Mike the Mad Biologist

Atrios is right: Fairfax County, VA’s policy about taking a birth control pill is school is nuts:

When a Fairfax County mother got an urgent call from school last month reporting that her teenage daughter was caught popping a pill at lunchtime, she did not panic. “It was probably her birth-control pill,” she thought. She was right.

Her heart dropped that afternoon in the assistant principal’s office at Oakton High School when she and her daughter heard the mandatory punishment: A two-week suspension and recommendation for expulsion….

Health advocates say that harsh penalties for students who take birth-control pills at school conflicts with a campaign schools are waging against teen pregnancy.

….in Fairfax, even carrying the pills in a backpack is counted among the most serious offenses in the Student Responsibilities and Rights handbook.

….If she had been caught high on LSD, heroin or another illegal drug, she found, she would have been suspended for five days. Taking her prescribed birth-control pill on campus drew the same punishment as bringing a gun to school would have.

Because trying to avoid becoming pregnant so she could stay in school is exactly like carrying a mechanical device designed to kill people. In the grand scheme of things, I wasn’t a bad kid, but, given all of the stupid rules around, I very well could have ended up suspended. Fairfax County used to be not this stupid about these sorts of things (although some of this is due to state policies). What bothers me is this statement:

While the student awaits a decision on whether she will be expelled, she said she has learned one major lesson: It’s important “to read the fine print.”

No, the major lesson is that the conservative nanny state is out of fucking control. Well done, drug warriors.

Comments

#1 becca
April 7, 2009

That’s batshit crazy. But still less disturbing than the 13 year old strip searched for suspected ibuprofen.
#2 Scott
April 7, 2009

I’m glad we’re waging a successful battle against the horrors of anti-inflammatories and birth control.
#3 MikeMa
April 7, 2009

Can the administration or school board be charged with interfering in a medical treatment plan? What a pile of loons they are.
#4 Johnny Vector
April 7, 2009

I like this quote from the story:

“If they are just pulling something out of their pockets and sticking it in their mouths, we don’t know what they are taking.”

Exactly! It would help a lot if when you got birth control pills the pharmacist didn’t just empty a scoopful of them into your hand. The manufacturers could even put them in some kind of easily identifiable packaging, where you can tell how many have been taken. Maybe even label the pills by day of week or something. I wonder why they don’t do that?
#5 abb3w
April 7, 2009

This isn’t nuts; it’s just plain stupid.

“Nell,” the Constable continued, indicating through his tone of voice that the lesson was concluding, “the difference between ignorant and educated people is that the latter know more facts. But that has nothing to do with whether they are stupid or intelligent. The difference between stupid and intelligent people—and this is true whether or not they are well-educated—is that intelligent people can handle subtlety. They are not baffled by ambiguous or even contradictory situations—in fact, they expect them and are apt to become suspicious when things seem overly straightforward.”
#6 jay
April 7, 2009

Schools have gone absolutely bonkers out of control. A little while back there was a high school senior who was suspended right through his graduation time (costing him credit for his extracurricular activities as well as graduation) for simply selling a pack of candy to a friend. Apparently the health nazis had determined that candy distribution is a serious offense.

It’s amazing that people seem to accept this. With all the authoritarianism of the mid 60s (when I was in school) we actually had much more personal freedom. I feel pity for school children today. I wouldn’t have made it.
#7 Richard
April 7, 2009

While you may disagree, I absolutely see birth control as a “device designed to kill people”. Taking a life, whether a few days old or a few years old, should always be avoided.
#8 Alex Besogonov
April 7, 2009

“Every sperm is sacred…”
#9 Rogue Epidemiologist
April 7, 2009

Have we national media attention and public outcries successfully shamed the school into backing down yet???

Protip to parents of adolescent daughters: NuvaRing or Ortho Evra.
#10 Rogue Epidemiologist
April 7, 2009

@Richard
And that complete misunderstanding of how birth control works makes you a complete dumbass.

I’ve been on birth control pills since high school because I have severe dysmenorrhea. Without it, I get very sick and anemic. A lot of women take it for the same reason as me.

