Middle School Prescribing Birth Control Pills

[realtraveller]

FOXNews.com - School Board Approves Birth Control Prescriptions at Maine Middle School - Health News | Current Health News | Medical News

This is a really dumb idea.

The girls will have a physical exam but the doctor or nurse practitioner at the school clinic will have no idea of the girl's health history or other medications she is on. They will be relying on a middle schooler to know that!

This school district is setting itself up for litigation if some medical complication happens to some middle school girl.

Yes parents have to give permission for the kids to use the clinic. In our schools, if a kid needs to get medication during the school day, they have to go to the nurse's office and have it administered there. Diabetics for example. It's not clear from the article if parents give permission for their kid to be seen in the nurse's office for this sort of thing or playground injuries, they are also giving permission for all treatment. It isn't clear if this clinic also serves as the school nurse's office or if they are two different things.

[mjfrombuffalo[$]]

The AP coverage provides some more details including the answer to the consent question (no, parental consent for the health center does not break out contraceptive-realted services) and the mention that the school has had 17 middle-school pregnancies in the past four years (not including miscarriages or terminations not reported to the school).

[realtraveller]

So the school has created a system in which if a parent wants her child to be treated for a bee sting or a skinned knee by the school nurse, they are also giving consent to BC pills without their knowledge?

I'm not going to argue morality or all that. I'm arguing safety. A child cannot make an informed decision as to whether or not to take a drug that can cause blood clots, bleeding, nausea, weight gain and may raise the risks for certain types of cancer. Legally, a child can't even give informed consent, so legally it's as if the doctor is giving a prescription drug without telling the patient about any of the risks. Puts the doctor in an untenable position if anything goes wrong.

Then on top of that, without the parent or even the child's regular doctor knowing about the BC pills, if there are any of those complications, treatment could be compromised.

I really doubt if the school district contacted their lawyers before dreaming up this nonsense.

A school doctor or nurse shouldn't be prescribing prescription drugs to a child without the parent's knowledge, period. BC pills shouldn't be treated any differently than any other prescription. Prescription drugs have risks that are beyond a child's ability to determine, legally and practically.

[erik_kosberg]

AP story said

Students need parental permission to access the school's health center. But treatment is confidential under state law...

Parents who don't like the fact that prescriptions are written have two very powerful options. They can not give written permission for their kids to access the school's health center or they can work to change existing state law. Otherwise they can I suppose whine about policies they don't like, for all the good that will do.

[realtraveller]

Or they can pull their child out of that school.

I don't understand the 'treatment is confidential'. If your child is treated at school for anything, the school nurse calls home and either says 'this is what happened and your child is fine' or 'you have to get over here now and take this child to the doctor'.

I doubt if all treatment is confidential. They must just mean the BC pills.

[conradd]

I don't understand why the school is choosing to lump all medical treatment under one blanket permission. I would want my child to have full access to the school clinic for minor cuts, scrapes, and illnesses. Writing prescriptions for birth control is a whole new level. I wouldn't want the clinic writing prescriptions for anything without my approval and oversight. That's part of being a parent and I wouldn't sign that responsibility over to anybody else.

If my child was sexually active at 13, I would need to know that. There are many risks for sexually active children besides pregnancy.

[phoenixx]

It occurs to me that if nothing else, this blanket permission discussion may have initiated many discussions about sex in houses that may have formerly chosen to be ostriches about it or assume preaching abstinence was enough. Could be an interesting twist to a story that has sounded odd from the moment I heard it the other day.

[drmomentum[$]]

I'm pretty sure that being pregnant is more dangerous than taking birth control pills, so the safety issue isn't much of an issue.

I'm more sympathetic to what Deb is saying. I'd want to know, too. However, I'm imagining myself as I am. What about all those situations with parents who are not like me?

What about girls who are being abused? Do you contact the abuser (assuming you don't know the sexual activity is abuse because the girl didn't reveal that information)?

If a person is sexually active, intentionally or not, they have already entered a realm of increased problems and responsibility. They're there whether we like it or not. They now have adult problems and adult responsibility. The parent may have already failed; involving the parent further would certainly be appropriate in some cases, but not all. But the school wants to set up a policy that it feels will help in most cases.

I assume the school is lumping together these things because they believe they're doing the right thing for their students, who are apparently multiplying like rabbits in an environment where the parents are failing.

I am ignoring the legal questions because it's a lawyer's job to ignore practical solutions until someone finds a way to make practical solutions legal.

