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Inside County Government

Mecklenburg health director: Long-acting contraceptives will curb unintentional pregnancies

By Jonathan McFadden

jmcfadden@charlotteobserver.com

February 05, 2016 2:01 PM

Mecklenburg County’s health director said he wants the county to step up its efforts at providing new mothers and sexually active women with contraceptives to help reduce their chances of an unintentional pregnancy.

About 29 percent of county mothers on Medicaid receive access to postpartum contraception in the six-week period after giving birth. That’s below the statewide average of 35 percent, said Marcus Plescia, who has led the county health department since 2014.

To boost services, Plescia wants the county to invest in long-acting reversible contraception, which includes birth control implants and other pregnancy suppressants that can be inserted into a woman’s uterus. They last for years and can be voluntarily removed.

“We are not doing enough to help women who have just given birth to a child to have control over when or if they get pregnant again,” Plescia told commissioners during their budget retreat last week.

At the tail-end, we are doing an abysmal job of making sure they have what they need to plan where they go from there.

Mecklenburg County health director Marcus Plescia

Prenatal clinics in the county do “an extremely good job of taking care of women who are pregnant,” he said. But “at the tail-end, we are doing an abysmal job of making sure they have what they need to plan where they go from there.”

The result: Many women are getting pregnant again at six months, a year, and a year and a half. That puts them at “great medical risk in that next pregnancy,” he said.

It’s not happening just in Mecklenburg. The Centers for Disease Control and Prevention reported that 50 percent of all pregnancies in the U.S. in 2013 were unintentional, with higher rates among young women, minorities and women with lower levels of education and income.

Long-acting reversible contraception methods “have a good track record” of preventing those unplanned pregnancies, Plescia said. “We think those are very safe and very much a viable option. This is the way to go for many women who need a convenient way to control their family size.”

Some commissioners last week were concerned that Plescia’s efforts only target women. Commissioner George Dunlap asked what the department is doing to educate men.

The last woman I knew to have a baby without a man was Mary.

Mecklenburg County Commissioner Ella Scarborough

“How many men know that if you have intercourse with your woman after a pregnancy, she’s probably more inclined to get pregnant again in a short period of time?” he asked.

Fellow Democrat Ella Scarborough took it one step farther: “What’s wrong with us talking about having vasectomies for men and boys? The last woman I knew to have a baby without a man was Mary.”

A vasectomy – although reversible – is a form of sterilization that should be considered permanent, Plescia said.

And considering the state’s painful history involving sterilizations and eugenics, he said Friday, “that’s not something we’re going to promote.”

Marcus Plescia, Mecklenburg County health director Diedra Laird dlaird@charlotteobserver.com

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