Promoting Adolescent Reproductive Health: The Case for On-Site Contraception in Low-Income Public High Schools

There clearly exists an epidemic plaguing adolescents and, the school system has the power to stop its escalation. Trends in low income high schools prove the teenage birth rate in the United States has reached a starting high and, there appears to be no indications of decline. The assessment of such soaring birth statistics lends a mere fraction of the indicative pregnancy rate as not all pregnancies are carries to term. Extensive studies express the public-school system as the ideal location to enact free contraception availability programs as the predominance of teenagers attend public schools, thus making it an ideal setting for change. Successful ongoing research indicates on site access to both hormonal and non-hormonal contraception can further the academic success of students by allowing the focus on academic endeavors instead of their health. Free contraception would permit the eradication of social stigma surrounding topics of a sexual nature. Students who go on to elect from health resources have a likelihood of seeking further preventative services thus increasing teenagers’ comprehensive health. Individuals who benefit from school based health services profit from the added value of becoming literate in the mechanics of prevention. Condom availability programs go on to provide the most effective prevention of sexually transmitted diseases as condoms are the only established safety method against reproductive illnesses. Moreover, on site contraception will counter drop-out rates among young parents who are forced to abandon their academic pursuit as a result of premature pregnancy. Both hormonal and non-hormonal contraception should be provided to adolescents in low-income pubic high schools.

To understand the fundamental concepts of teen pregnancy prevention there must be a familiarization with the corresponding terms: adolescent, contraception, sexual behavior, and school-based health center. The participants whose sexual activity is analyzed is students ages 13 to 18 years old with the median age of adolescents being 16 years of age. This selection of adolescents attend low-income public high schools within the continental United States. Diversity in socio-economic sectors of the study include traditionally liberal states such as Oregon and Massachusetts and the conservative state of Texas. The research primarily refers to condoms as the principal non-hormonal contraception choice; hormonal contraception consists of a plethora of methods, extended but not limited to, the pill and the Depo-Provera shot. Any activity that may result in pregnancy would be defined as sexual behavior. Melina and others explain, school-based health centers (SBHCs) are implemented to provide readily available and affordable health services to students. “Reproductive health visits are amongst the most common reasons adolescents seek care at SBHCs”. The multi-layered research methods utilized to design these studies vary in nature. Statistical data was most prevalently provided through data regression analysis, multi-stage sample clustering design, Chi-square coefficient test, and the AHLERS Integrated System. Edmund Husserl's phenomenology research strategies lent the basis for the qualitative portion of the research provided.

To properly treat and educate adolescents on the significance of their sexual reproductive health it is essential the stigma is eliminated from the topic. There are often three barriers associated with students of this age group receiving affordable and timely contraception. First, extracurricular activities and school work often allot the students free time; students who do not participate in outside activities are inclined to manage a school and home-life balance. Additionally, adolescents often do not have access to transportation to medical facilities; in turn they do not receive treatment or refills on their prescriptions. Ultimately, as women's health expert, Pooja and others note, the most avoidable barrier is the embarrassment students feel when their reputations are associated with alternative clinic environments. If adolescents feel alienated for their choice in taking part in SBHC services, then in turn they will refuse sexual reproductive health resources. PhD Melina and others emphasize “SBHC users were more likely to report higher levels of screening and/or counseling to prevent pregnancy and sexually transmitted diseases than non-users'. The absence of SBHCs places students' academic endeavors at jeopardy but also, the safety of their health. SBHCs dispense free contraception to prevent serious illness; they equip adolescents with information and knowledge to prevent sexually transmitted diseases and unplanned pregnancy. For the wellbeing of teens, it is imperative states implement health programs that allow schools to distribute contraception on site. A positive perspective on contraception coupled with an encouraging environment for contraception use are the first components to oversee when becoming involved in sexual health care for adolescents.

A significant percent of adolescents continue to pursue their health journey after initial consultations with nurse practitioners in SBHC. Recurring consultations at SBHCs encourage students to become comfortable in a private clinic setting, which empowers students to report candid responses. Yale scholars Daley and Polifroni explain, gaining rapport with teens is critical in becoming a trusted administrator as it “facilitated access to comprehensive services throughout high school'. The indicated statement affirms the conviction, adolescents sustain visits with sexual reproductive health providers because nurse practitioners allow adolescents to feel heard. For youth in low socioeconomic neighborhoods SBHC are often the only accessible source of sexual reproductive and comprehensive care. In Texas, Peggy and others emphasize the need for on site contraception, “52% of Hispanic girls and 50% of black girls under 20 years of age will become pregnant as opposed to 19% of non-Hispanic white girls”. The disproportionate percent of unplanned pregnancies further drives the socioeconomic divide and, negatively impacts both mother and child. For student from low-income households' financial restraints are often a barrier when attempting to obtain contraception. Students who do not have insurance, did not have contraception coverage, or could not afford copays often times became pregnant. Daley and Polifrontis’ research illustrates the frustration nurse practitioners in Texas felt when, adolescents who once expressed interest in hormonal contraception return to the clinic pregnant because they could not afford to pay for birth control.

Sexual reproductive health is ordinarily discussed by guardians and their teens in a confidential nature. This idea of sexual education being a private affair dealt with in a family setting is typical of American culture. It is understandable, the trepidation adults may have when presented with alternative programs. Parents and adults who view abstinence programs as the exemplary model of sexual education, often dismiss the opportunity to providing free contraception to public high school students. Reluctant parents fear the availability of free contraception in public high schools will urge students to engaging in sexual intercourse. One of the most significant dangers of eliminating free birth control would be the increase of sexually active high schoolers. Researchers Dr. Susan and others from, the Department of Prevention and Community Health at George Washington University, emphasizes, “Adolescents enrolled in schools with condom availability programs were no more likely to report ever having had sexual intercourse”. What Dr. Susan and others assert is, the integration of free contraception into public high schools, will reduce the students’ risk for early sexual intercourse. Statistical data through means of logistical regression analysis was used to provide an understanding of the sexual patterns in 4000 adolescents in schools that do and do not provide free condoms and birth control. Therefore, adults may let go of their presumptions around providing gratuitous birth control and, the inaccurate conclusions surrounding their integration into the public education relm.