A state public health official is urging Gloucester officials to take swift and decisive action, including allowing prescription birth control, to curb a spike in teen pregnancy among students at Gloucester High School, where a record 17 girls are pregnant.
"We see this has a serious public health urgency," said Dr. Lauren Smith, medical director for the state Department of Public Health. "We stand ready to support the Gloucester community to develop an appropriate . . . response to what is clearly a significant problem in their community."
A dispute over prescription contraceptives appears to have divided a 12-member advisory committee overseeing the Gloucester High clinic. Northeast Health System of Beverly, which owns Addison Gilbert Hospital in Gloucester, manages the eight-year-old clinic.
The clinic's medical director and chief nurse practitioner have resigned because they do not believe Northeast will support their recommendation that contraceptives be prescribed at the clinic.
"It is very clear that the board [at Northeast] is not in favor, and will not support, contraception in the school," said Dr. Brian Orr, a Gloucester pediatrician who has managed the clinic since it opened. "There is an epidemic of teen pregnancy at the school."
Orr said both he and his top assistant, Kim Daly, who also works at Orr's private pediatrics practice in Gloucester, will leave their posts when school ends next month.
But a Northeast official, who confirmed the resignations, disputed Orr's assertion. Prescription contraceptives are included in a proposal on reproductive health education approved by the clinic's advisory committee at its May 21 meeting, said Cindy Donaldson, , administrative director at Addison Gilbert.
"We're working on a multifaceted approach to this problem . . . including providing oral contraception," she said in an interview.
The proposal - which also includes information about the impact of teen pregnancy on a school community, goal-setting, and sex education strategies - has been sent to the School Committee for review. "We made it clear we will not offer [contraceptives] if it has not been to the School Committee for approval," Donaldson said. "We need a strong program. No one approach will fix this."
The Gloucester School Committee, which was due to meet last night, has been awaiting the advisory committee's proposal since it first learned of the high number of pregnancies, said Greg Verga, the committee chairman.
"We're hoping they come with a full plan," Verga said. "This is a significant issue we're facing."
Orr doubts Northeast will allow prescription contraceptives even if the School Committee approves the plan. In meetings held over the last several months, Northeast officials expressed concern over liability issues related to the possible side effects of birth control pills, including stroke, Orr said.
"The example they used was a stroked-out teen from birth control pills. Would there be any liability to the hospital?" he said. "It was very clear that the board of the hospital is not in favor, and will not support, contraception in this school."
Donaldson said liability was one of three key issues that concerned Northeast. The other two were the reaction of the community, and the impact on the health center, she said.
Donaldson said the Northeast board will have to vote on the pregnancy prevention plan, even if the School Committee approves it.
"That's the appropriate process for us," she said. "We as a hospital support the paper. We support the recommendations. We're asking the School Committee for approval."
Smith, the state health official, believes Gloucester should give strong consideration to prescription contraceptives.
"There are far more health risks to adolescent pregnancy than there is taking birth control," Smith said. "Pregnancy among young girls is not something that doesn't have its own consequences."
Smith said birth control pills are "a very safe medication," for younger-age women. "It's very rare that there are adverse consequences."
In 2006, the most recent year for which data are available from the state, Gloucester had 19 births by teens. "Not all of those would be within the school," said Jack Vondras, city public health director, who also sits on the health clinic advisory committee. "They may have left school, or attend school somewhere else. What we know now is there are 17 pregnant young ladies at Gloucester High."
A large number of the pregnancies are among younger students, Donaldson said.
"It's very sad," she said. "A good portion of them are sophomores."
School Superintendent Christopher Farmer said he is working to resolve the dispute. "I'm very dismayed at what has happened," he said Tuesday. "I think there may be a lot of misunderstanding here . . . The important thing to remember is that my staff has been working" with the advisory committee to develop a comprehensive plan. "Contraceptives is only one piece of it."
Gloucester High is one of 47 school clinics funded by grants from the state Department of Public Health. About one-third of them prescribe contraceptives. Other local clinics are at high schools in Chelsea, Lynn, Revere, and Salem.
Although parental permission is required for students to be treated at the clinics, state law allows confidential care for reproductive health issues. The Gloucester clinic conducts pregnancy tests and offers birth control counseling.
Kathy McCabe can be reached at firstname.lastname@example.org.