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When high schools offer family planning.


 Over 40 school-based health clinics, which provide general medical services as well as family planning services and counseling to high school students, have been established to date in the US. These clinics, generally located in low income areas where adolescent pregnancy is a serious problem, have generated significant controversy. Proponents of school-based services argue that schools are an ideal place to reach teenagers, especially since teens who seek care related to family planning do not experience the embarrassment that might accompany a visit to a Planned Parenthood facility. They stress the benefits of inexpensive, comprehensive health care for adolescents who might not otherwise have access to medical care and the need for a pragmatic approach to rising rates of adolescent pregnancy. Opponents of the clinics argue that providing contraceptives in the schools condones adolescent sexual activity and constitutes an abdication of moral authority. They believe that parents, not schools, should be the agent responsible for providing young people with information about contraception and sexuality. The cost of school-based medical care has been estimated at US$100-125 per year of student use. Existing facilities are funded through a mixture of federal, state, local, and private monies. Although few effectiveness studies have been carried out in this area, data from a St. Paul, Minnesota, clinic indicated that the fertility rate among high school students dropped from 79 to 35/1000, the dropout rate among girls who delivered and kept their babies declined from 45% to 10%, and the use of contraception by these adolescent mothers doubled during the 3 years the program was in operation.
