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5 Baltimore School Clinics To Offer Students Norplant

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Public-health and school officials in Baltimore announced last week that they will begin offering Norplant, the surgically implanted contraceptive, in two more high school health clinics next month and in three others next spring.

The Baltimore city school system last January became the first district in the nation to offer the long-term contraceptive to its students when it opened a pilot program at a high school for girls who are pregnant or who have had children. (See Education Week, Dec. 16, 1992.)

The five clinics slated to be included in the expansion of the program are all in regular high schools.

"There are huge teenage-pregnancy problems in all these high schools, and offering options is one of the minimal things we can do,'' said Elizabeth S. Miola, the director of the city's school-based-clinic program.

In Baltimore, 97 out of every 1,000 girls between ages 15 and 17 gave birth in 1990, a rate that is three times the statewide average, according to local health officials.

Last year, the city school board authorized that Norplant be offered along with such already available birth-control choices as condoms, diaphragms, and oral contraceptives in public school clinics.

Norplant consists of six matchstick-sized capsules that are implanted in a woman's upper arm. The capsules release a hormone that will prevent ovulation for up to five years.

Some Opposition

The decision to increase the number of Baltimore schools that offer Norplant has sparked opposition from some local leaders. The district does not require parental notification or consent before dispensing contraceptives, including Norplant, to minors, and some city leaders fear parents will be excluded from the process.

"The health department has decided they want to do surgery on girls without parental consultation,'' said Karl Stokes, a city councilman who has opposed the program from its inception.

But Dr. Peter Beilenson, Baltimore's health commissioner, said students there are "very well-informed about the procedure'' and that three counseling sessions are conducted before the device is inserted.

Mr. Stokes and others also contend that Norplant will make teenagers less likely to practice "safe sex,'' thus putting them at an increased risk for contracting AIDS and other sexually transmitted diseases. City health officials said they recognize this hazard and noted that clinic workers provide free condoms to students.

Critics elsewhere also argue there has not been sufficient research on the effect of Norplant on the health of adolescents who use it.

But one high school principal involved in the Baltimore program's expansion said he is pleased he will soon be able to provide another choice for his students.

"The teenage-pregnancy problem is a serious problem here,'' said Principal David M. Benson of Southwestern High School. He estimated that of the 1,600 students at his school, 200 are teenage parents. The more birth-control choices these students have, he said, the better.

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