Norplant offers sense of control in a time of chaos


December 08, 1992|By MICHAEL OLESKER

Waiting for the bus at North and Druid Hill, Patricia leans into a church window ledge to protect herself from a blustery wind. She is 16 years old. North and Druid Hill is cold this morning, so she's wrapped a knit cap around her head and a purple jacket around a little boy named Nathaniel who is holding her hand. He is not quite 3 years old.

''Where you going?'' Patricia is asked.

''My grandmother's,'' she says softly.

''Where you coming from?''

''My mother's.''

Patricia's mother lives a block from here, on Druid Hill Avenue. Her father lives about 40 miles from here, in Washington, the last time Patricia's mother heard from him.

The little boy holding Patricia's hand is her own son, a fact which is a mixed blessing. Nathaniel is beautiful to behold: chubby-cheeked, chomping on a piece of bubble gum so large '' that it threatens to swallow him.

He is clearly adored by his mother, but he's also an anchor holding her to her troubled family history. She is the unwed mother-child of an unwed mother who also is the daughter of an unwed mother.

We are now several generations into this breakdown of the American family structure, a fact raised to wrenching proportions in Baltimore, where the rate of teen-age pregnancies is as high as any place in the nation. A year ago, teen-agers accounted for about one out of every four of the city's births.

Now there's a move to change this, as frustrated public health officials are planning to offer a surgically implanted contraceptive called Norplant to sexually active teen-age girls. The implant lasts five years. It would be offered at clinics in city schools. Once, such a gesture would have brought all sorts of outcries; now, whatever protests exist are still muffled.

Let's get this straight: This isn't the mere handing out of birth control here, it's a belated acknowledgment of a sea-change in the American culture. No longer is it enough to preach abstinence, because the kids simply don't listen to such talk any more.

We're now dealing bluntly with this modern fact of life: In matters of sex, the great religions do not reach the kids, the notions of sexual morality do not reach them, and their parents do not reach them as, in many cases, no one ever reached the parents.

Over a few decades now, we're looking at a clear link in America, much of it crystallized in the big cities, of unwed teen-age pregnancies and subsequent despair: of kids dropping out of school and not finding jobs, of poverty and deepening anguish and the blind alley of drugs and crime.

At North and Druid Hill now, Patricia wraps one arm around her son and leans the two of them into the church window ledge. There are 10 windows at street level, all with bars over the windows. Around the corner, a sign on the church reads, "No Trespassing." On many nearby buildings, there are boards over windows and nobody living inside. Police cruise past every few minutes.

The notion of introducing Norplant to teen-age girls isn't strictly about birth control. It's about life control, about youngsters getting old enough to take care of themselves before they're taking care of a child, and about neighborhoods getting a chance to come out from under a terrific social weight.

Are there problems with Norplant? Absolutely. Teen-age girls aren't necessarily able to absorb all the information thrown at them by health counselors, and yet their decisions can affect five years of their lives.

We're now deep into an AIDS epidemic, in which the need to use condoms for disease prevention has been stressed. How do you hand out Norplant for five-year stretches without blunting the message about condoms as AIDS prevention?

(That's a problem health officials say they'll address, but it's also up to the teen-age girls who use Norplant. If they're smart, they won't even tell sexual partners that they're using it, because such an admission will be seen by a lot of young men as an excuse not to use condoms.)

In some cities, using Norplant as a tool of social policy has brought angry charges of racism and big-government paternalism. Maybe such charges are muted here because, at last look, nobody had a better idea for rescuing so many of the city's teen-agers from themselves.

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