, Gloucester, MA

May 30, 2008

Top state health official backs high school birth control

By Patrick Anderson

A top state health official yesterday recommended an "evidence-based" response to the spike in pregnancies at Gloucester High School that would include confidential access to birth control at the high school clinic.

Dr. Lauren Smith, the state Department of Public Health's medical director, offered to help the city combat the rising number of teen pregnancies and said she had held preliminary discussions with representatives of Addison Gilbert Hospital, which runs the high school health clinic, about the best way to bring the fourfold spike in pregnancies at the school this year under control.

"We have urged them to use an evidence-based response to the problem, which would involve a school-based response," Smith said. "Our pledge is that we will work with them to respond in a way that is sound public health principles and practice. That would include contraceptive counseling and services."

School, city and hospital officials have been discussing a response to the high school's teen pregnancy rate after learning that 17 girls at the school had become pregnant this year, around four times the average annual number.

But work on a new policy was disrupted last week when Dr. Brian Orr, the medical director of the health clinic and a member of the hospital-led advisory board, resigned because of what he said was a reluctance on the part of the hospital system to provide birth control at the high school.

Representatives from Addison Gilbert Hospital and its parent company, Northeast Health System, have denied Orr's claim that the organization opposes providing birth control to high school students.

On Wednesday, Addison Gilbert Hospital Director Cindy Donaldson said the reason the decision regarding birth control had not already been made was a desire to give the School Committee a chance to weigh in on the issue.

A draft of the policy paper being worked on by the advisory committee, which was obtained by the Times, includes several recommendations, including research and deliberation into the best ways to reduce teen pregnancy using health education, reinstating fifth-grade sex education, updated staff training, involving parents in prevention efforts and improving "confidential access to reproductive health care services for teens in Gloucester."

Hospital officials yesterday declined to clarify whether improving access to reproductive health care services meant providing contraceptives to students in the high school health clinic.

Smith's recommendation for the school clinic to include contraceptive services and to be based on maximizing results, would appear to be in line with Orr's desire to see a swift policy decision to provide birth control. Smith noted that the school health center, although housed within the school, was an independent medical facility run by a hospital, not by the school.

But Smith did not it was wrong to put the issue in the hands of the School Committee or to research the issue further.

"I think each school-based health center is unique, within the school and community," Smith said. "I would urge the public health department and the hospital to have a frank discussion about what has happened and prevent this kind of thing in the future."

In light of Orr's resignation and critique of the advisory committee process, Mayor Carolyn Kirk, also a member of the School Committee, has called for independent experts not already connected with the health center to study and advise the city on the best course of action.

Yesterday, Heather Jones, a spokesman for Northeast Health System, said now that Kirk had requested a separate advisory effort, led by Public Health Director Jack Vondras, it was unlikely the formal recommendation the health clinic advisory committee was working on would be presented to the School Committee.

"We (Northeast Health System) feel it is important to wait to receive direction from Mayor Kirk on this issue," Jones said. "We support the mayor in her recommendation to bring in independent advisers and her efforts to come to a resolution on this issue."

Smith said based on the last available statistics compiled by the state on teen births in 2006, which showed the number of children born to teen mothers decreasing statewide, the rise in pregnancies in Gloucester was unusual.

"For the most part, the teen birth rate has gone down in Massachusetts each year," Smith said. "Based on that the department is concerned about what seems to be a spike in pregnancies there."

Patrick Anderson can be reached at