TIME Television

Craig Ferguson Fed Ribs to a Pregnant Zoe Saldana

Guardians of the Galaxy star admitted she was having pregnancy cravings

Guardians of the Galaxy actress Zoe Saldana told Craig Ferguson on The Late Late Show Wednesday that she was experiencing cravings– like any pregnant woman.

So the late night host responded by taking out a platter of ribs, donuts and sandwiches from behind his desk. He even brought out more food after a commercial break.

The actress has her due date in eight to ten weeks and will be having twin boys according to People. She’s promoting the animated move, Book of Life, which is in theaters now.

MONEY mortgages

Wells Fargo Settles Charges It Refused Mortgages to Moms

A woman walks past teller machines at a Wells Fargo bank in San Francisco, California.
Wells Fargo promised to enact new Temporary Leave Underwriting Guidelines and educate their loan officers. Robert Galbraith—Reuters

A woman says a mortgage loan officer told her, "Moms often don’t return to work after the birth of their little ones."

Wells Fargo Home Mortgage agreed Thursday to pay $5 million to settle allegations that its home loan officers discriminated against pregnant women and women on maternity leave out of fear that the mothers would not return to work, potentially jeopardizing their ability to repay the loans.

Six families alleged that loan officers employed by Wells Fargo, the biggest provider of home loans, made discriminatory comments during the mortgage application process, made loans unavailable to them, and even forced mothers to end maternity leave early and return to work before finalizing the loans. One of the six complainants was a real estate agent who alleges he lost a commission due to discrimination against one of his clients.

Lindsay Doyal, one of the women who filed a complaint with the Department of Housing and Urban Development, says that she was denied a mortgage despite providing several letters from her employer confirming that she intended to go back to work, the Washington Post reports. Doyal says she received an e-mail from a Wells Fargo loan officer that said, “moms often don’t return to work after the birth of their little ones.”

Since 2010, HUD has received 90 maternity leave discrimination complaints, 40 of which have been settled, with a total of almost $1.5 million going to loan applicants. The families in the Wells Fargo case will receive a total of $165,000, and Wells Fargo will create a fund of up to $5 million for other affected mortgage applicants.

“The settlement is significant for the six families who had the courage to file complaints, and for countless other families who will no longer fear losing out on a home simply because they are expecting a baby,” HUD Secretary Julián Castro said in a statement. “I’m committed to leveling the playing field for all families when it comes to mortgage lending. These types of settlements get us closer to ensuring that no qualified family will be singled out for discrimination.”

Wells Fargo promised to enact new Temporary Leave Underwriting Guidelines and educate their loan officers.

“We resolved these claims to avoid a lengthy legal dispute so we can continue to serve the needs of our customers,” Wells Fargo said in a statement. “Our underwriting is consistent with longstanding fair and responsible lending practices and our policies do not require that applicants on temporary leave return to work before being approved. The agreement resolves claims related to only five loan applications from a period when Wells Fargo processed a total of approximately 3 million applications from female customers.”

[Washington Post]

TIME women

Doing Shots in Vegas—The IVF Kind

Las Vegas sign
ranplett—Getty Images/Vetta

Who needs a man to get pregnant when you've got a lemon drop shot in one hand and a fertility shot in the other?

When people talk about doing shots in Vegas, this isn’t what they have in mind. But on a Tuesday night in July, I sat at the black granite dressing table in a bathroom at the Palazzo, my bikini still damp from the pool, and prepared to jab myself in the abdomen.

I had been thinking about freezing my eggs for a long time. At 38, happily single with a career just starting to take off and a lot of travel in my immediate future, I knew I wasn’t ready to start a family. But since I want a child of my own some day, I figured now was the time to freeze my eggs.

Once I’d decided on the procedure, I told all of my close friends. At first I felt sheepish, as if the decision signaled that I had “given up” on finding a partner. The traditional model of an American woman’s path to happiness and a family, reinforced in movies and television, does not leave much room for deviation. It feels as if the options are black and white—either you follow the traditional path (love, marriage, baby) or you’re a spinster with cats.

