Policy & Practice


Teen Births Up, Reversing Trend

The teenage birth rate increased by 3% in 2006, rising for the first time since 1991, according to preliminary data from the Centers for Disease Control and Prevention. Between 2005 and 2006, live births among teens aged 15–19 years rose from 40.5 per 1,000 to 41.9 per 1,000. This increase comes after 14 years of declines in the teen birth rate, which peaked in 1991 at 61.8 live births per 1,000 females. “It's way too early to know if this is the start of a new trend,” Stephanie Ventura, head of the reproductive statistics branch at the CDC, said in a statement. “But given the long-term progress we've witnessed, this change is notable.” Some abortion rights advocates point to the news as a sign that the federal government's push for abstinence-only education is backfiring with teens. “Congress and President Bush need to face the facts: Refusing to teach teens about birth control only leads to higher birth rates and rising rates of sexually transmitted infections,” Dr. Suzanne T. Poppema, board chair of Physicians for Reproductive Choice and Health, said in a statement. The full CDC report is available online at

ACOG Defines 'Conscience' Policy

There are limits to when it is appropriate for physicians to refuse to provide reproductive health care on moral grounds, according to a new committee opinion from the American College of Obstetricians and Gynecologists. Physicians have a responsibility to refer patients to other providers in a timely manner if they cannot perform reproductive services in good conscience, according to the opinion issued by ACOG's Committee on Ethics. The committee also cautioned that physicians working in resource-poor areas should ensure that referral processes are in place so patients can continue to access services. ACOG's policy was viewed as an attack on “pro-life” physicians by the Christian Medical Association (CMA). In a letter to ACOG president Dr. Douglas W. Laube, the CMA and a number of other faith-based organizations called for the withdrawal of the committee opinion. “ACOG's misguided and uninformed public statement on conscience limits is bound to have the effect, whether unintended or actually intended, of discouraging persons of faith from practicing or choosing obstetrics and gynecology as a profession,” CMA wrote in the letter. ACOG officials had no comment on the letter.

Covance Makes iPledge Changes

Covance, the company that developed and manages the iPLEDGE risk management program for the acne drug isotretinoin, has formally incorporated changes to the program that have been finalized by the Food and Drug Administration. The most important change was an elimination of the 23-day lockout period for women of child-bearing potential. At that time, the FDA also said the program would now start the 7-day window for the initial prescription for women of child-bearing potential from the date of pregnancy testing, instead of the date of the office visit. To see all the latest changes, please visit

Education May Delay Teen Sex

Adolescents who received formal sexual education before having sex for the first time were more likely to have delayed sex until at least age 15 years, according to an analysis from researchers at the CDC. Among adolescent girls aged 15–19 years who had received formal sex education before first sex, only 9% reported engaging in sex before age 15, compared with 22% of those who did not receive sex education before first sex. The study, which was published in the January issue of the Journal of Adolescent Health, found similar results among male adolescents. Only 10% of boys who received sex education before their first time having sex engaged in intercourse before age 15, compared with 32% of boys who had not had formal sex education. The analysis is based on the results of the 2002 Survey of Family Growth, a nationally representative survey with information on sexual activity, use of contraception, and births. The researchers analyzed data from 2,019 individuals aged 15–19.

FDA Sets User Fees for DTC Ads

The FDA is charging pharmaceutical companies about $40,000 to review each of their direct-to-consumer television advertisements, according to a notice issued by the agency last December. Last September, Congress authorized FDA to create a user fee program for the advisory review of DTC prescription drug television advertisements. The program is voluntary and drug sponsors can choose whether to seek FDA advisory review of their ads before broadcast. However, if they seek review by the agency, they must pay the fee. The $41,390 fee established for fiscal year 2008 is based on the number of ads slated for review and is expected to generate $6.25 million in total revenue during the first year of the program.


Next Article: