Are all school nurses now encouraging teenage girls to have the contraceptive implant?

[idohopenot]

Apparently the dc's school nurse is really keen on them having it, and claims the government wants all school nurses to push it strongly, to bring down the nation's high teen pregnancy rate.

Is this the case in your dc's schools?

I had only heard of it in Southampton, and thought it was a trial, not a new national policy.

SQ I wasn't keen at all on the idea of a catholic school, but I presume in a catholic school this policy will not be as enthusiastically received. That is all. Nothing to do with other forms of contraception.

What's wrong with pleasure?

In the context of the post that says that for some/many girls the use of these devices will adversely affect their responses?

sexual reponses obv

"I would also encourage her to be careful with the number of partners she is having."

Hahahahaha

You're a parent right?
Our DDs are 2 and 4
When the time comes DH will take the view of "over my dead body" and I will take the view of... I don't know yet but it won't be a calm chat about being careful with the number of partners she is having! Maybe it will revolve around quality not quantity... that takes us back to SAF's point

Nothing is wrong iwth pleasure and pleasuring oneself if desired. However, the risk of getting STI does rise with the number of sexual partners because we do not know where the partner has been and again, condoms do not give protection against all STI...

I have raised (with DH and his ex) 3 dsd (oldest is 24) and now pg with my dd2 (dd1 died as a baby). So I have some experience. And yes, dsd were bringing their bf to stay with us. I am not against sex. I can only share what I know in this life.

"quality not quantity"
Spot on. THis is what I was always focusing on if we talked about sex with dsds.

Sardine: I calmly told my oldest that I would, as part of her 16th birthday present, not object to her going on the pill. I also advised her not to get an implant as this would decrease her desire and she is entitled as a human being to getting all what life brings. Her going on the pill lasted approximately 1 year and she later admitted that her desire decreased. I don't want that for her, never, and so I suggested that she use condoms and encourage partners to do so. I said if they don't want to then they are not worth the effort and she should tell them so.

My eldest took my advice. She's currently a very happy human being in a loving relationship.

Good for her and you Dworkin.

Sounds great

I don't remember ever being told in my secondary school years that sex was supposed to be fun and pleasurable. I mean, sure, orgasms were talked about in mizz. But still...

I am really coming around to the idea that talking/thinking of sex in pregnancy / std terms is all about male orgasm and overlooks anything the girl might be feeling somehow. It's all wonky.

Female sexuality needs to be reclaimed as something in it's own right and not through the prism of current porn-type norms...

As contraception condoms are pretty shit, as a barrier to STDs they are often compromised. They are usually promoted alongside methods of contraception that make the risk of pregnancy very small. If girls want to have sex, if they want the best contraception and choose an implant then I respect their decision.

If they are chaotic and vulnerable then if they choose an implant I hope it helps them through. A girl I worked with recently had 3 pregnancies in a short space of time, one baby and 2 abortions all 3 events profoundly traumatic for her. She has the implants and feels much happier, she wishes she had them earlier and would not equate the possible side effects of removable contraception with the damage from her pregnancies.

Are there bigger issues to be addressed, of course but do i think girls have a choice to choose contraception, absolutely. Is this the one area where i think we should get all paternalistic and over ride consent, never. Is the school nurse the contraceptive trend setter, not usually. It is imperfect but the alternative is worse.

I just can't believe that the reduction in female desire and pleasure is glossed over.

So that's another, really good reason for condoms, then.

Incidentally there are school nurses who go in some Catholic schools. The school has no control over the nurse whose practice is governed by the usual ethics and competencies.

readyveg this thread is talking about the school nurse promoting implants to girls. And not talking about condoms.

The girl who had all the pregnancies and was vulnerable. Who was she having sex with, why. I assume she was under 16. Who was she sleeping with and was it entirely consensual and in no way groomed/coerced etc

Readyveg, have you got a link to the ethics of school nursing, please?

Is it right that the school has no control over the nurse? Not at all?

it's massively glossed over, as is weight gain and digestive issues and generally feeling a bit bleurgh. most people don't even realise that their problems with all that were due to the pill/other hormonal contraceptive until they stop taking it.

likewise actually with antidepressant medication which more women than men take. there was a time where all they ever wrote on the side effects was male sexual side effects like delayed ejaculation and erectile dysfunction and no mention of the very common effect of making it damned hard for women to come - anorgasmic effect? i forget the terminology but yes glossed over and not seen as a legitimate reason to change medication or be unhappy with it or not want to use it. it's as if female sexual pleasure is frivolity with no importance but the second a man has problems with his that is serious and ego damaging and must be medicated and dealt with.

Yes, actually, one of the factors is the judgement of the nurse as to the individual situation of the girl. How can they know how abstemious or high risk a girl is likely to be? And shouldn't that decision-making process be documented and verified by another medical professional?