-JP

[realtraveller]

I don't think that a vote of the school board can change the state laws on consent for minors to get prescription drugs. (I don't know what Maine's laws are).

[realtraveller]

That the parents have to consent to the clinic access indicates that there is no blanket state law giving minors the ability to get BC pills without their parent's consent. Otherwise, the kids could go to the clinic for BC pills whether or not their parent's signed the consent form.

[mjfrombuffalo[$]]

In NYS, minors can get prescription birth control without parental consent, so whether the clinic was in the school or down the street is immaterial. It is the doctor's determination that the minor has the capacity and maturity to follow the instructions and use the contraceptives properly that determines if the minor receives them, not parental permission - or knowledge, for that matter; reproductive health is carved out of both the parental consent rules and the parental rights to treatment records of their children.

[frazzledspice]

If girls aged 11-13 can be given birth control without their parents' permission, I would be more comfortable if the only forms of birth control that were dispensed were non-hormonal in nature.

There may be reasons within the family history that contraindicate the pill. (Or cigarette smoking, and there is probably a fairly strong correlation between rebellious adolescents smoking and having sex.)

It seems as if what this educational system really needs are parent-child communication skills classes.

[jgibson2[$]]

I would hate to have to choose between having my child refused all care in the health center and having them able to write prescriptions without my consent.

Also, I see enough middle-school moms to know that the kids who are getting pregnant at that age might not be helped by more readily available birth control. In this area, it's often not an unintended pregnancy. There is a combination of young teen/pre-teen girl who wants desperately to be loved (boy are they clueless) and significantly older male who is proud of the fact that he has impregnated multiple young women/girls.

[eris esoteric]

Me? I'm just really saddened by the number 17 reported pregnancies.

JP, there are issues with the pill that can become as serious as pregnancy. In addition, taking hormone treatments while the body is still developing can cause other issues.

On the other hand... 17 middleschoolers pregnant in 4 years... YIKE.

[mjfrombuffalo[$]]

eris esoteric said

taking hormone treatments while the body is still developing can cause other issues.

FWIW, have you seen a lot of those middleschoolers these days? Methinks they're already quited developed... Hubby can't get over how many of his 6th-graders he's mistaken for being students' moms instead of students themselves.

[eris esoteric]

Clothes and Wonderbras don't make the woman a woman, if she's still a young girl.

[emeleel]

Y'all beat me to all the discussion, I've been gone all day.

I'm wondering where it can end. If the school medical facilities can start dispensing BC, where does it stop? Will they later be allowed to dispense ADD/ADHD medication without parental permission, because the parents "won't" put them on medication?

[jgibson2[$]]

emeleel said

I'm wondering where it can end. If the school medical facilities can start dispensing BC, where does it stop? Will they later be allowed to dispense ADD/ADHD medication without parental permission, because the parents "won't" put them on medication?

I don't think they can get away with prescribing what are generally controlled substances without parental consent. Too much problem with kids dealing the legitimately prescribed pills without leaving the parents out of the loop. Also, I think the DEA would look askance at a school that was handing out controlled substances. Various and sundry court cases have put BC without parental consent in a totally different class than say antibiotics (or aspirin).

[mjfrombuffalo[$]]

eris esoteric said

Clothes and Wonderbras don't make the woman a woman, if she's still a young girl.

Honey, these girls are not packing padding. Mentally, of course they're not women but physically, these girls are tall, they got boobs, they got booties, and they've got altogether way too much knowledge of things I didn't know when I was their age, that's for sure. And the third-grade teacher runs out of sanitary supplies for her students every semester. I don't know if it's cow hormones in the milk or what, but these are not the same girls as in my 6th grade class, by any stretch of the imagination. It's really scary.

[magenta321]

My worry is that birth control pills give a false-sense of security. In an immature mind, thinking that they can't get pregnant is "safe." They are likely to gloss over the fact that they can get diseases.

I can remember actually reminding my friend about this in college. I have no doubt that if a 19 year old girl can get mixed up about it, an 11 year old girl DEFINATELY can.

What's wrong with teaching them to use condoms? What's wrong with what we were taught in the 1990s... that if you have sex without a condom you might have given yourself a death sentence?

[wivabef]

Yeah, birth control pills do not protect a child from STDs.

I wish more parents were responsible for their offspring so I wouldn't be forced to make such drastic choices.

But, then again, if they hadn't gotten pregnant at a young age, they might be better parents.

Its a problem that just keeps perpetuating itself, isn't it?