Luckily everyone—my parents, friends, and colleagues—was incredibly supportive. My friend Briita even texted me emoji of hypodermic needles and chicken eggs.

After getting over the exorbitant cost—the biggest barrier to egg freezing—my greatest fear was giving myself the shots. I imagined maneuvering giant horse needles into my butt, jabbing backward into the skin like puncturing a watermelon with a bread knife. Instead, the needle I held in the Vegas hotel bathroom was shorter than my thumbnail, and slid into the skin of my abdomen nearly effortlessly.

When Briita invited me to join her for a weekend in Vegas, I almost didn’t go because it was going to be the first night of my injections. But I figured if I had to do them, Vegas would be as good a place as anywhere.

Briita and I discussed the procedure poolside, lounging in the warm desert sun. Glancing at my watch, I realized the two-hour window for the injection time, which started at 6 p.m., was approaching. Briita gave me the idea to commemorate my first one: a shot for a shot.

A waitress came over, and we considered what kind of liquid encouragement was appropriate for my first stab into motherhood. “A lemon drop shot,” said Briita.

The drink arrived in a plastic mini-Solo cup. The purist in me wanted a real shot glass, but this would do.

“Do you want me to go with you?” Briita asked, her voice dropping, the words coming out more slowly and carefully, as if she wanted to offer her help but wasn’t exactly sure of the protocol.

“No, it’s fine. I got this. I’ll text you if I need help.”

Drink in hand, I went up to our palatial hotel room and retrieved my box of Follistim cartridges from its minibar perch on top of tiny cans of Red Bull and Heineken. I meticulously went through all the prepping steps, watching and re-watching YouTube instructional videos produced by fertility clinics, which usually featured married white couples with the husband administering the shot. They zoomed in on weirdly manicured and disembodied hands dialing back the dosage on the injection pen as if it were a gold watch on QVC.

The unofficial videos on YouTube by regular people were far more relatable. If a woman sitting at her computer could slide a needle into a soft roll of fat while talking to a camera without skipping a beat, then I knew I could do it. These women talked frankly about their fertility, the challenges of IVF, and the unexpected side effects. There were women struggling with infertility wishing each other good luck and “baby dust,” message boards where you could find “cycling partners” who were on the same hormone schedule, and endless tips about how to make the shots easier.

Pumping the music out of my iPhone (I had built an injection playlist that included Bon Jovi’s “You Give Love a Bad Name” and LMFAO’s “Shots”), I laid out some paper towels on a “clean, flat surface,” sang along to the refrains, and giggled at every “shot” reference. Silly puns, it turns out, have great healing value. Aging, single motherhood, infertility, fear of dying alone—these issues are serious enough. When they’re coupled with a syringefest reminiscent of a scene from Pulp Fiction, you don’t need any more fear and trepidation. You need Pat Benatar, cranked up. There is something incredibly rewarding about drawing a deep breath, putting “Hit Me With Your Best Shot” on replay, and just getting it done.

I took a swig of the lemon drop shot with my left hand and steadied the needle with my right. I made two aborted attempts. And then I sank the needle into my belly, released the pinch of skin I was holding, and slowly pushed the medicine into my body. I counted to five, pulled out the needle, and began celebrating.

Las Vegas is such an impossible, unlikely place, a neon metropolis in the middle of the desert. Equally marvelous and unlikely is the technology that allows me to safely retrieve and freeze my eggs for future use, without a single incision. Because egg freezing only recently lost its “experimental” status and the success rates are not as well known as with embryo freezing, I decided to keep my options open and freeze both eggs and embryos. It feels a little bit like I’m living in a science fiction novel.

Now, a few months post-retrieval, I wonder when and how I will decide to use the eggs I’ve just nourished, protected, collected, and frozen. It’s possible I’ll meet someone and have children the traditional way. It’s possible I’ll marry in time for one child, but need to return to my frozen eggs for a second one. It’s possible I’ll decide to be a single mother, the way my mother was for many years. It’s possible I’ll adopt or decide not to have children at all, and be equally happy. But if I do have a daughter or son some day from the eggs I retrieved, I look forward to telling my child about the unexpected summer night in Vegas when it all started.

