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Rhode Island colleges reluctant to offer morning-after pill

Linda Borg / The Providence Journal (KRT)

PROVIDENCE, R.I. - The morning-after pill has been a staple at many college health clinics for years and yet in Rhode Island, there seems to be a reluctance to offer the pill on campus.

Only four of Rhode Island's 11 colleges offer the morning-after pill on campus, considerably less than the numbers reported in a recent national survey published in the Chronicle of Higher Education last month, which found that more than half of college health centers offer the emergency contraceptive pills.

Of the 358 health centers that responded to the survey, published in the August issue of the Journal of American College Health, 52 percent said they provide emergency contraceptive pills.

But one-third of the colleges that provide the pill reported that they didn't publicize the service, "mostly because of concerns about creating controversy on campus and a desire not to promote use."

In Rhode Island, most colleges refer women to off-campus clinics, with one exception: Providence College.

"We do not offer it at the school nor do we put out any literature," said Catherine Kelleher, nursing director of PC's student health center. "If a student came to us, we would reiterate that we are a Catholic college and we have to abide by the church's teachings."

Another Catholic college, Salve Regina University, does not provide the pill, although it does direct students to places where they can get the emergency contraceptive.

A sense of discomfort pervades conversations about the availability of the emergency contraceptive pill, which, if taken within 72 hours, prevents pregnancy by keeping a fertilized egg from implanting in the lining of the uterus.

The emergency contraceptive pill puts some college health-care professionals on a collision course with their deepest beliefs about the sanctity of life.

At Bryant College, the health-care staff refer women to local clinics - and provide transportation to those clinics - if the students ask for the emergency contraceptive pill. But they do not offer the emergency pill on campus.

"No one here is comfortable offering the pill," said Elizabeth R. Cotter, director of health services. "We have to respect the providers' beliefs as well as the students' needs. It's a balancing act."

Bryant does, however, give out condoms and birth-control pills. It also screens and treats sexually transmitted diseases and performs routine gynecological exams.

Confusion abounds over the difference between the emergency contraceptive pill and the so-called abortion pill, RU-486.

According to Planned Parenthood, the emergency contraceptive pill does not cause an abortion and will not interrupt an established pregnancy. Nonetheless, the pill is controversial because some people believe that life begins at conception and that the pill induces an early abortion.

Still, many colleges see the emergency contraceptive pill as a way of preventing unwanted pregnancies that could derail a young woman's life. According to Planned Parenthood, the pill could prevent 1.7 million unwanted pregnancies and 800,000 abortions a year.

"We're pretty up front about it," said Lynn Wachtel, director of student health services at Rhode Island College. "The less stigma we attach to it, the more likely students will use that option."

Wachtel said the emergency contraceptive pill has become much more widely available in the last two years, thanks to a major push by groups such as Planned Parenthood, which launched a national education plan last year.

"Initially, pharmacists had a big issue with it," she said. "Now I hardly ever hear that a woman can't get it. Most of the New England colleges are offering it, except for the Catholic ones."

Colleges seem to fall into three categories: those that are unabashed in their support of the emergency contraceptive pill and make such information readily available to students, those that are conflicted about the ethical issues it raises, and those that are outright opposed.

Brown University, Rhode Island College, the University of Rhode Island and Rogers Williams University believe that women have the right to exercise this option with as little fuss as possible.

"Accidents happen," said Dr. Edward A. Wheeler, director of Brown University's health clinic. "People make bad decisions. Our feeling is there is no reason not to offer the pill. It's effective, it's safe. . . ."

Asked if anyone had ever protested Brown's decision to offer the pill, Wheeler said, "If anything, people would protest if we didn't offer it."

Whatever their personal beliefs, several college health-care professionals said it is crucial that women be provided with enough information to make the right choice for them.

"I'm a Catholic," said Mary Calner, the student health nurse at the Community College of Rhode Island. "But I have to be nonjudgmental. It's my job to give them the information. I'd never tell a student there is nothing available. I don't think my personal feelings should enter into it."

CCRI doesn't give out any prescription drugs, including the morning-after pill. But Calner said she always explains that the emergency contraceptive pill is an option.

Johnson & Wales University runs an aggressive campaign to educate students about reproductive health. It provides free condoms and free pregnancy testing. It invites Planned Parenthood to run safer-sex seminars in college dorms each year.

And yet its director of health services, Wendy Speck, sounds hesitant when asked about offering the emergency contraceptive pill.

Although the university began offering prescription birth control this year through its doctor, who runs a clinic off-campus, it does not offer the emergency contraceptive pill.

"It's never been brought up," Speck said, adding that she gets very few requests for the pill - a couple per month.

The Rhode Island School of Design doesn't offer the emergency contraceptive pill because it doesn't have the staff. However, Karen O'Brien, director of health services, says she sees this as "a great teaching opportunity."

"If they aren't using anything," she said, "this is a good time to say, `Would you be interested in talking about birth-control methods?' "

Although no one knows why, the pregnancy rate among young women ages 15 to 19 has been declining nationally. In 1980, the rate was 97 per 1,000; in 1995, it had dropped to 83.6, according to the Alan Guttmacher Institute, a nonprofit organization that does research on sexual and reproductive health.

Some experts attribute the drop to a more effective use of birth control while others say that teenagers are delaying intercourse.

There is another important reason why colleges should offer the emergency contraception pill, according to Chad Henderson, director of health services at URI: sexual assault.

A 2000 study by the U.S. Department of Justice found that 1.7 percent of college women have been raped.

"There are two reasons we offer it," said Jennifer Longa, coordinator of URI's Violence Against Women Prevention Program. "One, because of sexual assault, and more importantly, because so many women don't identify what happened to them as sexual assault.

"One out of four women will be sexually assaulted in their lifetime," she said. "And college, especially the first six weeks, is the most dangerous time."

URI also trains students to be peer sex educators on the assumption that students are much more comfortable discussing sex with someone their own age.

The students, who receive two credits for the semester-long training, also run workshops in dorms, fraternities and sororities on contraceptives, sexually transmitted diseases and healthy relationships.

Michelle Bromley, a peer educator who founded an AIDS awareness team in high school, said that programs such as URI's SpeakEasy are critical because there is so much misinformation out there.

"Everyone should know where to get this information," she said. "If you don't know how to take care of your body sexually, who knows what can happen?"

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(c) 2002, The Providence Journal.

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