Norplant joins war on teen pregnancy - Baltimore, Maryland schools to offer long-term birth control implant - Cover Story

0 Comments | Insight on the News, March 8, 1993 | by Gayle Hanson

Summary: Baltimore's decision to offer schoolgirls a long-term birth control implant has refocused attention on the issue of teen pregnancy. The idea that contraceptives must be made easier to obtain and use is predicated on the assumption that all teen pregnancies are unwanted, and that's not clear.

Like most teenage girls, Mary N. has her dreams. There are parties to attend, classes to take and, best of all, there is the moment next year when she'll put on her prettiest party dress and, wrapped in the arms of her sweetheart, dance through the night at her high school prom.

"I'm really looking forward to going to it," she says. "I'm lucky because I have a lot of friends, and they've told me that when I need a baby-sitter they'll be glad to help me out."

Mary, 15, is three months into her sophomore year and five months into her first pregnancy. As she plays with her youngest sister in the living room of the East Baltimore apartment she shares with her mother, her mother's live-in boyfriend and three siblings, Mary doesn't want to talk about the painful swelling in her feet. She would much rather chat nostalgically about the years she spent marching with the local color guard and the trips that enabled her to take.

"I went to Wildwood, N.J., every year," she recalls. "This year they're going to a really big competition in Ohio. But my doctor said that I had to give up color guard during my pregnancy, that it wasn't good for me to be marching. But I hope that someday I'll be able to go back to it."

There is something at once poignant and depressing in Mary's hopes. Although she is only four months away from giving birth, some part of her hasn't yet grasped the fact that having a baby will change her life, if not forever then at least for the next couple of decades. But then Mary herself is still a child; her pictures line the living room walls and her name is etched on trophies that her mother bought for her to mark year after year of perfect attendance at school.

"I didn't think that I could get pregnant," she says. "My boyfriend's mother told him that when he was little his brother bit him and he couldn't have children."

Mary has known the father of her baby since she was in kindergarten. He is also 15. These days he visits her two or three times a week and accompanies her on her visits to the doctor.

But contact between the two is carefully monitored by both their mothers. Mary's mom is against the notion of them marrying anytime soon.

"They're too young," she says matter-of-factly. "When they turn 18 if they want to go ahead and get married that's fine. But right now they're just too young."

Not so long ago, this would not have been the case.

Three generations ago in Baltimore, the rates of teen childbearing were higher than today, but the moral code was different. In the 1950s, if a girl of 16 found herself "in the family way" she would most likely have dropped out of school and married the father of the baby. He probably also would have dropped out of school. But the economics were different then as well. Chances are he could have found work, say at the Baltimore area's largest employer, Bethlehem Steel Corp. The family would have had a decent income and health insurance.

Today's pregnant teen most often does not marry the father. She drops out of school and, if lucky, finds a low-paying job without any health insurance. She probably does not have the skills to acquire a job at the Johns Hopkins Institutions, now the area's largest employer, and most likely she will end up on welfare. The costs, financial and emotional, will be much heavier for her and her children.

This, in a nutshell, is why teen pregnancy, though low by historical standards, is now considered a social problem of the first order. So acute is the problem in Baltimore that the Health Department has adopted extraordinary measures. Public health officials there have established nine school-based health clinics that, besides dispensing aspirin for headaches, provide contraceptives to teens. For more than two years, these clinics have given birth control to all comers. And they have done so with little protest from the community.

In early December, however, newly appointed city Health Commissioner Peter Beilenson upped the ante, announcing that the long-term contraceptive Norplant would be made available to females in Baltimore public schools. Surgically implanted under the skin of the arm, Norplant's six silicone rubber capsules, each about the size of a wooden match, slowly release a synthetic hormone that causes infertility for about five years. The effects are reversible upon removal, which also requires minor surgery.

Beilenson's Norplant initiative seems to have focused the eyes of the world on the city and its teens. Critics denounced the intent as racist, even genocidal, saying the action was targeted at black teens.

Beilenson, for his part, stresses that Norplant is simply "an incredibly effective form of birth control, and we see it as just another option that is being made available. This is really nothing different than what we have been doing all along. It's the media which have made this into an issue. The community is certainly behind the decision."