"Plan B" Distribution in Schools Gets a B-
This week, the New York City Department of Education announced a controversial decision to make Plan B, an emergency contraceptive commonly known as the "morning-after pill," available in 13 high schools around the city. Apparently the pilot for this program, called CATCH (Connecting Adolescents to Comprehensive Healthcare), began in five schools around the city in January 2011; CATCH is now active in some 40 city schools nationwide. The program works with health department doctors and trained school nurses to provide more reproductive health services to teens, particularly in areas with limited access to nearby health clinics.
On principle alone, I'm in favor of such a program. I've long been an advocate for more comprehensive sex education in public schools and for unimpeded reproductive rights on a national level. I support both classroom-based information sessions and the ability for students to have private discussions with school faculty wherein they can receive condoms and answers to their personal questions. My outlook is partly based in my own social liberalism, and partly on pragmatism: I've been teaching for nearly a decade now, and I've seen far too many teen pregnancies. I'd estimate that, in an average school year, I'm usually made aware of 3-4 pregnancies among the approximately 150 students I teach. While I do not endorse fifteen year old students' decisions to engage in sexual activity, for all the obvious reasons having to do with maturity, safety, and self-respect, I cannot over-emphasize the importance of arming students with the knowledge to be safe and make good choices. Whatever can be done to prevent teen pregnancies--of which there were 7000 in New York City last year among girls 17 and under, almost all unplanned--I'm in favor.
All that aside, I have questions about how Plan B would be administered in a school setting. I could not locate a website for CATCH, and so I was unable to find out what training the school nurses who dispense Plan B would receive, or what type of counseling or information would be available to students obtaining the drug at school. It concerns me that, in a school wherein we're not allowed to give kids Tylenol because of the infinitesimal risks associated with it, students would be able to procure Plan B--a drug which has far more serious side-effects--with only nominal oversight by anyone with medical qualifications. I'd feel more comfortable if a policy were in place wherein, should a student find herself in need of emergency contraceptive, she were given a voucher for a free Plan B and directions to the nearest Planned Parenthood. (A friend points out that part of the purpose of CATCH is to make Plan B available to kids under 17 who are not legally able to get Plan B without a prescription, and while I understand this issue, I feel that especially in situations concerning young teen pregnancies there needs to be more extensive medical supervision.)
Another issue is parental notification. Parents claim they were not notified about CATCH; in fact, according to the city, parents were sent an "opt-out" letter (meaning they were given the option to prohibit their children from receiving CATCH's services.) Only 1-2% of parents opted out of the program, which is fine, so long as due diligence was actually done in notifying the parents. In particular, I would want to be certain that letters clearly explaining the program were sent home by registered mail, as opposed to given to the children to hand-deliver to their parents (a notoriously unreliable method I'll admit to having used myself, when I wanted to show the R-rated film of "Lord of the Flies" in class, and didn't want too many parents to object.)
My last concern has to do with the efficacy of the program itself. I asked the kids in my 10th grade Honors class (several of whom had already heard about the controversy on the news) what they thought of the situation, despite CATCH not being implemented in our school. About half the students said that they thought giving out Plan B in school was a bad idea, that making emergency contraceptives so easily available would render their peers more cavalier about engaging in unprotected sex. As one young lady put it, "They already shouldn't be getting into that business." A young man said he agreed that teens were "not physically or emotionally mature enough to have sex," but pointed out that since they were having it anyway, providing contraceptives was the only way to stave off teen pregnancies.
However, when I asked the kids if they understood what Plan B did and how it worked, it became clear that they were confused: Some of the students thought it was a pill form of Depo-Provera, a hormonal birth control injection one receives every few months, while others believed Plan B was an abortion pill, evidently mixing it up with RU-486. When I explained how emergency contraceptives do work, and about the need to take the morning-after pill within a 72-hour window, the kids were even more confused; most of the teens they knew who had become pregnant only realized it 1-2 months along, because of a missed period or morning sickness. At that stage, emergency contraceptive would no longer be an option. The kids did not believe their peers would have the self-awareness to realize they needed a morning-after pill within the allotted 72-hour window. One boy, who said he was "speaking for the guys," also pointed out that making Plan B available should not occur in lieu of distributing condoms and information.
I realized that if even these thoughtful, mature students did not understand how Plan B worked--and, once they found out, where unconvinced of its utility within their lives--then some kinks probably need to be ironed out within CATCH's program. Nevertheless, though I'm ambivalent about its mechanics, I support the underlying goal of keeping kids from getting pregnant and dropping out of school; I'm interested to see how this initiative develops and is implemented throughout the school system.