Tara Prescott is a lecturer in writing programs and faculty in residence at the University of California, Los Angeles. She is co-editor of Feminism in the Worlds of Neil Gaiman and editor of Neil Gaiman in the Twenty-first Century, to be released by McFarland & Company in 2015.

This piece originally appeared on Zócalo Public Square.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME diabetes

Here’s Why Women Should Avoid Fried Food Before Pregnancy

Fried chicken
Getty Images

So much for those burger-and-fries cravings.

A new study published in Diabetologia found that women who eat more fried food before conceiving are at greater risk for developing gestational diabetes—the kind that starts or is first noticed during pregnancy. Researchers looked at diet questionnaires from about 15,000 women enrolled in the Nurses’ Health Study II.

Once they adjusted for BMI, researchers found that women who ate fried food seven or more times a week had an 88% greater risk for gestational diabetes than those who ate fried food less than once a week.

MORE: Mom’s Diabetes Linked To Autism and Developmental Delays

Interestingly, the association was particularly strong with fried foods eaten away from home compared to home-cooked fried food. Restaurants tend to reuse their oil for multiple fryings, a practice that deteriorates oils through oxidation and hydrogenation. “Refrying may produce more of those detrimental chemicals,” says co-author Cuilin Zhang, MD, an investigator at the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Frying also creates inflammatory compounds that may contribute to cell damage and diabetes—which Zhang suspects are related to the fried food.

No one would argue that a chicken nugget is a health food, but that kind of dining may be more hazardous when you’re getting ready to eat for two.

TIME Race

Dear White Ladies, You Will Have To Raise Your Black Baby and Love Every Minute of It

Jennifer Cramblett
Jennifer Cramblett is interviewed at her attorney's home in Waite Hill, Ohio, on Oct. 1, 2014. Mark Duncan—AP

During her pregnancy, Jennifer Cramblett found out what she thought was sperm from donor vial No. 380, a white guy, actually came from donor No. 330, a black man

xojane

This story originally appeared on xoJane.com.

What to do? What to do? Jennifer Cramblett is suing a Chicago sperm bank for wrongful birth because a lab mix-up produced a baby of the wrong color — black.

The Uniontown, Ohio, resident who lives with her lesbian partner Amanda Zinkon and biracial daughter Payton, two, also alleges breach of warranty in the suit filed this week in the Circuit Court of Cook County, which has the largest population of black folks in America, by the way. (This population is what probably explains the creature that is Barack Obama, but that’s another story.)

During her pregnancy, Cramblett found out what she thought was sperm from donor vial No. 380, a white guy, actually came from donor No. 330, a black dude. So now this lesbian couple living what until very recently was widely considered a nontraditional lifestyle is clutching their chests over the prospect of having to raise a black girl, though they report having “bonded with Payton easily.”

It’s just that the neighbors are a problem. And the family.

“Family members, one uncle in particular, speak openly and derisively about persons of color. [Cramblett] did not know African-Americans until her college days at the University of Akron,” the suit says.

“Because of this background and upbringing, Jennifer acknowledges her limited cultural competency relative to African-Americans, and steep learning curve, particularly in small, homogenous Uniontown, which she regards as too racially intolerant.”

This suit, these women, America’s un-evolved racial attitudes present some problems, so let me start here:

They’re right.

The couple questions their “cultural competence” to raise a black child given their limited experience with black folks. Not enough white parents involved in what’s called transracial adoption question their competency in these matters. “Love will conquer all,” they say, until the first time they’re perplexed by the inability to get a comb through their little black girl’s hair, then cut her “bangs” that shrivel up into a curious forehead afro. Mark that No. 1 on things to discuss with the therapist when that little girl grows up.

As white women, they’re certainly typical. Most white people don’t have any black friends, as we know from a recent Public Religion Research Institute study showing three-quarters of white Americans don’t have any non-white pals. It’s so easy to pretend America’s racial problems (think: #jordandavis #ferguson) don’t exist until they populate your Twitter feed.

The couple also say they live in what they consider a racially insensitive town that might give the child hell one day. Yup, that could happen. Just ask Trayvon Martin. Oh, we can’t.

