By Senti Sojwal
In January of 2011, New York City launched a pilot program to provide free prescription contraceptives including Depo-Provera and the morning after pill, Plan B, to students in five public high schools. The program, called CATCH (Connecting Adolescents to Comprehensive Health) is a nationwide first and has expanded in the past year to thirteen high schools throughout New York City, where over 70,000 young women become pregnant each year, 90% with unplanned pregnancies.
Parents do not have to be notified if a student obtains birth control or Plan B from their school under CATCH, but they can choose to sign an “opt-out” form, removing their child from the program. In the past year, CATCH has come under fire for “promoting teenage sex” as do all sex education programs that do not follow the abstinence-only model. Because the program is only one year old, there is not sufficient data to say that CATCH has made an impact on the teen pregnancy rate in New York City. As the program begins its second year, there is much to deliberate on regarding the impact of CATCH on NYC’s teen girls, their futures, and their communities.
On one hand, the philosophy behind CATCH is clearly to be celebrated – in launching the program, the municipal government is acknowledging that teen sex exists, that young women deserve to make their own choices about their bodies and their sex lives, and that teen pregnancy is an issue in New York City that is clearly affecting young women’s educations (in 2011, about 70% of girls who got pregnant in NYC dropped out of school).
However, there are little discussed aspects of the CATCH program that require a second look. The program is clearly targeted towards poor women of color – the thirteen schools where CATCH was implemented were chosen because they are located in neighborhoods with high pregnancy rates or that lack nearby clinics. Depo-Provera, a birth control injection that is more often promoted to working class women and women of color, is one of the options offered by the CATCH program. In an enlightening piece entitled I’ve Lost My Mojo, Baby, Aline Gubrium addresses the impact of Depro-Provera on female libido, and contends that the contraceptive specifically affects women of color, low income women, women with low levels of education, unmarried and young women in especially harmful ways that are oft unaddressed as contraceptive discourse ignores the importance of social histories.
The fact that Depo-Provera was used for decades as a population control device in the Third World (notably widespread in South Asia and Africa) and is now being used as a “magic bullet” in the United States to reduce teen pregnancy rates among women of color is a disheartening and dangerous correlation. Through the DifferenTakes series, Amy Oliver and Diana Dukhanova have provided insightful and critical analyses of government endorsement of Depo-Provera, noting that the injection “may prevent pregnancy, but it does not take into account the social factors that surround teen pregnancy or question why teen pregnancy is more prevalent in the social groups who benefit least from new economic opportunities for women.” There are also serious health risks associated with this method. A recent study published in the Lancet for Infectious Diseases found that women who use Depo-Provera are twice as likely to acquire HIV from HIV-positive partners compared to women on the pill or non-hormonal birth control. Depo’s effect on women’s bone mineral density also raises questions about the safety of the drug, which puts women at a higher risk for osteoporosis and bone fractures later in life. Excess weight gain and depression are also serious and dangerous side effects that have been long associated with Depo-Provera.
A truly effective movement for reproductive health moves beyond the narrow idea that more contraceptive choices automatically empower women and looks to the assurance that all options are safe as well as effective. If New York City’s CATCH program is to truly stand at the vanguard of public health for teens, it will have to widen its focus from easy contraceptive fixes to a wide ranging health conversation that includes completely informing young women about their choices, their bodies, and the various risks included in birth control.