Norplant getting few takers at school

By STEVEN A. HOLMES

Special to The New York Times 05-03-94

BALTIMORE, April 26 - Now that the rancorous debate over offering the contraceptive Norplant in school clinics has died down, Latia Garner is looking forward to completing the eleventh grade without again becoming pregnant.

Ms. Garner, 17, is one of a handful of young women who have had the birth control device implanted in her arm since January 1993 by doctors at the, Laurence T. Paquin School in Baltimore.

For Ms. Garner, who had the device implanted a few days after giving birth to her son, Darius, Norplant has been the means to allow her to get her life back in order.

"You know, I've seen a lot of girls who had babies the same time I had my son, and they're getting ready to have another one," Ms. Garner said as Darius crawled on a table. "I feel as though that probably would have been me if I hadn't gotten the Norplant."

Pioneering School Program

The school, established for pregnant teenagers or those who have given birth, is believed to be one of the first in the country to provide students with Norplant, which are matchstick-size capsules. When six of the capsules are inserted under the skin, the contraceptive renders a woman sterile for five years and is completely reversible when removed.

'Providing Norplant to Paquin's students was seen as an example of the struggle being waged by officials in Baltimore and other cities to reduce the rising number of out-of-wedlock births, a phenomenon that is held responsible for many of today's social ills, including poverty, welfare dependency and high crime rates.

But so far, officials say only 36 of 700 students at Paquin have turned to Norplant in the nearly 15 months it has been available.

Earlier this year, health officials here extended the Norplant option to 2,.more of the 21 high schools in the city. But Bernice Rosenthal, director of school-based clinics for the health department, said only two students have had the device inserted by staff members in those clinics.

Shunned by School Boards

Officials of Advocates for Youth, a Washington-based group that promotes sex education and birth control for adolescents, say school boards around the country have shied away from offering the contraceptive in school-based health clinics. About I percent of 105 such clinics that responded to a survey provide Norplant in their clinics, the organization said,

Baltimore health officials say many young women have shunned Norplant because of misinformation about its side effects and because of accusations by some blacks that making Norplant available in predominantly black schools like Paquin was "genocide."

"I know anecdotally from patients that it's still being talked about on the street," said Dr. Peter Beilenson, Baltimore's Commissioner of Health. "There are rumors about Norplant that are just not true."

Indeed, Ms. Garner had to overcome her initial fears and rumors she heard about the contraceptive. "Didn't want it at first," she said. "I heard a lot of negative things about it; you know, your hair will. fall out; you'll get real, real fat, get bumps all over your face; you'll get cancer, or it will blow up in your arm."

Clergy See Girls at Risk

Mary Morris, 17, another Paquin student who chose to use Norplant, recalled Ms. Garner's initial aversion to the implant. "When Tia was pregnant, me and her were best friends," Ms. Morris said. "And we were in here talking, and she was like, 'I'm not getting that mess in my arm.'"

Doubts about Norplant's safety are still being raised here by clergymen, who say that the drug has not been adequately tested on adolescent girls, that it encourages promiscuity and that it would lead to an increase in sexually transmitted diseases.

"All we're saying is, 'Look, since the long-term effects are unknown and there is the possibility of the spread of these deadly, sexually transmitted diseases, why should place our children at risk?' " Said the Rev. Gregory Perkins, pastor Paul Community Baptist Church.

Health officials say that Norplant has been widely used in Europe more than a decade and that there is no evidence that it causes cancer. Except for irregular menstrual bleeding and slight weight gain they said, there are no known harm effects.

Pressure on the Mayor Paquin officials say that follow up studies showed that the incidence of sexually transmitted diseases students using Norplant was  no worse than it was for other women at the school who use other contraceptive methods.

Still, Mr. Perkins said a group of clergy who originally fought the idea of providing it in the schools plans to step up pressure on Mayor Kurt Schmoke to halt its distribution.

The ministers contend that Nor plant can lead to promiscuity may encourage girls to engage in unprotected sexual relations that could cause them to contract transmitted diseases like AIDS.

"You don't have to have a PhD. in child psychology to know that if you give a 13 year old  child this kind of birth control they will feel you are sanctioning this kind of behavior",Mr. Perkins said.