They didn’t ask for their lives to be turned into a giant social experiment. Yes, the sperm bank messed up big time, and they should take the hit for it. Whatever money this family receives could be used for Payton’s education or to provide enrichment opportunities of the culturally enriching kind so she just grows up happy and well rounded regardless of her skin color. I hope she doesn’t grow up hating herself or other black people because that happens, you know.

They’re wrong.

They’re gay, so they’re already a social experiment (meaning, homosexuality is only now being accepted as a norm in mainstream society). Gay marriage may soon one day be the law of the land, but the fact that it’s a fight proves the point.

They’re women living in what author Tara Mohr calls a “transitional historical moment.” On one hand, women have more freedom and opportunity than ever, thanks to everything from the first-wave feminism of 1848 Seneca Falls to the success of the 50-year-old Civil Rights Act of 1964, largely thought to be aimed at minorities like Payton. This law is totally responsible for breaking open workplace doors for women, mostly white ones. The very nature of being a woman is a social experiment.

Both women say they were sexually abused as girls, so when “you think of sperm, you think of sexual encounters and neither of us wanted to think of males in our lives again,” according to the suit. In other words, the fact that the baby came out in a way they didn’t plan underscored the lack of control they have felt over their own bodies.

These are strong women for surviving sexual abuse and carefully planning to have children who would be blood relatives by virtue of being inseminated by the same sperm. But did they consider the fact they could have had a boy?

The genetic engineering (and entitlement) tendencies of these women is nauseating. So what, life didn’t turn out the way they planned. Look at employment stats, housing numbers, the failure of public education and mass incarceration — that’s black life, baby.

And what? They don’t know any black lesbians? With children?

Each woman seeks an undetermined amount that exceeds $50,000 in damages. Because they certainly are — damaged.

Deborah Douglas is a journalist living in Chicago.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Research

The Link Between Asthma and This Chemical

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Bisphenol A molecule Laguna Design/Getty Images

Bisphenol A, or BPA, lurks in the plastics of all kinds of consumer goods, from can linings to plastic bottles—but its influence doesn’t end with the product. BPA is an endocrine disruptor that can leach into food and is linked to all kinds of health problems from aggression to obesity. Now, a new study published in JAMA Pediatrics finds that prenatal exposure to BPA is also linked to lower lung capacity in some young children.

MORE: How BPA May Disrupt Brain Development

The study looked at urine samples of 398 mother-infant pairs, both during and after pregnancy. Every 10-fold increase in the BPA concentration of maternal urine—meaning every time that number went up 10 times—was linked to about a 55% increase in the odds of wheezing. Lung capacity was also affected: Higher BPA concentrations during pregnancy were also linked to decreased lung capacity in four-year-olds, but by age 5, that link disappeared. Once a child was born, the BPA levels in their own urine weren’t associated with wheeze at all.

Exposure during pregnancy, not after, appears to be the critical time for BPA, possibly because it’s affecting important pathways that help the lung develop, says study author Adam Spanier, MD, PhD, associate professor of pediatrics at the University of Maryland School of Medicine.

That link between prenatal BPA exposure and wheeze might be reflective of asthma, Spanier says, which would be consistent with what animal models are finding. “Some animal studies out there suggest that BPA prenatally might affect the development of some of the cells in our airway,” he says. Asthma has been on the rise for the past three decades, and environmental exposures like BPA are thought to be a possible link. A 2013 study also found a link between BPA and asthma, and though the mechanism behind the connection is complex and unclear, Spanier sees a definite association. “If my sister who’s pregnant asked me for advice, I would tell her try to minimize her BPA exposure,” he says. “I wouldn’t say let’s do some more research.”

TIME

Why Having an Epidural Should Count as Having a Natural Birth

Pregnant Pregnancy
Getty Images

Most people define a “natural birth” as delivering a baby without the aid of any kind of medication. But maybe the definition of "natural" needs to be broadened.

