Teen Pregnancy in Mississippi: A History and Analysis of Recent Legislative and Governmental Attempts to Address Different Aspects of this Issue in Mississippi.

Background Mississippi has one of the highest teen pregnancy and birth rates in the nation. From 1991 to 2014 the birthrate to Mississippi teens decreased by 55 percent, which ranks number 35 in the rate of decline (versus 61% nationally). However, in 2014 Mississippi's teen birth rate still kept it at number 48 out of 50 states.' Mississippi has implemented Healthy Teens for a Better Mississippi as a Governor's initiative and best practice programs to reduce teen pregnancy in the state of Mississippi. Several bills have been passed into law that address various aspects of teen pregnancy prevention. Methods Recent legislation implemented from 2011 to 2015 was reviewed and summarized. Results and Conclusions Teen births have decreased 55 percent from 1991 to 2014. It is not possible to point to any one factor that can explain this reduction. It is likely that many factors have affected this change in teen pregnancy and birth rates. It is still too early to be able to assess the effect of the various laws that have been passed to address teen pregnancy.

A second opinion: response to 100 professors.

Induced abortion is a controversial topic among obstetricians. "100 Professors" extolled the benefits of elective abortion in a Clinical Opinion published in AJOG. However, scientific balance requires the consideration of a second opinion from practitioners who care for both patients, and who recognize the humanity of both. Alternative approaches to the management of a problem pregnancy, as well as short and long term risks to women as published in the peer reviewed medical literature are discussed. Maintaining a position of "pro-choice" requires that practitioners also be given a right to exercise Hippocratic principles in accordance with their conscience.

Predicting depressive symptoms and grief after pregnancy loss.

Women who experience pregnancy loss are at high risk for depression and grief. We conducted a prospective cohort study to identify antenatal predictors of depressive symptoms and grief following pregnancy loss. Particular emphasis was given to the potential role of religiosity and spirituality. In multivariable linear regression models, depressive symptoms were significantly positively associated with baseline depression score and a history of mental illness. Depression scores were significantly inversely associated with age. Increasing age was also protective against post-pregnancy loss grief, as was participation in organized religious activities. Clinicians should be particularly alert to signs of depression following pregnancy loss in younger women and in women with a history of mental illness during or before pregnancy. The inverse association between religious attendance and grief following pregnancy loss merits further study.

Do antenatal religious and spiritual factors impact the risk of postpartum depressive symptoms?

OBJECTIVES: Previous research has identified an inverse relationship between religiosity/spirituality and depressive symptoms. However, prospective studies are needed. This study investigates the association between antenatal religiosity/spirituality and postpartum depression, controlling for antenatal depressive symptoms, social support, and other potential confounders. METHODS: This is a prospective cohort study. Women receiving prenatal care were enrolled from three obstetrics practices. Follow-up assessment was conducted at the 6-week postpartum clinic visit. Four measures of religiosity and two measures of spirituality were assessed at baseline. A measure of overall religiosity/spirituality was also created using principal component factor analysis. Depressive symptoms were measured at baseline and again at follow-up using the Edinburgh Postnatal Depression Scale (EPDS). A cutoff score of >or=13 was used to identify women with significant depressive symptoms. RESULTS: Four hundred four women were enrolled, and 374 completed follow-up. Thirty women experienced pregnancy loss, leaving 344 with postpartum assessment; 307 women had complete data and were used for analyses. Thirty-six women (11.7%) scored above the EPDS screening cutoff. Controlling for significant covariates (baseline EPDS score and social support), women who participated in organized religious activities at least a few times a month were markedly less likely (OR = 0.18, 95% CI) to exhibit high depressive symptom scores. No other religiosity/spirituality measure was statistically significant. CONCLUSIONS: Organized religious participation appears to be protective from postpartum depressive symptoms. Because this association is independent of antenatal depressive symptoms, we hypothesize that religious participation assists in coping with the stress of early motherhood.

Religiosity, spirituality, and tobacco use by pregnant women.

BACKGROUND: Tobacco use during pregnancy is associated with adverse child outcomes. There is evidence that religiosity/spirituality is associated with less tobacco use. This study aims to investigate the association further, including an assessment of overall religiousness and specific aspects of religiosity/spirituality. METHODS: 404 pregnant women receiving prenatal care in three southern obstetrics practices were surveyed regarding religiosity/ spirituality, other psychosocial characteristics, and recent tobacco. RESULTS: Recent tobacco use was reported by 8% of study participants. In multivariable modeling, black race (OR = 0.32), social support (OR = 0.92), and overall religiousness (OR = 0.57) were significantly associated with lower odds of reporting recent tobacco use. Participation in organized religious activities and self-rated religiosity were the religious/spiritual measures most strongly associated with lower odds of tobacco use. CONCLUSIONS: More religious/spiritual women appear to be less likely to use tobacco during pregnancy. Additional research is needed to investigate potential pathways for this association.

Religiosity, spirituality, and depressive symptoms in pregnant women.

OBJECTIVE: Depression during pregnancy has potential repercussions for both women and infants. Religious and spiritual characteristics may be associated with fewer depressive symptoms. This study examines the association between religiosity/spirituality and depressive symptoms in pregnant women. METHOD: Pregnant women in three southern obstetrics practices were included in a cross sectional study evaluating religiosity, spirituality, and depressive symptoms. Symptoms of depression were measured using the Edinburgh Postnatal Depression Scale (EPDS). The depression outcome was measured in two ways: the EPDS score as a continuous outcome, and a score at or above the recommended EPDS cutoff (> 14). A wide array of potential confounders was addressed. Special attention was given to the interplay between religiosity/spirituality, social support, and depressive symptoms. RESULTS: The mean EPDS score was 9.8 out of a maximum possible score of 30. Twenty-eight women (8.1%) scored above the recommended EPDS cutoff score. Overall religiosity/spirituality was significantly associated with fewer depressive symptoms when controlling for significant covariates, but there was a significant interaction such that the association became weaker as social support increased. Social support did not appear to be an important mediator (intermediate step) in the pathway between religiosity/spirituality and depressive symptoms. CONCLUSIONS: Religiosity and spirituality may help protect from depressive symptoms when social support is lacking. Longitudinal research is needed to assess the directionality of the observed relationships.

Are married/cohabiting women less likely to experience pregnancy loss?

Women who were neither married nor cohabiting were far more likely to experience pregnancy loss. The reasons for this association are unclear, and confounding due to medical, social or behavioral factors that are correlated with marital/relationship status is possible. On the other hand, our findings are consistent with a recent British study in which women who were neither married nor cohabiting had 73% greater odds of first trimester miscarriage. Based on these two studies, we recommend that clinicians who provide obstetrical care be especially vigilant to encourage healthy prenatal behaviors for patients who are not married or cohabiting.