The first time the 16-year-old student visited Roosevelt High School's health clinic, she needed emergency contraception. This time, she wanted regular birth control.
"I don't want to be pregnant," she said while at the clinic. "I'm too young. I can't take care of a baby."
Throughout the school year, students visit the on-campus clinic to get birth control, pregnancy tests, counseling and screening for sexually transmitted diseases. The services, which are free and confidential, are offered through a unique collaboration between Planned Parenthood and the Los Angeles Unified School District designed to reduce the number of unplanned pregnancies among teenagers at the Boyle Heights high school.
Although nonprofit groups frequently offer reproductive healthcare on school campuses around the nation, the partnership involving Planned Parenthood — long a target of antiabortion lawmakers in Washington — is the only one of its kind.
Birth rates among teenagers have dropped throughout California and Los Angeles County over the last several years. Statewide, the rate of births to teenagers 15 to 19 hit a record low in 2010 at 29 births for every 1,000, down from 37 in 2005.
Despite the decline, there are still certain areas within the county with disproportionately higher numbers of young mothers, according to the Los Angeles County Department of Public Health. The heavily Latino and low-income neighborhood around Roosevelt High School is one of them. Several other neighborhoods in East and South Los Angeles also had higher percentages of teenage births than the rest of the county.
"All areas of LAUSD are not created equal," said Christine De Rosa, who works on adolescent health for the HIV and STD division of the Los Angeles County Department of Public Health. "Rates vary according to high school attendance areas."
Nurse practitioner Sherry Medrano, who runs the Roosevelt health clinic, said teenagers rarely go outside their comfort zone for family planning. By law, students can go to Medrano and her staff without the permission of their parents. "They feel much safer and much more comfortable coming to a school-based health clinic," she said.
The 16-year-old student said she felt relieved to know that she could visit the clinic without telling her mother. "Just knowing you can come somewhere to get birth control just feels good," she said. 'It's a relief."
Once in the student was in exam room, Medrano explained how birth control worked and gave her the options: a patch, a ring, pills or a shot. The girl chose the shot, which lasts for 12 weeks. "I'm gonna forget the patch or the pill," she said.
A few minutes later, a 15-year-old girl brought her friend to see Medrano and helped her fill out a questionnaire. The girl said she watched her older sister drop out of school after becoming a teenage mother. Now she receives birth control pills from the clinic and urges her friends to visit Medrano too.
"If I got pregnant now, I don't know what I would do," she said. "I still want to do good in school and have a career."
The health center, which is separate from the school nurse's office, also serves as a primary care clinic, providing physicals and administering immunizations. This school year, about half of the visits have been for reproductive health.
The campus began offering contraception and counseling in 1997. But in 2006, a collaboration with a local hospital ended and the school no longer had the resources to provide free contraceptives. In 2008, Medrano said, she saw 32 positive pregnancy tests during her peak period between March 1 and June 1 — around the time of spring break and prom.
Medrano then reached out to Planned Parenthood, which now provides a medical assistant, the contraceptives and the pregnancy and STDs testing. The organization bills Family PACT, a public program that provides family planning to low-income and uninsured California residents.
In 2009, Medrano said, she saw three pregnancies during the same time period. The numbers have since climbed to about 10. Only a few parents have complained about the program since it began, she said.
Planned Parenthood's Los Angeles executive director, Sue Dunlap, said Latino families generally want access to information and care. "We really don't experience the traditional narrative of angry parents not wanting access to reproductive care in the schools," she said. "It's really the opposite."
Planned Parenthood also trains Roosevelt students as peer advocates to talk to their classmates about STDs and pregnancy prevention. Aurora Bermeo, a student who has worked as a peer advocate, said she tried to get the word out about the free care. In advance of the prom, the advocates made presentations and handed out fliers.
"It's super important," she said. "When prom season comes around, things happen.... We try to get them on birth control."