And even those who use it for contraceptive purposes aren’t taking lives if they’re not ovulating to begin with.
#11 Pierce R. Butler
April 7, 2009

Health advocates say that harsh penalties for students who take birth-control pills at school conflicts with a campaign schools are waging against teen pregnancy.

Whereas grammar advocates say that noun-verb disagreement conflicts with a campaign schools are (allegedly) waging for literacy.

As for the Fairfax County policy, haven’t you heard? Birth control pills are drugz!!!1!!1!!

Anyone whose mental processes still function after exposure to the D-word is automatically barred for life from employment in school administration at any level.
#12 Richard
April 7, 2009

@Rogue
I’m very sorry for your condition, but I have actually done quite a bit of research into this. There are several varied treatments for dysmenorrhoea, however oral contraceptives are not proven to be as clearly effective over a placebo: http://www.ncbi.nlm.nih.gov/pubmed/11687142 “No conclusions can be made about the efficacy of commonly used modern lower dose combined oral contraceptives for dysmenorrhoea.”

Regardless of this (that is, even if it was the sole effective treatment) the issue always comes down to whether or not humanity begins at conception. If it does, then where does the line fall for taking one life to save another, relieve suffering, or simple convenience. I won’t propose where I believe it is in order to avoid a lengthy, and I suspect emotional, argument.

I just wanted to remind readers that some believe life begins at conception (and that it doesn’t get a postmodernist exemption to protection of an individual’s right to life)
#13 Edward
April 7, 2009

While I agree these policies are nuts, you have had your head in the sand if you think they are new. What isn’t said here is that they generally DO provide a mechanism for the kids to get their medications at school: they must be stored with and dispensed by the school nurse. It’s largely a drug control measure, and does actually have some positive points (e.g. makes it harder for teenagers to pop legal but unneeded diet pills) as well as the negative ones.

I will also have to disagree slightly with the “fine print” comment. While the student handbooks that get sent home can be far too verbose, generally both students and parents are supposed to read them, and, in many places, are required to sign forms saying that they have. Furthermore, I’ve sat through sessions nearly every year since my kids have been in school, where, along with the Principal’s intro, the school drug policies are covered in detail. So, while I don’t agree with such policies, I think you would have to be asleep not to be aware of them.

The biggest problem with these policies are the draconian penalties the kids face for using legal drugs appropriately. I can see some good reasons for having the school nurse dispense drugs as a policy, but it should go something like: 1st violation call the parents, 2nd violation, set up a conference with the parents and child, etc. and only after repeated violations go to suspensions, etc.

There are also other aspects of these rules that can be really stupid: If a girl gives her friend who is having cramps a Midol, the school may treat it like dealing drugs.

These policies got a foothold in the Reagan/Bush era, IIRC, and seem to continue to spread, despite the evidence that “zero tolerance” doesn’t work:

http://www.indiana.edu/~safeschl/ztze.pdf
http://psycnet.apa.org/journals/amp/63/9/852/
http://everydaypsychology.com/2009/03/zero-tolerance-policies-no-substitute.html
#14 Edward
April 7, 2009

@Richard

Guess what? Lots of folks here can use pub med. I just did and what do you know – most of the articles (all the ones I clicked on besides the one you link) say that oral contraceptives ARE an effective treatment for dysmenorrhea.

What you have done is cherry-pick an article from 2001 that appears to only review much earlier studies. You ignore the more recent articles that do support the effect. You wouldn’t happen to be a creationist as well? Cherry-picking fails to qualify as “quite a bit of research.”
#15 Rogue Epidemiologist
April 7, 2009

@Richard
You purport objection to termination of conceptus. So again, tell me what your objection is to a drug that prevents a woman from ovulating, thus preventing conception??? If nothing is ever conceived, how could it have died, in your opinion?

