The World of Homis: School adds birth control options

The School Committee votes to let contraceptives be prescribed to students at King Middle School.

By KELLEY BOUCHARD, Staff Writer October 18, 2007

The Portland School Committee decided Wednesday to make prescription birth control available to students who have parental permission to be treated at King Middle School's health center.

Photos by Doug Jones/Staff Photographer

Diane Miller, a Portland resident and former school nurse, said she was “horrified” by the proposal.

The committee's 7-2 vote means King will be the first middle school in Maine to offer a full range of contraception in grades 6 to 8, when students are 11 to 15 years old.

The King Student Health Center, which is operated by the city's Public Health Division, has provided condoms as part of reproductive health care since it opened in 2000.

The proposal to expand birth control options drew national attention and raised local concern about its impact on the rights of parents to oversee their children's health care.

While students need written parental permission to be treated at Portland's school-based health centers, state law allows them to receive confidential care for reproductive health, mental health and substance abuse issues.

Doug Jones/Staff Photographer

Kelley McDaniel, a librarian at King Middle School who supported the measure, said she would have benefited if there had been a school health center when she was molested as a child and raped as a teenager.
Committee member Sarah Thompson, whose daughter is an eighth-grader at King, supported the change even though it made her "uncomfortable."

"I know I've done my job as a parent," Thompson said. "(But there) may be a time when she doesn't feel comfortable coming to me (and) not all these kids have a strong parental advocate at home."

Committee members Rebecca Minnick, Robert O'Brien, Peter Eglinton, Lori Gramlich, Ellen Alcorn and Susan Hopkins also supported the measure. John Coyne, chairman, and Benjamin Meiklejohn voted against the change.

Coyne said he believes social agencies and public schools have distinct roles that have blurred over the years. "At some point there needs to be a clearing of the gray lines," he said.

Meiklejohn said after the meeting that he would have supported the measure if his vote had been necessary to ensure passage.

It's unclear whether prescription birth control will be offered this school year or next, said Lisa Belanger, a nurse practitioner who oversees the student health centers.

When prescription birth control is available, parents will be sent a new enrollment form that clearly states the services offered and related student confidentiality requirements under Maine law, she said.

During the public hearing, nine people spoke against the change, largely because parents wouldn't be notified and because they believe it would encourage adolescents to have sex.

"We are dealing with children," said Diane Miller, a Portland resident who is a former school nurse and now works in a gynecologist's office. "I am just horrified at the suggestion."
Supporters of the change said a small number of King students are sexually active, but they need better access to birth control.

"This isn't encouraging kids to have sex. This is about the kids who are engaging in sexual activity," said Richard Veilleux, whose daughter attends King and who was one of three people who spoke in favor of the proposal.

Five King students, ages 14 and 15, reported having sexual intercourse last year, said Amanda Rowe, head nurse for Portland schools.

In the last four years, Portland's three middle schools reported 17 pregnancies, not counting miscarriages or terminated pregnancies that weren't reported to the school nurse, Rowe said.

The percentage of middle school students in Maine who reported having sexual intercourse dropped from 23 percent in 1997 to 13 percent in 2005, according to the Maine Youth Risk Behavior Survey.

The city's Public Health Division operates health centers at Portland High School, Deering High School, King Middle School, West School special education program, and Reiche and East End community schools, which are elementary schools. They are funded by state money and foundation grants, MaineCare/Medicaid and private health insurance reimbursements, and in-kind contributions of space and services provided by the city.

There are 27 school-based health centers in Maine, 20 of which are funded and overseen by the state, including those in Portland. Maranacook Community School in Readfield, which is a combined middle and high school, has the only school-based health center outside Portland that also provides contraception, Belanger said.

Of 1,700 school-connected health centers in the United States, one in four provides birth control ranging from condoms to prescription contraception, according to the National Assembly on School-Based Health Care.

Of 2,877 students eligible to attend Portland's six health centers last year, 1,261, or 44 percent, were enrolled. The center at King, which has 510 students, enrolled 307 students last year. Belanger said 134 of those students were treated at the center for a total of 266 visits last year.

Contraception would be prescribed after a physical examination by a physician or nurse practitioner and would include follow-up care, Belanger said.

Types of prescription birth control available through the health centers include contraceptive pills, patches or injections, as well as the morning-after pill. Diaphragms and IUDs are not usually prescribed, she said.

King is the only one of Portland's three middle schools with a health center, primarily because it has more students who get free or reduced-price lunch, Belanger said.

Moore and Lincoln middle schools don't have health centers, and their students are ineligible for treatment at the King Student Health Center.