There's been a lot of buzz over the past few days about a middle school in Maine that plans to make birth control available to 11-14 year old students without parental consent or notification. Newspapers and blogs and discussion groups across the country and beyond are debating whether or not middle-schoolers should have access to birth control. The recurrent arguments between the "they're going to do it anyway" crowd and the "giving them birth control only encourages them" crowd are in full swing...and absolutely everybody seems to have missed the point.
My daughter is in the sixth grade. Her middle school can't give her a dose of Motrin when she has a headache unless I run up to the school and not only sign a consent, but provide the medication. They can't let her use her prescribed inhaler with her name and her doctor's name printed on the label unless BOTH her doctor and I sign authorizations. And as much of a hassle as those things sometimes seem like, there's a good reason for all of those checks.
What if, for instance, my daughter was allergic to Motrin? At what age should she be expected to know and take responsibility for that, and to learn all of its alternative forms and names and related drugs, so that she would recognize that she couldn't take Ibuprofin if she'd had an allergic reaction to Motrin? It's my job, at least at this stage of the game, to know those things. It's my job to look out for side effects and allergic reactions, too, and to make sure that prescribing doctors and pharmacists are aware of anything else she might be taking so that we're not mixing drugs that shouldn't be mixed.
If we have to take all of that into account in order to ensure that it's safe to give a kid Tylenol, how do the politics of adolescent sex suddenly make it safe to prescribe them hormone-altering drugs with multiple known side-effects without parental knowledge? What if we have a family history of blood clots or stroke or any of the many things that make hormonal birth control dangerous? Is the average 7th grader conversant enough in that information to provide the prescribing doctor with adequate information? And what if she begins to have symptoms and side effects? Is she ready to be wholly responsible for making her own judgment about when medical follow-up is required? She'd better be, because if there's no parental notification and she chooses not to tell her parents, then no one is going to be keeping an eye on her for those warning signs. If she complains about cramps in her legs, no adult will be able to make the connection and tell her she'd better get in touch with the doctor.
If she's having more headaches than usual...well, then what? Because if a child suddenly starts having serious headaches on a regular basis, you take her to the doctor, right? But what happens when you get there? You're asked...the parent, not the child...to complete a list of current medications. You do it, unwittingly leaving off the most important piece of information. Does the child speak up? We can hope, but she might not understand that there's a probable connection, and if she's gone this far to obtain the prescription and use it without letting you know, odds seem to be against her cheerfully adding it to the medications list in the doctor's office.
And the debate rages on--should adolescents have access to birth control? Are they really having sex at that age? Will they be more likely to have sex if we give them birth control? Isn't birth control at 12 better than pregnancy at 12? Aren't we sending the wrong message if we give them birth control? The soundbites fly, and the real issue never rises to the surface. Like every other parent in America, I have concerns and opinions about all of those issues. But none of them have the first thing to do with this issue.
11-year-old children need their parents involved in their medical care. Period. We need to check their temperatures and give them Ibuprofin when they need it, talk with their doctors, understand how their prescription drugs interact, make sure they drink enough fluids when they have the flu...and we sure as hell need to know when they're taking hormone-altering drugs that can have serious short and long-term side-effects.