Three things happened when I went to my first Lamaze class: I was forced to slow dance to “Just Breathe” by Faith Hill (almost as horrifying as labor), I learned about the joys of episiotomies, and I was repeatedly asked if I’d made a birth plan. Actually, make that a natural birth plan. I quickly came to learn that natural birth is just like regular birth, only better because you aren’t medicated while a watermelon-sized human mercilessly makes its way down your birth canal. I also heard that if you really want to get in touch with your body, popping out a baby in an inflatable kiddie pool definitely earns you extra mommy-points.

Most people define a “natural birth” as delivering a baby without the aid of any kind of medication. But maybe the definition of “natural” needs to be broadened so that women don’t feel like second-class citizens for requesting an epidural.

A 2012 CDC study found that out-of-hospital deliveries (arguably the most natural of natural births) have a lower risk profile than hospital births, while a 2013 CDC study found that the c-section rate has declined to just 32.7 percent. All good news, but with the growing trend toward organic birth comes a growing (and misplaced) judgment toward mothers who embrace pain relief with open arms. I was met with more than a few side-eyes at Lamaze class when I flirted with getting an epidural, but what’s so terrible about having medication shot into your spine during the most agonizing moment of your life?

The Natural Birth Movement is becoming increasingly in vogue among millennial mothers, and of course this isn’t a bad thing. The CDC ran a 2008 survey of epidural and spinal anesthesia use during labor, and 39 percent of documented vaginal births in the U.S. were natural. This implies that somewhere around 61 percent of women had “unnatural” (read: medicated) births, and I’m guessing they didn’t feel less connected to their birthing experience.

For some natural birth enthusiasts, it’s the fear that pharmaceutical drugs will increase the likelihood of an emergency Cesarean section that makes them go med-free. For others, it’s the fear that drugs will cross the placenta and harm the baby. Both are frightening possibilities, but the American College of Obstetricians and Gynecologists released a statement in 2006 (reaffirmed in 2013) explaining that epidurals do not increase the chances of C-section and a 2011 English study found that there’s no difference in the Apgar scores of babies born via medicated vaginal delivery and babies born au naturale. Of course, sometimes it’s impossible to avoid a C-section, but the delivery of a baby through medical intervention doesn’t make a mother’s birth experience any less natural. One way or another, she’s still going through labor, welcoming a child into the world, and entering parenthood –– one of the most fundamental, and yes, natural, experiences a human body can go through, whether you indulged in drugs or not.

By classifying Cesarean and medicated vaginal births as unnatural, mothers who prioritize natural delivery are potentially put in a position of feeling inferior if their birth plan is unexpectedly thrown out the window. An unplanned emergency C-section is stressful enough without worrying that your birth experience was somehow less legitimate and authentic than you’d hoped.

“I wanted a low-intervention birth, but that changed when my daughter was delivered via emergency C-section at 25 weeks due to severe pre-eclampsia,” says Adele Oliveira of Santa Fe, New Mexico. “A high degree of medical intervention saved both of our lives. For many women, natural birth just isn’t an option, but that doesn’t make our experiences less valid or valuable.”

While medication-free labor is certainly a cause for celebration, new mom Lucy Foma believes we can simultaneously embrace the natural birth experience while also welcoming hospital births. “To me, a natural birth is one in which I used as little intervention as possible: no medications, no inducing, and very little help from the midwife,” says Foma. “I chose to do this because I believe that my body is built to perform this task and medications would inhibit my intrinsic ability. I wanted my own experience of this process, as well as my baby’s, to be intact and fully conscious so that we could embrace the moment when we first met each other. However…ultimately I think the only thing that matters in birth is that the baby and mama are ok.”

The health of mother and baby is certainly paramount, and the natural birth movement does its part to educate women in the benefits of vaginal delivery (The American College of Obstetricians and Gynecologists says an estimated 2.5% of births in the U.S. are elected C-section), and encourage mothers to assume more control of their birth experience –– both great things. But the idea that women should prove their physical and mental prowess by grinning and bearing pain seems outdated, and the implication that choosing medication is unnatural is divisive. More importantly, restricting the definition of “natural” to only encompass un-medicated birth has the potential to alienate those who fear the pain of labor and want help managing that pain.

