Norplant and Baltimore Teens

December 12, 1992

When Norplant first became available in this country in early 1991, family planning professionals hailed the implant as an important new contraceptive choice for women. And that's exactly the proper focus of the Baltimore City Norplant Consortium -- making it possible for women, in this case sexually active teen-aged girls, to consider a new contraceptive choice that otherwise would be too expensive.

Formed recently by city Health Commissioner Peter Beilenson, the group of doctors, hospitals and foundations intends to provide information about Norplant to sexually active teen-agers, along with funding for those who choose to use it. The financial support is crucial, since the Norplant kit itself costs $365, plus the fee for insertion. For five years' worth of birth control, that may be a relatively reasonable cost, but it's certainly more than many women can afford all at once.

AReports of Baltimore's new efforts to target teen-aged girls have drawn national attention. In fact, contraceptives have been available in school-based health clinics here for a couple of years -- in large part because of a wise school board policy that considers school-based clinics a health service. The board leaves the clinics' operation and policies up to health department officials, who consult with parents and the schools in question. That way, the issue has been kept out of a forum which would attract people with ideological agendas but no real connection to the program in question.

Nothing about this program -- or about the school-based clinics in which it operates -- is coercive, nor should it be seen as a substitute for encouraging abstinence. The Norplant consortium simply helps clinics offer another option to students, many of whom could not otherwise afford it and who recognize that a reliable contraceptive could mean the difference between preparing themselves for employment and a life of welfare dependency. But Norplant also has the advantage of being reversible. The implant is easily removed, and fertility returns within a couple of days.

Dr. Beilenson has been in office only a few weeks, but the reaction to the Norplant consortium suggests he will quickly become a familiar name in the city. That's just as well. With budget cuts at every level of government, public health services will need leaders with a great deal of creativity, energy and good political sense. If Dr. Beilenson can demonstrate those qualities when it comes to a potentially controversial issue like teen-agers and Norplant, there will be hope that he can make substantial headway on other problems as well.

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