Also, considering OCPs are the gold standard treatment for dysmenorrhea, I’d have to say your selection of publications (meta analysis? really???) was a weak one. You do realize the alternative is to either ablate the endometrium, perform a hysterectomy or just let the girl suffer.
#16 TheEngima32
April 7, 2009

@ Rogue

You can’t do hysterectomies! In his mind, it’s the same thing as birth control, which means you’re murdering babies that DON’T EXIST, and NEVER DID EXIST. It’s so OBVIOUSLY the same thing as murder; never mind that these “people” are completely imaginary and DO NOT EXIST. Do you NEED that in any clearer terms, Rich? Maybe I can spell it out for you: D-O N-O-T E-X-I-S-T.

Richard is obviously stupid, like so many other Americans. And their stupidity is toxic – as this story, and many, many more like it show.

Enigma
#17 Claire
April 7, 2009

I think most of you are missing the irony in this situation.

This girl is being punished due because the “harsh penalties for students who take birth-control pills at school conflicts with a campaign schools are waging against teen pregnancy”

I went to a school that preached abstinence before marriage. Almost half of my graduating class (including myself) ended up pregnant BEFORE getting marriage. Teaching abstinence doesn’t work.

You should be rewarding this girl for remembering to take her pill. It means there is one less child raising a child in this world.
#18 Claire
April 7, 2009

*before getting married*

Sorry
#19 Troublesome Frog
April 7, 2009

Richard,

For all of your crazy good pubmed-fu, you seem not to understand how these pills work. You should probably remedy that before offering medical advice.
#20 Monado
April 7, 2009

Richard, everyone else has said it but I’d like to use smaller words for you: Birth control pills prevent a woman from releasing an egg. We call that “ovulating.” Without an egg, she can not get pregnant. There is no egg (ovum) to fertilize. So the pills do not “take a life.” They prevent sperm from meeting egg. They prevent conception. They prevent pregnancy.

“Morning after pills” do the same thing: they prevent ovulation (ov-you-lay-shun). They do not end a pregnancy. They prevent one.

Is that clear enough?

If you wish to prevent pregnancies, please get a vasectomy. That means going to the doctor and getting your sperm ducts cut so that you can never, never make a woman pregnant. Thank you. Otherwise, mind your own damn business.
#21 Richard
April 7, 2009

You are all correct that the primary method of action for combined oral contraceptives is the prevention of ovulation. Two other preventive actions were not mentioned though: changes in cervical mucus and endometrium. By increasing the acidity and thickening of cervical mucus, it helps prevent sperm penetration.

However, the third action of progesterone in OCP is the thinning of the uterine lining which can prevent implantation of an egg that is released and fertilized. How often this happens is certainly debated, but from my understanding (and there are undoubtedly better experts out there) depending on how much estrogen is in the dose, eggs can be released 2-10% of the time. In fact, in the “mini-pill”, which only contains progesterone, inhibition of ovulation only occurs in 40% of women.

Despite putting words in my mouth and straw man attacks, I have no problem with the prevention of ovulation or changes to cervical mucus. I do however, have deep reservations in the termination of fertilized eggs that slip through a drug that is not 100% in its prevention of ovulation.

Given the maturity, respect, and prejudices shown in this discussion, this will probably be my final post.
#22 Matt Springer
April 8, 2009

“Taking her prescribed birth-control pill on campus drew the same punishment as bringing a gun to school would have.”

That’s not actually true. It draws the same punishment from the school, because a recommendation for expulsion is the maximum possible punishment the school can levy. However, possession of a firearm on school property is an actual crime under the legal system, for which she’d have gone to jail.
#23 DuWayne
April 8, 2009

Richard -

I suppose this means that you have reservations about the homicidal urges of the human body, which massacres huge numbers of fertilized eggs quite naturally?
#24 Nemo
April 8, 2009

I have zero tolerance for such policies.
#25 ShortWoman
April 8, 2009

As much as I sympathize and even agree with all the logic of the original post, the fact is this: having, let alone taking, medication at school has been against the rules for at least 30 years. This isn’t some new thing she got caught up in. It’s been the way things are since before her parents were in high school She should have taken her pill before class.
#26 Azkyroth
April 8, 2009

Given the maturity, respect, and prejudices shown in this discussion, this will probably be my final post.