In fact it must be possible for the girl to see the notes the school nurse makes about her?

And is the girl's GP informed, even though the parents aren't?

ok the confidentiality thing means a girl can get an implant at 13 without her mother being informed BUT if the mother then notices the bruising or something and takes her child to the GP and demands it is removed do they have to follow the parent and legal guardians request or ignore her and follow the 3yo child's request to keep it in?

surely it must be possible for a parent to see the school nurses notes on their 13yo too?

Oooooh...good questions...

Can you imagine how you would feel on discovering the implant in your dd's arm?

I'm surprised that the school nurse would be "pushing" this or any other form of contraception. I would ask if this were Health Board/Trust policy and take it to a more senior level if I wasn't happy with the answer.

I believe it school nurses and other HCPs should be able to give information, contraception and even referral for termination for a young person without a parent's consent. It would need to be a situation where they were confident the young person was making a fully informed choice, that they had relevant medical history (as a school or GP should,) and that they've encouraged the young person to talk with the parent and/or there's a compelling reason why that is not advisable.

But, there's a conundrum here. I don't work in a school, but some of my work does involve engagement with young women.

• Boys and young men DO pressure girls to have sex, at a younger and younger age. There has always been pressure to have sex with girls as an indicator of masculinity, but imho, that's becoming even more acute.

• Depressingly, I think girls and young women now more than say 10 or 20 years ago feel that they should have sex to be accepted not just by boys but by other girls. Personally, I think increased sexualisation/pornification of society has ALOT to do with that.

• Most boys aren't bothered about contraception. If a girl isn't using it, that's unlikely to make a difference. Condoms are the least invasive form and best protection against STI's but the boy has to agree to use one. Anecdotally, it's couples in stable relationships most likely to use condoms but not those who have more casual sex because they don't feel confident discussing it with someone they don't really know.

• Yes, there are risks with all hormonal and mechanical forms of contraception. There is always the risk of STIs, particularly if you're not using barrier contraception.

• There are also huge risks involved in becoming pregnant at an early age, particularly if continuing the pregnancy to term. These aren't just health risks, but pregnancy can disrupt education, family relationships and alter the course of the young person's life. There's stacks of evidence of poorer outcomes for children of teen parents in general as well.

So, we live in a society that sends the message to girls that they should be available for sex and the message to boys that they are entitled to sex from girls. In that context, young people will be having sex, and exposing themselves to risks.

Do we refuse refuse to provide contraception to girls because that would mean colluding with, if not endorsing their sexual exploitation?

Or, do we offer them only condoms as a contraception and means of preventing STI prevention, knowing that the boy(s) they have sex with in all likelihood will refuse to use them?

Or, do we provide contraception which will carry health risks but at least affords them a means of preventing pregnancy that could drastically alter their health and the course of their life for the worst?

I know it's a Hobson's Choice, but it is a dilemma that HCP's are having to deal with every day.

Ideally, all young people would have good relationships with their parents and be able to talk these things through openly and make supported and informed decisions about their sexual relationships and health. They don't.

Ideally, young people wouldn't feel pressure to have sex when they aren't ready for it and aren't able to make informed choices, but this happens.

Ideally, we wouldn't live in a society that sends out the message 24/7 that girls/women are passive, inferior, sexualised objects and boys/men should be controlling, competitive and assert their masculinity through having sex. But, we do live in that society.

So other than throwing our hands up and saying, "God this is shit," what can we constructively do about it?

one thing we need is to have a situation where every male in the country pays for his children with zero exceptions and non payment is a criminal offense such as non payment of council tax that can be criminally prosecuted rapidly and can incur a prison sentence. make pregnancy have real, tangible, hard consequences on boys as well as girls. so that they both have an interest in preventing it.

do the kind of education stuff that lapsed described above. do boy only sex education and don't shy away from talking about coercion, using condoms, consequences of unprotected sex, respect, self protection etc.

seriously, properly prosecute men who have sex with underage girls - investigate those who are obviously doing so and caution them - don't wait for a girl child to report them. it is often older men who will have sex with girls and have a powerful enough position to refuse to use condoms etc.

stop pushing hormonal contraception when there is a simpler, safer method that can be nearly as effective at preventing pregnancy and effective at preventing the majority of stds.

the constant defeatism means no one even tries imo.

Kritiq that is a great post.

I am off to bed soon though and there are so many issues. So not going to respond fully now!

KRITIQ, part of my problem with this is that the implant policy seems to be indiscriminate.

I have every reason to hope and expect that my dc will behave responsibly in relationships. There are various reasons why that is likely to be the case. But it doesn't look like the school nurse will bother with that. She will say my dc should have the implant anyway, just in case they get drunk and lose control.