I myself felt alienated by the natural birthers in my Lamaze class, but didn’t hesitate to ask for an anesthesiologist as soon as I arrived at the hospital to deliver my son. I received my epidural straight away, but after a few blissful hours of napping and watching The O.C., my medication bag sprung a leak and I spent the last six hours of my labor drug-free. The majority of my delivery fit the current definition of natural, yet being drug-free felt decidedly less organic than lying in bed with my epidural while Seth Cohen and Marissa Cooper lulled me to sleep. In fact, watching my favorite high school drama and lounging around with my boyfriend felt familiar and comforting, while being suddenly catapulted into pain felt scary, foreign and completely unnatural.

Whether you have an epidural (or a partial epidural, in my case), an emergency C-section, or an un-medicated birth, every mother’s experience is special and unique. But the one thing we should have in common is permission to define our labor experience as natural. This can only happen once the term’s currently restrictive definition expands to include medicated and unmedicated births, regardless of whether a child was delivered with the help of doctors, or delivered by a doula to the dulcet sounds of Sting playing a lute.

TIME Healthcare

Woman Delivers Baby After Womb Transplant

It's the first successful birth after such an operation

A 36-year-old woman who received a womb transplant has given birth to a healthy baby, a Swedish doctor announced according to a report in the Associated Press. The birth marks the world’s first successful birth following such an operation.

“The baby is fantastic,” said Mats Brannstrom, the doctor who delivered the baby. “But it is even better to see the joy in the parents and how happy he made them.”

Brannstorm, a professor of obstetrics and gynecology at the University of Gothenburg and Stockholm IVF, has been working on womb transplants for the past two years. He transplanted wombs in nine women, but two needed to have the organs removed following complications. At least two other women with pregnancies have passed the 25 week mark, he said.

[AP]

 

TIME Research

Why Pregnant Women Who Smoke Might Have Kids With Worse Sperm

Pregnant smoking
Getty Images

One more bullet point on a long list of reasons to quit smoking

Add diminished fertility to the long list of reasons why women should avoid smoking while pregnant or breast feeding. The mice sons—called pups—of mothers exposed to the smoke equivalent of a pack of cigarettes a day during that time wind up with sperm that struggle in the reproduction process, according to a new study in mice published in the journal Human Reproduction.

“Our results show that male pups of ‘smoking’ mothers have fewer sperm, which swim poorly, are abnormally shaped and fail to bind to eggs during in vitro fertilisation studies,” said study leader Eileen McLaughlin, a chemical biology professor at the University of Newcastle in Australia, in a press release. “Consequently, when these pups reach adulthood they are sub fertile or infertile.”

Unlike previous research, the new study looked at pregnancy in mice to try to determine not just the consequences of smoking during pregnancy but also the mechanism behind it. Cigarette toxins affect the stem cells in the testes, McLaughlin says, which results in permanently lowered sperm production—and these results likely apply to humans, she adds. “We also know that oxidative stress induced by these toxins causes damage to the nuclei and mitochondria (the cell’s ‘power’ supply) of cells in the testes and this results in sperm with abnormal heads and tails, that are unable to swim properly or successfully bind and fuse with eggs.”

The knowledge that smoking has devastating long-term implications for the health of children is nothing new. Previous studies have suggested that smoking stems fetus growth, leads to premature delivery and causes birth defects. Nonetheless, 20% of women in the United States continue to smoke during pregnancy. The number is higher in Australia, where the study was conducted.

“We would ask that smoking cessation programmes continue to emphasise that women should avoid smoking in pregnancy and while breast feeding as the male germ line is very susceptible to damage during early development and the resulting sub fertility will not be apparent for several decades,” said McLaughlin.

TIME Sex/Relationships

Teenage Girls Given Choice of Free Contraceptives Get Far Fewer Abortions

IUDs
Illustration by Miles Donovan for TIME

Girls allowed to choose between free contraceptive methods had 76% fewer abortions than their peers in the general population — and most chose IUDs

Three in 10 teenage girls in the U.S become pregnant each year—a rate far higher than in other industrialized countries. But when girls are counseled about the most effective contraceptives and given their pick of birth control at no cost, their rates of pregnancy drop by 78% and they get 76% fewer abortions than the general population of sexually active teens.