As I’ve said elsewhere:

“Once it’s been established that a person thinks “sound reasoning” means “sharing their biases,” debating them is pointless, but poking them with a stick may yet be entertaining.”
#27 Azkyroth
April 8, 2009

As much as I sympathize and even agree with all the logic of the original post, the fact is this: having, let alone taking, medication at school has been against the rules for at least 30 years. This isn’t some new thing she got caught up in. It’s been the way things are since before her parents were in high school She should have taken her pill before class.

The amount of time an unjust, nonsensical policy has been in effect is relevant only to how embarrassing its continued existence is to the sane, thinking minority.
#28 David Irving (no relation)
April 8, 2009

Richard, many of us are very sorry for your condition (near-terminal stupidity combined with wilful ignorance), but there really is no excuse for it.
#29 Julie
April 8, 2009

Oh sweet Jesus, is Richard for real?
#30 AJS
April 8, 2009

Richard wibbled:

While you may disagree, I absolutely see birth control as a “device designed to kill people”. Taking a life, whether a few days old or a few years old, should always be avoided.

Get a clue, will you? Birth control pills contain a chemical which tricks the body into thinking it is already pregnant, so it holds off from flushing out the uterus and releasing a fresh egg.

The only “life” which I can see being taken in this is the life of a single sperm which makes its way to the uterus, only to find no egg waiting. Considering that in the same shag, about 99 999 999 other sperm didn’t even make it that far, it’s hardly such a big deal.

How appropriate that your name is Richard. We all know what is short for that.
#31 AJS
April 8, 2009

ShortWoman bleated:

As much as I sympathize and even agree with all the logic of the original post, the fact is this: having, let alone taking, medication at school has been against the rules for at least 30 years. This isn’t some new thing she got caught up in. It’s been the way things are since before her parents were in high school She should have taken her pill before class.

Appeal to tradition = phallacy. You lose.
#32 Adrienne
April 8, 2009

The thing is, if she had gone through the school nurse as she was supposed to, she would have been able to take the pill without punishment.

I see the logic of why they would want kids to take medications through the nurse’s office, but obviously the two-week suspension is far too harsh a punishment for what this girl did. At most, she should get a warning or a detention. Not a freaking suspension.

As for Richard, he is correct about the pill inhibiting the implantation of a fertilized egg as one of its contraceptive actions. But I have even seen a Catholic defend oral contraceptives on the basis that this is not the primary or intentional means of how oral contraceptives operate. It’s a minimal (if unfortunate to pro-lifers) side effect that occurs at most 10% of the time.

If Richard opposes oral contraceptives, he must oppose breastfeeding too, as breastfeeding also has the same anti-implantation efect. Or maybe he just thinks women shouldn’t have sex at all during the entire time they are breastfeeding.
#33 Ishi
April 8, 2009

@Richard:

Hey, Richard -

How many kids have you adopted? I’m curious.

You see, if you’re so very anti-birth-control, pro-life, life-is-sacred, and so-on-so-forth, surely you’ve opened your home to at least one unwanted child, putting your proverbiable money where your mouth is?

or maybe two, or three?

“And ye shall know them by their works”, indeed, mm?
#34 Susan
April 8, 2009

Are there no reasonably sane adults involved in Fairfax County’s school system administration? This is making them look ridiculous. Education FAIL.
#35 Ross
April 9, 2009

Look, I think this is a bad policy too, but it’s not like this is anything new. School policies have said “You can’t take any medication, perscription or not, in school. If you have a prescribed medical need with a note from your doctor, you take it any your prescription in a sealed package to the school nurse and get a note excusing you from class at the prescribed time and she will give you your medication and watch you take it. And if you don’t do this, you will be presumed guilty of doing drugs at school, and suspended, and we will recommend expulsion.” since I was in elementary school more than twenty years ago.

The same thing would have happened had she taken an asprin. The same thing would have happend had she taken an antibiotic. The same thing would have happened if she’d had a serious medical condition where failing to take her pill at the right time would have killed her. (In fact, I recall witnessing an incident back when I was in middle school in the late 80s where a fellow student with juvenile diabetes got himself into a bad way because the nurse was out that day and it took too long to find someone authorized to let him have his insulin.)

