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Middle School Based Health Clinic to Offer Prescriptive Contraception - Without Parental Consent or Notification

Like many of you, I’m here at the annual conference of the American Society for Bioethics and Humanities. (And if you’re here, and reading this, please do stop by and say hello – I’ll be at the AJOB table most of the weekend, and would love to put faces to names!) Hopefully unlike most of you, my brain is spinning and flying at twice its normal speed, stimulated beyond belief by all the amazing conversation going on here. Thus I found myself awake at 3:30am, deciding I might as well catch up on the internet, since sleep was apparently going to be elusive. (The 7:30am “meet the professor” breakfast ought to be even more fun on two hours of sleep!) It seems that, despite his fulltime job, as well as being exec editor, and co-manning the AJOB table with me at the meeting on top of it all, Sean’s been able to keep up on updating the bioethics newsfeed, and one story literally had me sitting up in bed going “whoa – that’s unexpected!”

Seems that the Portland, Maine school board approved, on Weds night, a measure that will allow students at King Middle School to gain access to prescription birth control methods without parental notification. It was a near-unanimous vote, justified by two very simple things:

1. there are students being seen in the health center who are engaging in risky behaviour (unprotected sex)


2. it has been shown, time and again, that providing access to birth control does not increase who is sexually active, only who is safely sexually active

Reaction, as you might expect, has been mixed, from utter outrage and threats of lawsuits and claims of violations of parental rights, to people saying that the reality is, not every student is receiving the sort of guidance at home necessary to make good sexual choices. (And to that, I would add, or receives good guidance and tosses it right out the window in a fit of pique and/or hormones.)

What might be most interesting about this decision is that the independently operated health care center (which offers things like immunizations, physicals, and other clinic-based medical care) says only about 5 of the 500 students at the school have identified themselves as sexually active. While I do realize that those who’re actually good at maths have ways of extrapolating from admitted rates of sexual activity actual (and typically higher) rates of sexual activity, I can’t imagine any sort of mathematical wizardry is going to make the number substantially higher. So it really is an offering of services to a limited number of students.

Several of us were sitting around a table earlier tonight, and the conversation drifted (thanks to a stress-relieving spermatozoa fellow blogger Andrea Kalfoglou was showing us) to sex education, and the average age boys and girls hit puberty. None of us knew off the tops of our heads when boys first start producing fertile ejaculate, but we did know that the average age of menarche has dropped to middle school ages – thus meaning that these middle school bodies are being hit by hormones at an age they perhaps might not have the wisdom necessary to handle the urges and inclinations. But at the same time, even though I have long been an advocate for free access to contraception in high schools, I find the idea of middle schools providing not only access to contraception but hormonal/prescription contraceptives slightly alarming.

While the clinic is independent of the school, and thus providing a service the students could receive if they went to a local Planned Parenthood, simply at easier access, I wonder at the prescription emphasis, and why other methods of birth control are not mentioned. Do they offer free condoms? What are they telling the students about safe sex? Is there some very specific and targeted situation going on they are trying to address, with only a few students – abuse, questionable relationships, accusations of rape, or some other need to provide this ease of access to prescription - motivating the measure? After all, as we all know from the endless education done in pharma adverts for hormonal birth control, it protects against pregnancy, not sexually transmitted infections.

-Kelly Hills