A School Birth Control Clinic--Has Its Time Arrived?

If Los Angeles school board members Jackie Goldberg and Roberta Weintraub are successful, a pilot clinic offering primary health care, including birth control counseling and the dispensing of contraceptives, will open on a high school campus in the district next fall.

Under the proposal, students would be required to have parental permission to obtain birth control devices. One critic of the proposal, however, says the school district may not have the legal right to make consent mandatory.

The clinic is the subject of a proposal, authored by Goldberg and Weintraub, that the seven-member school board will consider today. It appears to have the support of all board members except David Armor, who represents the West San Fernando Valley.

Armor said he strongly objects to dispensing birth control information and devices on school grounds. He also has asked the district’s legal staff to determine whether the board can require parental consent. Under state law, minors are free to seek contraceptive services without it.

If the motion is passed, Los Angeles would join a growing number of school districts nationwide that have established or are planning school-based health care centers. According to a spokesman for the Support Center for School-Based Health Clinics in Washington, about 35 such clinics are in operation and an additional 75 are being planned. Most of the clinics offer family planning services.

School officials are favoring such clinics as one way to deal with the rise in teen-age pregnancies and sexually transmitted diseases, as well as to treat other common adolescent health problems, such as acne, depression and eating disorders, that health experts say are too often neglected.

“It will be strictly an adolescent clinic,” said Goldberg, who has been studying clinics in the Dallas, St. Paul, Minn., and Chicago school systems. “The staff will be trained to work with an adolescent population. That is really critical. Because if kids are going to do things like diet or use birth control, they will get official medical information, not what someone thinks may be true. Those are the reasons why I’m really supportive of this.”

The proposal does not specify a location for the clinic. But it does call for the clinic to be privately financed, perhaps by a medical foundation or groups interested in family planning. The clinic would be open to any student who attends the school and possibly also to the children of teen-age parents. Goldberg said she would like the services to be offered free.

However, the board intends to require parental consent to use any of the clinic’s services. Furthermore, parents would be able to specify that their child may not obtain birth control information and devices.

Goldberg said she would prefer that students be able to use whatever services they desire. But at the urging of board member Larry Gonzalez, who represents East Los Angeles, she and Weintraub agreed to have a two-part consent form, one part giving the teen-ager permission to use general health services and the other part specifically allowing him or her to seek contraceptives.

“Parents have to be directly involved” in a teen-ager’s decision to use birth control, Gonzalez said.

However, if it turns out that the board cannot legally require parental consent, Armor said, “That is going to to be a big problem.” Board members will receive an opinion from the district’s legal staff today.

But Armor said his main worry is that the clinic would encourage promiscuity.

“On a philosophical level, my major concern is we may be sending a message to young people that sex is OK at this young age as long as you have a contraceptive,” he said. There is the suggestion, he indicated, of: “ ‘Have a hot date tonight? Drop by the clinic.’ I know that’s not the intent of the clinic, but that is the message. . . . I’m one who believes that sexual involvement is not the healthiest thing for a 15- or 16-year-old to do.”

Opposition Group

The clinic also is opposed by the California Coalition for Traditional Values, a conservative political action group based in Anaheim. Beverly Sheldon, a member of the group, said the clinic would “contribute to promiscuity and delinquency.”

However, Weintraub emphasized that the major reason she is backing the clinic is to make birth control information and contraceptives more readily available to teen-agers.

“I have spoken to kids in schools for pregnant minors,” the East San Fernando Valley board member said. “Every single one of them, without exception, said they would not have been pregnant if they had a birth control clinic on campus.

“I wish teen-agers would refrain from sex at this age,” she added, “or at least until they understood the full consequences of what they’re doing. But that’s not how it is. We’ve got to deal with all these kids who are having kids.”

According to the Los Angeles County Department of Health Services, in 1984 teen-age girls accounted for 12% of the total births in the county. In addition, among teen-agers there were 8,840 cases of gonorrhea and 117 cases of syphilis.

Douglas Kirby, director of research for the Support Center for School-Based Health Clinics, said there is some evidence that teen-age pregnancies and the dropout rate of teen-age mothers markedly decreased in schools with clinics.

Citing figures from the St. Paul school system, which has five campus clinics, he said the number of teen-age pregnancies has been cut by 50%, and the rate of repeat pregnancies has dropped. In addition, about 80% of the teen-age mothers finished high school. In California and other states, about 80% of teen-age mothers drop out of school.

Called Compelling

“That is rather compelling evidence about the success of that program,” Kirby said.

Weintraub said another reason she supports the proposed clinic is that it would help prevent adolescents’ health problems from slipping between the cracks in the health-care establishment.

“It’s pretty obvious that when boys and girls reach the teen-age period, they don’t get proper health care. They’re too old for the pediatrician and too young for the primary care doctor. So there is a whole period of time when they just don’t show up (in a doctor’s office). That’s why I see this as being really helpful.”

According to Kirby, about 35% of students who visit school-based health centers are seeking birth control information or devices. The majority of students go for general medical screening services. For instance, at a school clinic in Dallas, he said, the leading causes for student visits were respiratory infections, gynecological disorders, eye infections, stomachaches and headaches.

He said the Dallas clinic also has diagnosed about 100 previously undetected heart murmurs every year since it opened in 1970.