It’s a knee-jerk reactionary policy which is too-broad and too-harsh, and dates from a time when it was assumed that children could not be trusted to do something like take a medication without supervision, but it’s not “about” birth control or nanny states or anything like that. It’s just a bad policy from a different era. It’s the same class of rule that (when I was in high school, back some twelve years ago) required the school to call the police if a student was caught with a cell phone (the assumption being that the only way a teenager could get a cell phone was if they were involved in the drug trade)

(That said, come on. Who schedules their birth control pill for lunchtime? And if she did, why just just follow the procedure. I find it impossible to believe she didn’t know it — I had it drilled into me when I was 7.)
#36 MikeMa
April 9, 2009

The school system’s policy of requiring a nurse to handle all medicine fails on several counts.

If the student were ‘under the weather’ or administering an as needed drug it makes sense to get that medication at the nurse’s office but for drugs needed every day, every week, in school or out like birth control, you risk not being able take it when the nurse is unavailable. What recourse on the weekend? Drug companies don’t normally hand out ‘oops I left them at school’ extras and with birth control, there are 7 different ones that need to be taken in the right sequence. Messing with the nurse just guarantees a medical mess.

What about diabetics? I wear a pump and I’m sure as hell not going to deal with a nurse who knows less about my medicine than I do to bolus for a meal or correct for a high sugar.

Regardless of how long-standing a stupid rule is, it is still stupid. There should be an option to have the student register her birth control pills (or similarly used meds) with the nurse but not be required to take them or leave them there. Basically, she would have a hall pass that allows her to use her prescribed medication whenever she needs to.

What a waste.
#37 Margo Eve
April 9, 2009

Call me crazy, but why doesn’t she take the BC before going to school? Like at Breakfast? Or before going to bed?

Yeah, it’s an ridiculously over protective policy, and the punishment does NOT fit the “crime.” But if, hypothetically, she didn’t bring it to the school nurse to avoid the stigma possibly being labeled promiscuous by association (because people in HS are jerks like that), then why would she take it during school hours to begin with?
#38 Sean Micheal
April 9, 2009

What is this nonsense about how “she should have known better” and “should have just taken it earlier” ? She should obey an unjust rule because it’s less of a hassle? No. MikeMa is right: she should have taken whenever she damn well pleased, and if anyone questioned her, she could have promptly and easily explained that it was a prescription medication, and the school, if they still had doubts, could have called her parents, her doctor, etc. She did absolutely nothing wrong, and has nothing to apologize for.
#39 Margo Eve
April 9, 2009

@Sean Michael

I still think that giving her 2 weeks suspension is absolutely absurd. At the worst this deserved a call home and a “don’t do that again.”

The really stupid part is that if someone were taking actual hard core drugs in school, they aren’t going to do it in the middle of a freaking cafeteria.

That being said, having to go to the school nurse for medication has been a rule since I was in High School. And that was a *long* time ago. Why should she expect special treatment?

The issue I’m pointing out is that in the original article she talks about taking BC as her private choice, which it absolutely is. THEN she goes ahead and takes the pill in the middle of the very public bloody cafeteria. If she was so concerned with keeping her private choice private, maybe taking it not in school, or at the VERY least going to the bathroom to down the pill, might have been in order.

You don’t have a reasonable expectation of privacy when you do something in public.
#40 Benjamin Geiger
April 9, 2009

Margo Eve:

Sometimes the best way to hide something is in plain sight. It’d certainly draw less attention, policies notwithstanding, to take the pill in the cafeteria than to have to make a special trip to the nurse’s office.

And it doesn’t sound like she’s asking for special treatment. It sounds like she’s asking for recognition that the rule is absurd and needs to be dropped.

I think the drugs students are allowed to take by themselves should scale with age. Granted, you can’t have a kindergartner running around with aspirin, but by high school, only controlled prescriptions (schedule IV or higher) should require nurse’s supervision.
#41 MikeMa
April 10, 2009

I have one issue with calling home to check with mom: It may be none of mom’s business to know that her daughter is taking birth control pills. HIPPA may prevent the disclosure in any case.

