Sep. 25, 2012 at 9:51 AM ET
New York City quietly launched a pilot program last year that allows a school nurse or doctor to dispense free emergency contraceptive pills and birth control pills to girls at 13 public high schools. High schools nationwide have distributed condoms for years, but the New York City program may be one of the first to provide contraceptive pills.
The program, called CATCH, or Connecting Adolescents To Comprehensive Healthcare, is aimed at reducing unplanned teen pregnancy. It began in January 2011, but wasn't publicized until the New York Post reported it over the weekend.
“In any given every year there are about 7,000 pregnancies to girls ages 15 to 17 in New York City, about 90 percent of those are unintended,” said Deborah Kaplan, assistant commissioner at the city health department’s Bureau of Maternal, Infant and Reproductive Health. "We wanted to make sure young people who are sexually active have easy access to contraceptive services and general reproductive health services."
Oral contraceptives, including the morning-after Plan B pill, have been available to students at most of the 40 schools that have school-based health centers for the last one to four years, depending on the school, Kaplan said. The centers, which serve about one-quarter of New York City’s public high school students, provide primary care health services and are run privately by separate institutions like hospitals.
For the first time, with the CATCH program, the Health Department is making the contraceptives available in schools without the private health centers. The program began in January 2011 in five schools, and is now in 13 schools. The schools were chosen because they are in neighborhoods with high teen pregnancy rates or with limited resources for young people to get contraception. City high schools have long provided condoms.
Parents learned of the program through a letter that gave them a chance to opt out, which 1 percent to 2 percent of parents did, she said.
“We’ve had no negative reaction to the CATCH program,” Kaplan said. “We haven’t had one objection. We’ve just had the opt-outs.”
The pilot program offers pregnancy testing, along with the Plan B morning-after emergency contraceptive pill, which helps prevent pregnancy when taken within 72 hours, and traditional birth control pills. To get Plan B, girls must see a nurse, who would obtain a doctor’s order for the drug, Kaplan said. For oral contraceptives, they would need to see a Health Department doctor, Kaplan said.
The Health Department is studying to the program before deciding whether to expand. In the last school year, fewer than 1,200 of the 12,000 girls enrolled in the 13 schools obtained the oral contraceptives. For the 2011-2012 school year, 567 students received Plan B and 580 received birth control pills, Kaplan said. Of the unplanned teen pregnancies in the city, about 64 percent are terminated, the city says.
Dr. Cora Breuner, a member of the American Academy of Pediatrics Committee on Adolescence, called the program, “totally new. Totally awesome.”
Teens nationwide aren’t doing a good job using birth control to prevent pregnancy and sexually transmitted diseases, she said, and most do not have access to contraception at school.
“This is the first time that a school nurse can give both Plan B and oral contraceptives to their students,” Breuner said. “This is great because it improves access to contraception and promotes education on reproductive health.”
Dr. John Santelli, an adolescent medicine specialist and professor at Columbia University who studies contraception use, said the program sends a strong message to sexually active teens about the need for contraception.
“Kids that see that level of support for condoms and contraception are more likely to use it,” he said. “It’s a big deal in the sense that it’s going to help the young woman that comes in, or the young man in the case of condoms, and it’s a strong statement to young people that contraception is important.”
Santelli predicted that the program will be effective, and said it could be replicated elsewhere. “I could see other big cities doing this,” he said. “I hope they do.”
The program is not without critics, though.
Valerie Huber, president of the National Abstinence Education Association, saw the program as an expansion of sex education and said the school system is not providing “meaningful skill building for abstinence education.”
"This new service is kind of, no pun intended, a plan D for what to do if sex education doesn’t work," Huber said. “We think it normalizes teen sex and does nothing to prevent sexually transmitted diseases.”
Kaplan, from the Health Department, noted that 38 percent of teenagers are sexually active, and said the city is committed to keeping them safe.
“We’re proud to play that role in promoting and protecting the health of our young people,” she said.
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