Reproductive health in the USA: must do better

January 22, 2014 • Reproductive Health, United States, News

Reproductive health in the USA: must do better
The Lancet

On Jan 7, the Washington-based Population Institute released its second annual report card-The State of Reproductive Health and Rights: 50-State Report Card-which compares US states’ rankings in reproductive health and rights. Because reproductive health and rights in the USA have had such a long and difficult history, the report makes for both intriguing and disturbing reading. Over the past 3 years, there has been a disappointing increase in restrictions on abortion rights. Many Americans have been aware of this debate at the national level, but uninformed about the status of reproductive health in their own state.

According to the report card, the results for reproductive health in the USA are neither encouraging nor consistent across the country. The report gives the nation a C- overall, largely due to abortion restrictions and cutbacks in support for family planning services. The grade is derived from a score based on four reproductive health categories-effectiveness (maximum 30 points), prevention (20 points), affordability (30 points), and access (20 points); and on nine indicators including teen pregnancy rate, sex education, access to emergency contraception, Medicaid family planning expansion, and abortion access. 13 states, including Georgia, Indiana, and Texas, received a failing grade (F). Only 17 states received a B- or higher, with Oregon receiving the highest composite score (A). Nine states were awarded a C grade, including Massachusetts, mainly due to its lack of both sex education in public schools and expansion for Medicaid family planning services.

Norway, one of the world’s most successful countries in terms of WHO’s reproductive health indicators (eg, access to abortion services and contraception), sets an excellent example for America to aspire to. Every woman in the USA should be able to access affordable reproductive health care irrespective of economic and social status. Moreover, comprehensive sex education services should be available for young people in school regardless of where they live. All US states should consider expanding Medicaid eligibility and reducing the cost of accessing contraceptive services to reduce such glaring inequalities in reproductive health.

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