say you want a job,
and then later, when we talk,
their greatest need is a job.
I need a job.
Some are motivated more so than others.
DeShazo: So is there an answer?
Well, we didn't find one.
Based on what we found financially,
we find it very hard to believe that anyone
can survive on what Medicaid and other
public assistance programs provide to teen moms.
So, what's the key here and how do we keep these girls
from getting pregnant in the first place?
Well, everyone from the top down seems to agree
that education is the answer.
But in Mississippi, that's easier said than done.
Many state laws make it hard for educators
and school nurses to discuss specifics with students.
One of the most frustrated people we talked to during
this entire process was a school nurse
who also works at a public health clinic.
By working on both sides of the medical world,
she sees what good and bad can be done
when teens get only one part of the message.
(voice is altered) In the school setting,
here in Mississippi, as you know,
the law forbids us to do much more education
than basic anatomy, which they're not getting
as it is, obviously.
We cannot do birth control, talk about birth control options.
We can talk about STDs, but not how to prevent them.
It's an abstinence only world in Mississippi
and I think that really hampers us at this point.
DeShazo: We aren't able to show you
this school nurse's identity because she is afraid
of the repercussions of speaking out.
She and her colleagues are incredibly frustrated
by the things they see every day in the schools
where they work, but fear that speaking out
will cost them funding or even worse, their jobs.
I don't think our viewers probably have an idea
how many pregnant kids there are
in some of our public schools.
I think I've heard you say that in some
of the Metropolitan areas, in some of the high schools,
the numbers are very large.
Can you give us a range?
Very high.
In some of the local schools in the area,
it can be as high as 50-60 girls.
50-60 girls in a single school?
How many high schools are you aware of in the state
that have large numbers of pregnant teenagers in there?
Just off the top of my head,
I can probably...six that I've worked with or know.
DeShazo: And that's just the six
that she knows and works with.
There are plenty more in other parts of the state
that are struggling with the same problems.
Why?
Because so many of Mississippi's teenagers are having sex.
Are most of the kids you're seeing thinking about
having sex or already having sex?
It's both.
I would say the majority, as you know,
some of the research done in the state,
have 75% of our high school students have had sex,
and I mean the numbers, I'd be surprised if it weren't
more than that to be honest with you.
Are the majority of the ones that are having sex
having unprotected sex?
Talking to them, yes, and it's because
a lot of times, they have no knowledge of what to do.
It's very frustrating.
A benefit of when I'm working in a regular clinic
and when I have the teens come in,
I have no barriers as to what I can discuss
with them and talk
to them about their options and stuff.
So I feel like I get my point across
a lot better in those settings
versus when I'm in a school setting where
I have to be real conscientious
about what we talk about.
But yes, I would say our numbers
are higher than that 75%.
DeShazo: So what does a school nurse do?
Are there ways to get around the rules?
Or do they break the rules?
Are there work arounds that health professionals use
to get this information or you just don't get it?
Well, we can't in the school system.
A lot of times we have good relationships
with outside the school system for referral.
The problem there is you gotta worry about
is the parent able to pick the child up
and take them to those appointments
and in some areas of the state,
it's so rural, it's hard, transportation
and other options.
There are no other options to get
to those other health care providers.
DeShazo: This is a problem
that continues to frustrate.
Because even if a parent comes with a child
to ask for help, she can't provide it.
Sometimes parents come in with their children wanting
information about birth control and planning
and so forth, and you can't give it
even when parents are there?
Right.
In the school setting.
That is correct.
Even with the parents coming in or calling
and saying, please, I know my daughter
is having sex or my son is having sex.
Please talk to them about this.
Our hands are tied.
We have to talk about abstinence
and abstinence only.
DeShazo: This nurse's frustration
with the abstinence message
was something we heard repeatedly.
Nurse: At this point, if they come in and ask
say if it's a school setting,
if they come in asking about,
they want birth control or how to prevent STDs,
we can't say put a ***, you need to teach
your boyfriend how to put a *** on
or we can't prescribe you
birth control pills or shots or anything
like that because of Mississippi Law.
We can't even talk about our options.
We have to talk about that abstinence
is the only way to go.
That no sex is it.
Abstinence is great.
I think it's the way to go.
But it's not working.
The kids are having sex and I think we'd be better off
for them to have the options on how to prevent it,
and what happens, the consequences.
DeShazo: Things may improve in the fall
for some school nurses when new Mississippi legislation
will lead to some schools teaching
abstinence plus sex ed in schools.
Do you think that the abstinence plus curriculum
that's been approved is going to be adequate
to prevent pregnancy, even with that?
I think that it will be a huge step
in the right direction.
Nothing's going to be 100% fool proof,
but I think for sure, it's a step
in the right direction.
It's a big step for Mississippi,
I'll put it to you that way.
A lot of information in this program tonight,
some of it good, some of it very bad,
and some of it very enlightening.
What can we take away?
Well we, as a state, need to do a better job
of educating our teenagers both boys and girls
about sex and the consequences of sex.
Whether those be consequences like
unwanted pregnancy or sexually transmitted diseases.
If we don't, more and more of them
will be spending time in places like this.
And if the images of these tiny,
sick babies don't tug at your heartstrings,
then maybe the cost to keep them alive will
because it's costing you, the Mississippi taxpayer,
to keep their heart beating and their lungs breathing.
So whatever it is that moves you,
your heart or your wallet,
hopefully it makes you take notice.
If you want more on the information we've shared
with you tonight, like the statistics surrounding
teen pregnancy or the department of Medicaid
or the Department of Health, just visit our website,
www.southernremedy.org.
All that information will there,
along with plenty other helpful information.
We'll be back here tomorrow night with more
on teen pregnancy in Mississippi
and I promise you
tomorrow night's show will be an eye opener.
We're keeping it simple.
Me, three girls and three babies.
One conversation.
You won't want to miss it.
I'm Dr. Rick deShazo.
Thanks for watching.
♪♪
♪ Hush a-bye don't you cry ♪
♪ Go to sleep little baby. ♪
♪ When you wake you shall have ♪
♪ All the pretty little horses ♪
Support for Southern Remedy and Premature Parenthood
comes from The University of Mississippi Medical Center.
More information at www.umc.edu.
Support for the Premature Parenthood comes
from the Healthy Teens for a Better Mississippi Initiative,
the Mississippi Department of Human Services
and the Mississippi State Department of Health
are working with community leaders in an effort
to lower teen pregnancy rates and advance healthy choices
among Mississippi teens.
For more information, go to:
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