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If even one woman decides to get on birth control while she is sexually active and drinking, it is worth all the efforts of a local program designed to help women make healthy choices, says Choices program coordinator Susan Pourier.

Choices, a national program that was brought to South Dakota in 2010, has grown from a small grant-based program with the Oglala Sioux Tribe to an active organization with a curriculum designed specifically for Native women.

The program, which was originally supported by the Center for Disease Control and Indian Health Services, now has offices in Rapid City, Pine Ridge and Kyle.

“It’s really a woman setting her own goals,” said Jessica Hanson, a Sanford Health doctor who helps facilitate the program. “We don’t dictate what they do. We work with them where they’re at to change their behavior. The program is not meant to tell a woman what to do.”

It does, however, provide options for women who are not pregnant but are actively drinking or participating in risky behavior. The program provides counseling, education and connects them with health care providers who can provide birth control.

It’s all done in the hopes of reducing fetal-alcohol syndrome or other health problems caused by a woman who drinks alcohol during pregnancy.

“If a woman doesn’t want to become pregnant, how can we help?” Hanson said. “And if she’s ambivalent, we want to talk to them about risky behaviors.”

The program is focused on two behaviors — drinking and being on birth control.

“If a woman decides to make a change with either, to stop drinking or to get on birth control while drinking, the risk is zero,” Hanson said.

The most dangerous time, Pourier said, is during the first couple months of a pregnancy when some women do not know they are pregnant and continue drinking.

“That’s scary, those first two months, if they’re still drinking,” she said. “We just have to educate them.”

Hanson said that up to 50 percent of pregnancies nationally are unintended.

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“Most women stop drinking, but some continue to binge drink and it leads to fetal alcohol syndrome,” she added. “Before a woman recognizes that she is pregnant, it has the potential to impact the developing fetus.”

The program offers incentives for women who participate, including gift cards for participating in group sessions and for following through on getting birth control if they are interested.

Pourier said she is encouraged by the number of women who have taken advantage of the program and how it has grown.

“When we started, we didn’t have an ink pen,” she said.

It took six months to write a curriculum that was relevant to Native women, which involved gathering input from focus groups. They eventually were given approval to hire an interventionist who works directly with the women.

They plan to focus on high school students next. One of the most encouraging moments this year came with an invitation to speak at the 2014 World Congress of Epidemiology held in Alaska.

“We must be doing something right if the world is asking us to speak,” Pourier said.

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