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Washington Times Examines Proposed Teen Pregnancy Prevention Initiative In Obama Budget Plan
The Washington Times recently included a two-part series examining President Obama"s proposed reallocation of abstinence-only sex education funding in his 2010 budget plan. The proposal would redirect funding toward a new Teen Pregnancy Prevention Initiative that uses comprehensive sex education curriculums. Summaries of the series appear below.~ Part 1: Obama"s budget proposal states that funds for the Teen Pregnancy Prevention Initiative should go to programs that are proven to help delay first sex, increase contraceptive use or reduce teen pregnancy, though a few advocates of comprehensive sex education say such goals are laudable but too narrow, the Times reports. William Smith -- vice president for public policy for the Sexuality Information and Education Council of the United States -- and James Wagoner -- president of Advocates for Youth -- wrote in a June 17 blog entry that preventing unintended pregnancy among teens is "incredibly important" but that it is "not the only sexual and reproductive health issue facing our nation"s youth." They continued that it would be more beneficial to "expand the scope" of the initiative so it can serve "all young people in all communities, including lesbian, gay, bisexual, transgender and questioning youth, whose needs fall wholly outside of the narrow teen-pregnancy-prevention framework." According to the Times, Smith said in an interview that money allotted for the initiative would be best used if it went to programs focused on "good outcomes" for youth, "not these disaster-aversion silos that don"t serve us well." Wagoner said that advocates have been "very clear in giving the president credit for shifting tracks here in a big way" by ending funding for abstinence-only sex education. However, he added that it is "our job to press for the right destination" and to see the changes implemented into law (Wetzstein, Washington Times, 6/28).~ Part 2: Some supporters of Obama"s proposal argue that it is "exactly the right idea, at the right time," as the U.S. teen birth rate has increased in the last two years after 14 years of decline, the Times reports. Sarah Brown, CEO of the National Campaign To Prevent Teen and Unplanned Pregnancy, said that Obama"s proposal is the "first really focused expenditure on effective teen pregnancy prevention programs." Brown noted that the U.S. has the highest rates of teen pregnancy and birth in the industrialized world. She said that the best programs will address one or more of the three goals of the initiative -- delaying first sex, increasing contraceptive use or reducing teen pregnancy. Last month, about 175 organizations sent a letter to Obama and members of Congress calling for an expanded initiative that would include subjects such as sexually transmitted infections and abusive relationships. However, Brown said that many teen pregnancy prevention programs include discussion of STIs and other areas, "[s]o we really don"t see much tension here" (Wetzstein, Washington Times, 7/5).
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Exercise Is Healthy For Mom And Child During Pregnancy

Physicians should recommend low to moderate levels of exercise to their pregnant patients, even if they have not exercised prior to pregnancy, states a report published in the August 2009 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS). According to this review article, exercise can strengthen and improve overall musculoskeletal and physiologic health as well as pregnancy related symptoms. Exercise such as aerobics, impact and nonimpact activities, resistance training and swimming: -- eases back and other musculoskeletal pain; -- lowers maternal blood pressure; -- reduces swelling; and -- improves post-partum mood, including sadness. According to study author Capt. Marlene DeMaio, M.D., M.C., U.S.N., Research Director, Naval Medical Center, Portsmouth, Virginia, data shows that the pregnant woman"s body can compensate for the changes with no harm to the fetus during low to moderate intensity exercise. "It is important to remember that pregnancy is a temporary condition, not a disease, and that the musculoskeletal and physiologic changes that happen are normal in the majority of patients," she said. Capt. DeMaio"s findings contradict what some physicians recommended in the past. As recently as the 1990s, there was concern that exercise could be detrimental to a pregnant woman and her fetus. These past concerns included a focus on normal changes related to musculoskeletal health that occur during pregnancy, such as increased ligament laxity, weight gain and change in the center of gravity. Today, some physicians continue to advise their pregnant patients to ease back on exercise or refrain from it altogether if they have not already made it a part of their lifestyle. DeMaio, who collaborated with Capt. Everett Magann, M.D., M.C. U.S.N., Chairman in the Department of Obstetrics and Gynecology, also at the Naval Medical Center in Portsmouth, not only reports that exercise is important during pregnancy, but also believes that starting an exercise program when pregnant, is a perfect way to begin - and stick with - a fitness program. "When a woman becomes pregnant, she often re-evaluates her lifestyle," said Dr. DeMaio. "She is motivated in a new way to deliver a healthy baby, and be healthy herself." Physicians may recommend exercise for pregnant patients in the following categories: -- Prenatal: Patients should begin or continue low to moderate exercise. The goal is to maintain fitness and adapt exercise as needed as pregnancy progresses. (For example, runners might switch to running in a swimming pool later in their pregnancy.) -- Postnatal: Continue exercising at low to moderate levels. Lactation is not negatively affected by exercise. There are fewer reports of mothers having post-partum depression or mood changes when they are exercising. -- Older: Exercise is even more important if the patient is older, according to Dr. DeMaio. The risk for high blood pressure and increased glucose goes up the older a patient is, but exercise can help reduce these levels. -- Obese: Physicians should discuss pregnancy as an opportunity to improve overall health and suggest the patient start exercise for life-long health and as an example to the child when the child is older. -- Infertile: Even if a woman is under treatment for infertility, she can exercise under the supervision of her obstetrician. -- Athlete: For a pregnant woman wanting more strenuous exercise, or who wants to increase training from moderate to high intensity, a qualified doctor should direct her exercise program. Disclaimer: The views expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense or the United States Government. Dr. DeMaio serves as a board member of the Association of Bone and Joint Surgeons and the publications American Journal of Sports Medicine and Clinical Orthopaedics and Related Research in an unpaid capacity. Neither Dr. Magann nor a member of his immediate family has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article. American Academy of Orthopaedic Surgeons


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