That’s what a new study published in the New England Journal of Medicine suggests, in which researchers at Washington University School of Medicine in St. Louis attempted to see what would happen when they tore down the three main barriers to teenage birth control—ignorance of options, limited access and prohibitive cost.

They studied a group of 1,404 teenage girls enrolled in the Contraceptive CHOICE project, a study of adolescents and women at high risk for unintended pregnancy. 62% of the girls were black and 99% were sexually active. Black teens have even higher rates of pregnancy than the rest of the population: 4 in 10 become pregnant, compared with 2 in 10 white teens.

In the study, peer educators, volunteers, medical students and others interested in health education counseled the girls on the available methods, presenting them in order of effectiveness—IUDs and implants, followed by Depo-Provera injection, pills, patch and ring, and condoms. They stuck to a script that encouraged the girls to choose for themselves, emphasizing that they can always change their method later. The contraceptives were in the room for the girls to see and touch. The clinic had flexible scheduling so that even if a teen was late to her appointment, she was guaranteed to be seen, and every girl received her birth control right after the counseling session.

That’s a world away from the experience of girls in the outside world, who are often asked by providers to come back several times before they start a method, given false information about IUD risks, and eventually mass-prescribed pills, says project director Gina Secura. “It’s often a one-sentence conversation: what do you want, and here’s a prescription,” she says.

MORE: How Having an (Insurance-Covered) IUD Is Saving My Life

Focusing the conversation purely on effectiveness was, well, extremely effective. “When we first started the project, we had hoped to double the national rate [of IUD or implant use]—about 5%,” says Secura. Instead of the hoped-for 10%, a whopping 72% of teems chose IUDs or implants. “We were shocked,” she says. And they stuck with them. Two-thirds of the girls were still on long-acting reversible contraception (LARC, which includes implants and IUDs) after 2 years, compared to one third of girls on short-acting methods like the pill.

IUDs are a solid choice according to the American Academy of Pediatrics, who just endorsed IUDs as the best method of birth control for teenage girls. And the evidence bears it out. The researchers tracked the girls for 2-3 years and followed up every few months by phone. They found that 3.4% of CHOICE teens got pregnant, compared to 15.85% of sexually experienced teens in the general population. Fewer than 1% of CHOICE teens got abortions (0.97%, to be exact), while 4.15% of the other population did.

That means that girls in the program were 78% less likely to get pregnant and had 76% fewer abortions than their peers in the general population. Of course, it’s not quite fair to compare these two groups, since the girls in the research project were given free access and would have been more encouraged to stick to their methods with follow-ups, but the implications are incredibly important for clinics and counselors.

Most notable of all, the low pregnancy rates between white and black teenagers in the project were almost identical. “If we really want to tackle this health disparity, that shows we can actually do it,” Secura says.

These rates far outpace even the CDC’s 2015 goal for teenage births; they’re aiming for 30.3 teenage births per 1,000 teens. The CHOICE rate was 36% lower than that, at 19.4 teenage births.

Secura attributes these dramatic drops largely to the high uptake of long-term contraceptive methods, options that are cost-prohibitive to many low-income teens and free clinics. “It can be difficult to justify spending the same amount of money on 10 devices, where they could buy five times as many packs of pills,” Secura says.

The researchers put their CHOICE methods on a site called LARC FIRST designed to guide clinics, and since data from the study began coming out over the past two years, Secura says they’ve gotten about 300 requests from clinics asking for help in implementing their best practices—including training people who aren’t time-pressed providers and nurse practitioners to deliver effectiveness counseling. Having a kind of AmeriCorps for contraceptive effectiveness counselors, Secura says, would be a dream.

Though the study is over, several clinics are trying to adapt some of CHOICE’s methods to their real world practices and evaluate them scientifically. “I’m hoping we build the demand in terms of teens wanting these,” Secura says.

TIME has called IUDs the best form of birth control that no one is using—but when teens are informed and cost barriers disappear, this study shows that teenage girls are clearly hungry for better birth control.

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