|All Access EKY trains young Eastern Kentucky women to|
push reproductive health. (Photo by Hero Images/Getty Images)
Barriers to getting birth control in Eastern Kentucky are "profound," Brashear reports, and extend way beyond the ordinary obstacles of cost and access to care, to things like having access to reliable transportation (there is no public transportation), knowing if the employees at the clinic go to the same church as your parents, or simply finding a doctor who is willing to prescribe it.
"This is all assuming she knows anything about her birth-control options in the first place," Brashear writes, adding that many young women in Eastern Kentucky "must battle abstinence-only sex education in their schools and a cultural veil of secrecy about their bodies in order to fully understand their options."
She reports that only six of the 19 health departments and federally qualified health clinics in All Access EKY's seven counties offer the full range of birth-control options, and have only four nurse practitioners at public health clinics who are qualified to insert intrauterine devices (IUDs).
All Access, which began in 2016, is working to overcome these barriers by offering young women from the region an eight-week paid fellowship to create educational films that focus on birth control, with interviews of local women about their reproductive health experiences.
The women have also produced social-media campaigns, set up tables at local festivals, and distributed printed materials through clinics and local businesses, Brashear reports in her story, titled "Where Birth Control is Scarce, Young Women Create Sex Education Outside the Classroom."
Project director Stacie Sexton told Brashear that All Access works to bridge the reproductive health information gap between the publicly funded health-care providers and community members and helps clinics educate providers about birth control, using materials created by the fellows.
“That’s what makes this project unique,” Sexton told Brashear. “It’s community-centric rather than focusing on just the media side of it, or just the institutional side of it.”
Brashear reports that All Access has completed two eight-week fellowships, hired 13 fellows, and produced 20 media pieces. This summer, seven are in a six-week media workshop in partnership with Appalshop’s youth media program, Appalachian Media Institute.
“We’re trying to build some of these bridges in our communities so it’s not just teenage girls on an island and health care providers on an island and educators on an island,” All Access Media Director Willa Johnson told Brashear. “They all need to be working together to give young people a better opportunity.”
Johnson added that the program has allowed the fellows to explore a career path other than nursing or education, and that many of them have provided birth control education outside of the fellowship.
The program has also worked with policymakers on this issue. Sexton noted that Rep. Chris Harris, a Democrat from Pikeville, sponsored a bill to make it easier for women to get their birth control, and even though it didn't pass, she said their work with him was important.
She said they have also worked to find ways to work with Sen. Brandon Smith, a Republican from Hazard, who sponsored a successful bill in 2017 to ban abortions after 20 weeks. She told Brashear that his political views don't deter her from reaching out to him, stating that that would be a disservice to the the region to not work with as many people as possible to increase access to birth control.
“At the end of the day, if [Smith] wants to increase access [to birth control] to reduce abortions, we have a common goal,” Sexton told Brashear. “We come from different places, but I think we both have our hearts in the right place based on our personal value systems. He’s doing what he thinks is right; I’m doing what I think is right, but we do have a shared interest in increasing access to birth control. I can work with that.”
Why does it matter?
The 2017 Youth Risk Behavior Survey found that 38 percent of Kentucky's high-school students report that they'd had sex, and 29 percent reported being sexually active, defined as having had sexual intercourse with at least one person during the three months prior to the survey.
Of the 29 percent who were sexually active, 16.5 percent of them reported not using any method of birth control the last time they had sex; and nearly 89 percent of them didn't use both a condom and another method of birth control as is recommended.
The survey also showed that Kentucky's sexually active teens aren't using the most reliable forms of birth control; 75.5 percent reported that they did not using birth control pills the last time they had sex; 92.3 percent did not use an IUD or an implant; 94 percent did not use a patch, birth control ring or get a shot; and 51.3 percent of them did not use a condom.
And while teen birth rates in Kentucky continue to drop, to an average of 34.6 per 1,000 between 2013 and 2015, down from 37.9 between 2012 and 2014, and 48.9 five years ago -- Kentucky's teen pregnancy rate continues to be significantly higher than the national average of 22.3 per 1,000, according to the 2017 Kentucky Kids Count report.
The report also found that 16 Kentucky counties had teen-birth rates of 60 or more per 1,000, with Wolfe County leading the way at 80.9 per 1,000. That's up significantly from 68.2 five years ago. The report shows teen birth rates for every Kentucky county.
Brashear reports that out of all the pregnancies in Kentucky, 47 percent are unplanned.
A much debated bill about sex-education standards, passed during the past legislative session, requires any Kentucky school that offers sex ed to include instruction that says abstinence is the desirable goal for children, that abstinence is the only certain way to avoid unintended pregnancy or getting a sexually transmitted disease, and to teach students that the best way to avoid sexually transmitted diseases is to establish a "permanent, mutually faithful, monogamous relationship."
The new law does not require abstinence-only education, but opponents say it should have required comprehensive sex education in Kentucky schools, and by that omission sends a message to schools to teach abstinence-only curriculums, which the critics say have been proven ineffective.
Kentucky has no specified standards for sex education curriculums, though the state Department of Education has said that it is working on them. That was before the recent ouster of the department's commissioner.