A CATCH 22: New York High Schools Give Morning After Pill to Teens

New York's public high schools become latest birth control dispensaries.

New York fights teen pregnancy in public high schools.

A 16-year-old at the High School of Fashion Industries in Chelsea was in desperate need of birth control pills and a free pregnancy test, but couldn’t bear to go back to the neighborhood walk-in clinic she had fled days before. The waiting room full of married couples intimidated her. “I went inside and saw the people, and I was like, I’m not doing this,” she said. “Not here.”

Her need for access to contraceptives is not unusual for New York teenagers. Statistics collected by the Guttmacher Institute show that 13 percent of teens have had sex by age 15, a number that jumps to 70 percent before they turn 20. Although confidential clinics are available throughout the city, navigating the medical system can be overwhelming for a teenager without help from an adult. The junior at Fashion, Carolina, who declined to share her last name, said that to ask her mother would have meant confessing that she was sexually active, which she, like so many teen-aged girls, wanted to avoid.

But embarrassment is not the only deterrent for teenagers who need professional counsel, both to choose the right method of birth control and then obtain it. A position paper from the Society for Adolescent Medicine points out that technical issues such as billing, notifications, and reimbursement procedures can be just as overwhelming to an adolescent. This was Carolina’s experience. “The thing about it is, in an outside clinic, you have to put down your information, and you have to open up an account,” she said. “They said my parents might find out through the insurance. So I didn’t want to deal with that.” All of these factors inadvertently conspire to promote unsafe sex among teens and and can lead to pregnancy-related dropouts.

For the past 45 years, both the New York Department of Health and the Department of Education have been working to address the issue of teen pregnancy in the city’s five boroughs. The latest iteration lets girls like Carolina turn to their school’s health center for comprehensive and confidential reproductive services. CATCH, short for Connecting Adolescents to Comprehensive Health Care, links sex education to safe sex practices. It began in January 2011 at five schools with high pregnancy-related dropout rates that happen to be located in neighborhoods that offer few, if any, related services.

The program got off to an inauspicious start. Parents reacted vociferously to an article in the New York Post that zoomed in on the inadequate way the schools had gone about informing parents about the project. On top of that, the health department and the Department of Education have shown reluctance to be transparent about the plan with inquiring parents or with the media. In response to inquiries over the past eight months, neither department has been forthcoming about the project despite repeated requests for interviews or for replies to written questions.

Bad press and parental brouhaha aside, results at the initial five schools in the pilot were promising enough for CATCH to expand to eight more schools at the beginning of the 2012-2013 school year. Under the program’s provisions, students who ask -- and whose parents have not opted them out of participation -- can receive pregnancy tests, condoms, and other forms of birth control, including Plan B. The program also offers education on contraceptive methods and provides referrals to outside, teen-friendly clinics. It makes all these services available without cost or parental permission.

But this is the Catch-22 that caused the negative reaction at the outset: Parents who never receive notice of a new school program are not in much of a position to opt their children out of it. When CATCH began, participating schools chose to inform parents by sending an informational opt-out letter home with freshmen in their orientation packets. Students in the upper grades also got a letter to take home. The inevitable non-delivery meant, in effect, that first word of the program for many parents came from the Post. “NYC Schools Give Out Morning-After Pills to Students—Without Telling Parents” was the inflammatory headline that appeared 18 days after classes began in September 2012. Parents organizations responded swiftly, speaking out against CATCH in televised interviews and at a protest on the steps of City Hall.

While some of the initial fury has since subsided, the program continues to generate controversy. One underlying issue is the assumed control parents believe they should have on what the sexual rights of adolescents are or should be. Another is a newly critical examination the pilot project has spawned: how city government handles the sensitive issue of sex education for its youth.

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