As Secretary of the Department of Health and Human Services, Mike Leavitt seems more concerned about leaving the agency the legacy of his faith than any victory for patients' rights or public health. His recent proposed regulation will extend to health practitioners the right to refuse any care to patients that they find "objectionable," a category the proposal disturbingly leaves up to the individual health care worker to define. The American public has a few days left (until September 25) to voice an opinion for the agency to consider before it makes its final decision to approve or reject the extreme proposal.

You may submit electronic comments on this regulation to http://www.Regulations.gov or via e-mail to consciencecomment@hhs.gov. To submit electronic comments, go to http://www.Regulations.gov, and click on the link ‘‘Comment or Submission’’ and enter
the keywords ‘‘provider conscience’’. (Attachments should be in Microsoft
Word, WordPerfect, or Excel; however, they prefer Microsoft Word.)

Usually after getting raped, victims are in the market for many years worth of therapy, several self-defense courses to try to put the mind at ease, and possibly a splurge for various bolt-locks and security devices for the car and home. But for those getting raped in Wasilla, Alaska, then-Mayor Palin had another idea for how victims' should spend their money. In a stroke of evil genius, Palin decided to pass the cost of rape kits and forensic exams used to collect criminal evidence onto the victim. According to the Women's E-News, Alaska has the highest sexual assault rate in the nation. So, clearly the situation reeked of a small income opportunity. But those digging deeper suspect that callously taking advantage of a woman in her most tormented hour was not the only motive for Palin. Appeasing religious extremists may have been another (not that the two don't normally go together.) Some smart bloggers are connecting the dots. Hekebolos at Daily Kos suggests that the real reason why Palin refused to foot the rape bill was because the rape kits contained emergency contraception--a pregnancy prevention method opposed by the anti-abortion movement (along with all other forms of contraception for that matter.) The thinking being: not only would the city profit a little by charging the victims, so could Palin's career.

Now that the national attention on Bristol Palin's pregnancy is fading (for the time being) it seems the only discussion it inspired was about John McCain's vetting process and, by extension, his decision-making abilities. But there is another far more important subject raised by the 17-year-old's pregnancy. For decades, teen pregnancy has been viewed as a problem, a danger to the children of young mothers and a hurdle to the success of the adolescent mothers. Even pro-lifers recognize this, and have said they want to reduce the number of teenage pregnancies. (Their solution, and the Palin's, to teach abstinence until marriage, is a proven failure, but that is a subject for another time.) Now, despite the apparent acceptance, and even cheering in some quarters, for Bristol Palin, all signs suggest the problem may get a lot worse.

Clearly one of the exacerbating factors is that someone like Bristol Palin is part of what feels like a growing trend: the normalizing of teen pregnancy and teen motherhood in the United States. Bristol is not alone in suggesting that to be a 17 year old mother is not only acceptable, but exciting. Last year Jamie Lynn Spears, Britney's then 16 year old sister, had her baby. (The Spears', it's worth noting, were proponents of abstinence-only too.) Last year also featured the movie Juno, in which star Ellen Page played a 16 year old whose quick-wit and sarcasm made her unwanted pregnancy seem as challenging as a bad case of acne. The attention garnered by each of these girls stripped away layers of what had for years been cautions against this very fate.

None of these occasions has prompted examination of the risks and damage caused by teen pregnancy and teen motherhood. And, it should be noted, recent data show that the rate of teen pregnancy in the U.S., which is already the highest in the developed world, is on the rise. The last year witnessed a dramatic 3% spike in the number of pubescent parents.

Of course, Bristol, Juno and Jamie Lynn don't exemplify the average American girl confronting unplanned pregnancy. And the problem is the average American teen doesn't really know that. The choice the fictional character Juno made, adoption, is almost a fiction these days too. Only 1% of pregnant teens opt to give a child up for adoption. And then Jamie Lynn Spears is a teen millionaire. Her pregnancy only enhanced her fortune. The first photos of her baby fetched a million dollars. The spotlight on Bristol Palin offers false comfort too. Bristol has resources available to her that none of her pregnant teen counterparts does—like the secret service, the ultimate nanny.

These public displays of contraceptive failure by girls of visibility and means gives the misleading appearance that teen motherhood might be a lifestyle upgrade. Based on the example of Jamie Lynn, Juno and Bristol, the average teen girl would be led to believe that teen pregnancy doesn't ruin adolescence, but instead brings lavish amounts of attention, an adoring and adorable teen father, and an endless supply of parental support. The reality for most teen moms could not be more different.

According to the National Campaign to Prevent Teen and Unplanned Pregnancy, eight in ten teen fathers do not marry the mother of their first child. Countless studies show the absence of a father can have life-long consequences. Kids without involved fathers are twice as likely to drop out of school, twice as likely to abuse alcohol or drugs, twice as likely to end up in jail, and two to three times more likely to need help for emotional or behavioral problems. Children who live apart from their fathers are also five times more likely to be poor than children with both parents at home.

Teen mothers, typically left to go it alone, are less likely to complete the education necessary to qualify for a well-paying job —less than 50
percent of teen mothers ever graduate from high school compared with about three-quarters of similarly situated young women who delay childbearing until age 20 or 21.5 In fact, parenthood is the leading cause of school drop out among teen girls. College then becomes the remotest of possibilities. Less than two percent of mothers who have children before age 18 complete college by the age of 30.

Too often heartbreaking sacrifices are also foisted on the child of a teenage mom. The children of teen mothers are more likely to be born prematurely and at low birthweight compared to children of older mothers, which raises the probability of infant death and disease, including chronic respiratory problems, mental retardation, and mental illness. Children of teen mothers do worse in school than those born to older parents. They are 50 percent more likely to repeat a grade and are less likely to complete high school. The children of teen parents also suffer higher rates of abuse and neglect (2 times higher).

Teen girls and their children are not the only ones paying dearly. Teen childbearing in the United States costs taxpayers (federal, state, and local) approximately $9.1 billion each year. Most of the costs of teen childbearing are associated with services to address the negative consequences detailed above.

The issue of teen pregnancy needs to be taken seriously and there's no better time than an election year to demand that.

Thanks to aki.kyozoku for the image