It does, however, make sense that the teens on birth control be responsible enough to have a record of the prescription on file with the nurse.
#42 Ross
April 10, 2009

@Sean Micheal:

The absurd thing is the “zero tolerance” part of this rule, the one that takes away the discretion of the administration to waive the penalty given the circumstances. But OF COURSE she should “obey an unjust rule because it’s less of a hassle.” If she disapproves, protest, round up a movement, bring it before a refferendum, but the fact that she finds a rule inconvenient doesn’t give her the right to flaunt it. I( think it’s unreasonable and unjust that I can’t drive 75 on the highway. Why should I be expected to follow a rule that so unfairly restricts my freedoms?

The rule itself is not even especially unjust, just inconvenient. I think it’s entirely reasonable to say that the public good — especially in the limited context of a high school — of disallowing students from self-medicating during school hours, of walking around with controlled substances (Birth control pills are, after all, not available over-the-counter) — outweighs the fact that it’s mildly inconvenient for her to either schedule her pill outside school hours or leave it with the nurse.

The failure here isn’t “Kids aren’t allowed to take pills on their own recognisance.” Think through the scenario thus: what if it turned out those weren’t birth control pills, but, say, ecstasy. This whole discussion wouldn’t have happened, and Mike the Mad Biologist certainly wouldn’t have found it worth posting about. The reason the policy fails isn’t that the girl was punished for breaking this rule, or for the rule that was broken. The failure *only* happens when, after hauling her down to the principal’s office, after investigating what went down, and discovering that she was indeed taking a legitimate medication in the manner prescribed to her under the authority of a licensed doctor (And I’ll even throw in “with parental consent”, but only because it was during school hours so there’s a complicated in loco parentis thing going on; obviously in the general case, there are protections specifically about such things), the administration was powerless to deviate from a prescribed punishment which assumes that the student is a drug abuser.
#43 MikeMa
April 10, 2009

Ross,
When people do something obviously and publicly against well published and understood but disagreed with rules, I suspect intent. She is either flaunting her invincibility or playing Rosa Parks. At her age, it is a tossup but given the stupidity of administrative intolerance and insulting lack of latitude, I vote for Rosa Parks. Kick the administrators in the butt hard enough so they can see more clearly that they are hired to be administrators, not lackeys.
#44 Ross
April 10, 2009

MikeMa:

That’s something I’d be interested to find out more about. Given her age and what information we have, i don’t suspect intent. I don’t at all think she was trying to make a point. I don’t think she was *thinking* at all. I think that, like most young people, all the way back to when I was a young person, she heard the rules, perhaps many times, and simply discarded that information. I doubt that it ever occurred to her that she was doing something wrong, because she wasn’t really listening when the rules were explained.

I don’t kow any of this, of course, but I’m disinclined to see anyone as a Rosa Parks in the absence of other evidence.
#45 MikeMa
April 10, 2009

Ross,
I graduated HS in the early 70′s so the idea of a high school student breaking the rules as a protest does not seem far fetched to me. In support of today’s youth, my daughter might have done the same but maybe not so many others. Even she might have found the whole subject too stupid to care about in light of more pressing civil or gay rights issues.

That said, I too would like to know more about this case and agree with you completely that the administration’s powerlessness to deviate is appalling.
#46 simba
April 10, 2009

Speaking as an asthmatic from Ireland, where I can bring whatever medicine I want to class provided I don’t jump up and down and scream that they’re drugs, how do people with conditions which require medicine at odd intervals cope? You can’t schedule an asthma attack to the nurse’s convenience, you need to have the inhaler at all times.
#47 llewelly
April 10, 2009

That being said, having to go to the school nurse for medication has been a rule since I was in High School. And that was a *long* time ago. Why should she expect special treatment?

In other words, schools have had abominably stupid rules for a *long* time, therefor they should retain abominably stupid rules. By the same logic, since creationism was around for thousands of years before Darwin came up with natural selection, we should have just stuck with creationism. Forget evolution – creationism been around for a long time.
#48 SLC
April 11, 2009

I have read that, in some jurisdictions, a student could be suspended for taking an aspirin.