Pregnancy resources for Cochise women limited

Many reproductive health resources in Cochise County focus on preventing teen pregnancies and promoting family planning, leaving abortion and sex education limited.

Limitations include a slant toward abstinence-only, Christian-based education in some schools and organizations, and a bias against homosexuality in HIV education.

A lack of free abortion referral services and “women’s right-to-know” counseling sessions earned Arizona a listing in 2014 as “extremely hostile”  toward abortions from the Guttmacher Institute, a sexual and reproductive health and rights research and policy group.

Services offered

Services available from Cochise County Health and Social Services, CareNet Pregnancy Center of Cochise County and area schools are limited, but still contribute to contraceptive use, sex education, family planning and the women’s right to know counseling.

Cochise County Health and Social Services offers abstinence-based education in eight high schools and six middle schools across the county through their Teen Pregnancy Prevention program. According to statistics provided by Judith Gilligan, prevention services director for Cochise Health and Social Services, 1,461 children and teens between the ages of 12 and 18 in Douglas, Bisbee, Sierra Vista and Willcox were served by program in 2015.

Four curriculums are offered to high schools, and three are offered to middle schools. Each curriculum slightly differs for age or school preference, but most include sections about abstinence, the consequences of sex, sexually transmitted infections, condoms or contraception and “refusal and negotiation skills.”

“There are two kinds of evidence-based teen pregnancy prevention curriculums – abstinence ‘only’ which means no protection methods are taught at all, and abstinence-‘based’ which means abstinence is proposed as the best method to prevent pregnancy but protection methods are also taught,” Gilligan said.

Meanwhile, the department’s Family Planning program offers pregnancy tests, contraceptives, STI treatment and family planning counseling. These resources are confidential and free for those under 18 and below 150 percent of the Federal Poverty level.

Unlike the Teen Pregnancy Prevention program, however, Family Planning is unable to work directly with schools, according to Catherine Welch, Family Planning Coordinator. This is because the federal Title X program allows for confidential access to contraceptives and family planning care for teens, but in Arizona, parental notification is required for sex education and care.

The offices for Health and Social Services, which provide Family Planning care, are located in Benson, Bisbee, Douglas, Sierra Vista and Willcox. Women in other towns and more rural areas will travel to one of these locations for services, Welch said.

In contrast to Health and Social Services’ multiple locations across the county, CareNet Pregnancy Center of Cochise County is set in Sierra Vista. Though the state of Arizona has 38 crisis pregnancy centers, CareNet is the only one in Cochise and the county’s only free women’s right-to-know counseling resource.

Tina Upshaw, executive director of CareNet Pregnancy Center of Cochise County stands in front of her clinic's baby boutique. Parents may exchange "mommy money and daddy dollars" earned through taking classes for clothes, toys, books and more. (Photo by: David Mariotte/ Tombstone Epitaph)
Tina Upshaw, executive director of CareNet Pregnancy Center of Cochise County stands in front of her clinic’s baby boutique. Parents may exchange “mommy money and daddy dollars” earned through taking classes for clothes, toys, books and more. (Photo by: David Mariotte/ Tombstone Epitaph)

The counseling walks pregnant women through three options: parenthood, adoption and abortion. A non-medically trained volunteer counselor will show the development of the fetus, offer resources like informational videos, create a pros and cons list with the client and provide a “pregnancy packet,” which is a collection of pamphlets, booklets and a magazine called “Before You Decide.”

“The motivation behind the center and this organization is no one should have to go through this major a decision by themselves,” said Tina Upshaw, executive director of CareNet Pregnancy Center of Cochise County.

The center also provides a number of parenting classes called “Earn While You Learn.” Parents can learn essential skills while earning credit at the center’s baby boutique store, a donation driven shop for baby clothes, diapers, furniture, books and more.

CareNet also offers abstinence-only sex education programs at schools in the Sierra Vista area, including Buena High School, which last year partnered with both CareNet and the Teen Pregnancy Prevention Program.

According to Buena Principal Joe Farmer, CareNet comes in for a two-day presentation each semester. The first falls during the week of homecoming in the fall and the other during the week of prom in the spring. Given the program’s abstinence-only nature, CareNet has not taught contraceptive use over its 15-year partnership with the school.

Now that Buena partners with the Teen Pregnancy Prevention program, a condom demonstration is included in  sex education curriculums. Parents are given permission slips and may opt their children out, though Farmer estimates that less than one percent of parents choose to do so.

Beyond their partnerships, Buena employs teachers certified in Health education who cover topics like STIs, HIV education, dating, relationships and the reproductive process. The Health class at Buena runs for one semester and is mandatory for graduation.

Limitations and loaded language 

Though the number of free and low-cost providers is small, there are some essential services rendered by Health and Social Services, CareNet and the schools. However, within those are problems from the inability of some to have easy physical access to family planning to state-mandated homophobia in education.

