Questions raised about state program offering birth control to i - WSMV Channel 4

A Channel 4 I-Team investigation found that an initiative is offering county jail inmates birth control as part of a larger state program.

The effort is part of a program that combats neonatal abstinence syndrome (NAS), which refers to the problems that can affect a newborn who was exposed to drugs in the womb.

Many of these preventative measures are playing out in the criminal justice system.

While many agree that NAS has become a major problem in Tennessee, some question if the state is going too far to prevent pregnancies.

On Sept. 23, women in handcuffs filed into a regional health center in Putnam County. Local deputies transported the group from and to the Overton County Jail.

Less than two hours later, the women walked out with birth control implants, the I-Team discovered.

 “I’m offended. I’m totally offended,” said Rep. Sherry Jones, D-Nashville.

“I was shocked. I was really shocked,” said Jeff Teague, president and CEO of Planned Parenthood of Middle and East Tennessee.

Interested inmates can sit through presentations that explain the dangers of NAS, according to the state health department.

The I-Team obtained the videos shown in the class, which are part of an effort to reduce the number of babies born dependent on drugs. A network news report details the symptoms newborns can live with as a result of NAS. The presentation also includes an interview with one woman who used drugs during three of her pregnancies.

“My middle child, he deals with it on a larger scale. It affects him on a day-to-day basis,” the woman said. “He has struggles everywhere, chewing his fingernails until he bleeds, unconsciously chewing on his clothes.”

A presentation explains all types of birth control. Afterward, inmates are given the option to start taking them.

In many of the presentations obtained by the I-Team, an emphasis is placed on “reversible, long-acting” birth controls, such as IUDs and implants.

But the initiative extends beyond jails. In one East Tennessee courtroom, drug offenders are mandated to take a class where they learn about the dangers of drug use and different options for birth control.

“The feedback I’m hearing is great gratitude that they know there’s this type of long-acting contraceptive … available to them at no cost,” said Judge Duane Slone, of the Fourth Circuit Court.

In some cases, taxpayers do help fund the costs.

At county health departments, a patient’s income and insurance determine how much he or she pays. In Tennessee, federal funding covers most family planning services.

“Patients with the lowest income may receive services at a very reduced or no cost, depending on their income relative to the sliding fee scale,” said Shelley Walker, a spokesperson for the health department.

The health department prices the implants at $632.75. An IUD is priced upwards of $681.35.

According to TennCare, it costs $44,000 to treat a baby with NAS, based on 2013 data.

“I suggest they do the math,” Slone said.

Since 2014, the health department said at least 244 women have received reversible birth control. State data shows that last year, more than 1,000 babies with NAS were born. So far this year, that number has dropped to 750.

Slone said that number reflects the success of the program.

“No question in my mind that’s true,” he said.

But others disagree.

“There is no way they can prove any of it,” Jones said. “They can’t prove how many babies someone didn’t have.”

Jones is on the House health committee. She questioned the program’s intent, especially since the state health department said birth control is available to all inmates, not just drug abusers.

“Do we just think women who have been incarcerated shouldn’t have babies?” Jones said.

Jones said the effort targets women in the criminal justice system.

Even organizations like Planned Parenthood that encourage accessible birth control have concerns.

“It certainly seems like it is,” Teague said. “It seems very … coercive. It seems paternalistic. It seems almost classist, in a way.”

Teague questioned whether the choice to take the birth control is truly voluntary.

“You are talking about women who are incarcerated, talking with people in positions of authority and who have power over their situations,” he said.

But those involved with the program countered those claims.

“I know the way we approach this population is anything but coercive,” Slone said.

The I-Team posed the same question to Tennessee Department of Health Commissioner John Dreyzehner, MD, MPH, FACOEM.

“What do you do to ensure this is 100 percent voluntary?” reporter Alanna Autler asked.

“At the end of the day, it’s a person, a nurse, a health care provider talking to a patient. That is our oath,” Dreyzehner said. “We want people to understand this is reversible. It’s not sterilization, it’s reversible, long-active contraception for women who want to take control of their lives.”

Tennessee became the first state to make NAS a reportable condition in 2013. Since last year, the effort has spread to more than 25 counties.

This program targets both men and women, but the health department could not provide figures on how many men have participated.

Documents obtained by the I-Team show patients are made aware of any side effects birth control may cause.

Officials said they meet with inmates as close to their release dates as possible.

Copyright 2015 WSMV (Meredith Corporation). All rights reserved.