Current legislation around HIV education in Arizona prohibits instruction that “portrays homosexuality as a positive alternative life-style” – despite recent findings from the J. Walter Thompson Intelligence group that show 52 percent of people age 13 through 20 identify as not exclusively heterosexual – or “suggests that some methods of sex are safe methods of homosexual sex.”

Sex education is similarly restricted in the state. According to the Guttmacher Institute, Arizona mandates that if sex education is offered, it must be age-appropriate and parents must consent. Any sex education in the state must stress abstinence, though abstinence-only education is at the discretion of school boards. Finally, the education must include information on “the negative outcomes of teen sex” and life skills on “avoiding coercion.”

It is not mandated, however, that the education be medically accurate, culturally appropriate or unbiased or that it cannot promote religion. Given the ability to teach abstinence-only, contraception information is not required.

This law exists despite a congressionally mandated study in 2007 that showed that abstinence-only programs “have no beneficial impact on young people’s sexual behavior,” according to the Guttmacher Institute. Since 2001, the rate of sexually active teenagers across the U.S. has remained in the 46 to 48 percent range by age 17.

Similarly, organizations such as the American Medical Association, the American Academy of Pediatrics, the Society for Adolescent Health and Medicine and the American Public Health Association have endorsed and supported comprehensive sex education that includes abstinence education, but also information about contraception. This approach is closer to the abstinence-based Teen Pregnancy Prevention program.

In terms of potential harm, a 2004 report by U.S. Rep. Henry Waxman, D-Calif., said that out of the 13 most common abstinence-only-until-marriage curricula of the time, 11 “contain medical misinformation, use fear and shame, blur religion and science, and perpetuate stereotypes about gender roles.” That misinformation included distorted information on the efficacy of contraceptives to shaming language that places value on virginity and dismisses sexually active women.

Access to abortion, abortion referrals and medically accurate information is also scarce in Cochise County.

CareNet, the only organization in the county that offers free women’s right-to-know counseling, does not provide abortion referral services because its volunteers are not licensed medical professionals.

To receive an abortion referral, one would have to visit a medical office in the county or drive to Planned Parenthood in Tucson. There are 38 free pregnancy centers in Arizona and seven abortion providers.

Many crisis pregnancy centers, including CareNet, are operated from a Christian point-of-view.

“My drive to continue in this field is absolutely the Lord,” Upshaw said. “I’m serving God first.”

Alternatives to abortion are encouraged, and CareNet employees are unable to give clients cost estimates of abortions.

CareNet’s “pregnancy packet” also includes emotionally loaded language — such as referring to a fetus as a “baby” — in a magazine-like booklet called “Before You Decide” about parenthood, adoption and abortion.

At the end of a Women's Right to Know counseling appointment at CareNet Pregnancy Center, clients are given a "pregnancy packet," including some of these materials. The information within some of the materials is medically misleading. (Photo by: David Mariotte/ Tombstone Epitaph)
At the end of a women’s right-to-know counseling appointment at CareNet Pregnancy Center, clients are given a “pregnancy packet,” including some of these materials. (Photo by: David Mariotte/ Tombstone Epitaph)

“Lots of growth happens during this time [implantation], settling the question of whether there is life, but some disagree about when this human life becomes a person,” the magazine says. It provides a very specific point of view.

The cover includes a sensationalized teaser  — “RU Sure? The ‘safe’ drug that can kill you” — in reference to RU-486, the medical abortion pill. Inside the magazine, it is only briefly mentioned that women who took RU-486 using off-label methods died because of an infection.

Meanwhile, on the next page, it mentions that the highest risk of death due to abortion is from a dilation and evacuation after viability, which is a surgical procedure that takes place far into the pregnancy. Even then, the quoted rate of death is about 1 per 11,000.

Similarly, some statistics are simply not mentioned, such as those for a first-trimester abortion done by pill, which is considered one of the safest medical procedures. The generally accepted rate of major medical complications from a medically induced abortion is about one-fifth of one percent, according to the Guttmacher Institute.

Revisions in reproductive education stall 

In President Obama’s proposed 2017 federal budget, all $10 million of the budget that funds abstinence-only education has been cut. Funding for comprehensive education remains, but the budget has not been approved and state efforts to reform sex education also seem to have stalled.

Arizona lawmakers introduced House Bill 2410 and Senate Bill 1019 in January to revise laws concerning sex and HIV education curricula. These proposed changes include removing homophobic material from HIV education, stressing the importance of proper contraceptive use, introducing sex education as early as kindergarten and requiring sex education to be medically accurate.

Neither bill has been revisited since January.

David Mariotte is a reporter for Arizona Sonora News, a service from the School of Journalism with the University of Arizona. Contact him at 

Click here for a Word version of this story and high-resolution photos.

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