Marie Simpson is a widow and grandmother who's bewildered when she has to count all her grandchildren. She names and numbers them on her fingers up to 10, then stops. ``I can't count 'em,'' she says, adding that some were born in wedlock, some out. Some had teen mothers; some didn't.
Although she's a shy woman and doesn't speak much above a whisper, Mrs. Simpson knows what she wants. She wants to curb the high rate of teen pregnancies - even if it means giving out contraceptives at school-based clinics. In 1985, teen pregnancy estimates topped one million for 15 to 19-year-olds, plus an additional 30,000 for teen-agers under 15 years of age.
Mrs. Simpson showed up at a meeting on Chicago's South Side to lend support to the DuSable-Bogan health clinic that has met with a blitz of opposition for dispensing birth-control devices. The clinic is based within DuSable High School - and that's where the snag is.
Verbal skirmishes over the clinic's birth control program erupted long ago between advocates and critics, but not until recently did the imbroglio land in the legal arena.
Thirteen black clergymen from the South Side, parents, and an anti-abortion group filed suit this fall in Cook County's Circuit Court to halt the handing out of contraceptives at DuSable-Bogan. Although the clinic itself isn't a defendant in the suit, multiple charges were brought against the Illinois Department of Public Aid, the Chicago School Board, and the DuSable principal.
The list of charges includes violation of students' privacy because of clinic questions relating to sexual activity; failure to warn parents of risks involved in the use of certain birth control devices; an invasion of parents' rights to instruct their children; and violation of a Supreme Court ruling requiring school neutrality on issues involving religion (the use of contraceptives is counter to some peoples' religious beliefs). The suit also charges that the clinic program is designed to control black population.
Ann Stull, secretary for Pro Life/Pro Family Coalition, a plaintiff in the suit, says, ``there are some things you can't fix quickly because they have been wrong for so long.'' And she views the dispensing of contraceptives at schools as ``a quick fix, a technical answer instead of character reformation.''
The Rev. Hiram C. Crawford, pastor of Israel Methodist Community Church and a plaintiff, also criticizes the clinic on moral grounds. ``It pushes fornication,'' he says, and ``usurps the authority of parents and church.''
Although the clinic exists, rent-free, beneath DuSable's roof, it's a separate entity funded by the Illinois Department of Public Aid and private foundations. The professional medical staff offers 10 health services to students, most of whom can't afford private health care. Much of the clinic's work reaps accolades or goes quietly unnoticed. It's the birth control aspect that has catapulted the name of DuSable onto local and national TV, into newspaper and magazine headlines, into a legal case, and onto the lips of people who previously had never heard of the all-black school on the city's South Side.
Patricia Davis-Scott, director of the comprehensive health clinic, which started in July, 1985, attests that the counseling sessions focus first on abstinence, and in no way is the clinic involved in abortions or abortion counseling. Written parental consent is mandatory, before any contraceptives are handed out, she says. Students also must pass physicals and be free from drug, alcohol, and tobacco use, she adds.
DuSable-Bogan is just one of 17 school-based clinics across the country that actually distributes contraceptives. Another 32 clinics write prescriptions for birth-control devices, and an additional dozen send students to various nearby agencies for such services. These figures, soon to be updated, were tallied by the Support Center for School-Based Clinics in Houston. The center's new count is expected to include 11 more clinics, an indication of a growing acceptance of school-based health centers that get into the family-planning act.
Although New York City's nine clinics have been involved in birth control for some time, out-and-out criticism just recently began to be voiced there. And in New England, Boston and neighboring Cambridge are crackling with debate, trying to decide whether it's a good idea to play follow the leader on this issue.
The first clinic of this sort opened at Mechanic Arts High School in St. Paul, Minn., in 1973, at a time when 79 out of every 1,000 female students in the school had babies. By 1976 the school birth rate had dropped to 35 out of 1,000. Although Mechanics Arts High School has since closed, four other St. Paul high schools have clinics, recording a teen birth rate of 26 out of 1,000 female students in 1984.
In that same year, DuSable had definite teen pregnancy problems. The school - with approximately 1000 male and 1000 female students - draws more than half its population from the city's Grand Boulevard area. In 1984, the Grand Boulevard area recorded that 436 females between the ages of 10 and 19 gave birth. About 300 of these were to high school age women.
``Kids today, you'd rather they used them [contraceptives] than not,'' says Simpson, the grandmother in a jaunty blue hat, who twists the handle of her pocketbook as she talks, visibly embarrassed about the whole topic, but convinced she should add her soft two-cents' worth to the pro-clinic chorus.
``When they [teen-agers] have the babies, they expect the mother or grandmother to take care of them,'' she says. And this particular grandmother doesn't view that set-up as a desired family situation. Retired since last year from a food-service job, Simpson says, ``I'll do what I can to help, but ...'' and she lets her sentence fade midway.
``It [DuSable] could have been a school for pregnant women,'' says Tyrone Cotton, a senior who has six brothers and three sisters. ``Some say it [dispensing contraceptives] encourages sexual activity,'' but the 18-year-old student doesn't agree with that charge, explaining that this particular lifestyle already was prevelant before the clinic opened. ``Anyway, now I see less pregnancy,'' he says.
But retired high school teacher and plaintiff Stull doesn't feel these ends justify the means, because she does ``not approve of lowering standards to fit the conditions. A parent who knows his kid is stealing doesn't say, `I'll teach you how not to get caught.''' Instead, says Stull, the parent keeps trying for reform.
According to Stull, who taught for 28 years in the Chicago Public Schools, the present contraceptive policy is ``basically saying: we don't care what you do, just don't get pregnant. It's as if schools have joined the soap operas. I can't see using the authority of the schools to condone immorality,'' she adds.
The DuSable-Bogan clinic is still too young to assess its effectiveness in stemming teen pregnancy, anyway. ``We have no statistical data yet, but unoffically, it seems less,'' says Mrs. Davis-Scott. ``I can tell you we're not giving prenatal care to 300!'' At present, 15 female students are receiving this prenatal help.
Donna McGruder is one of these. She's 18, unmarried, and expecting in December.
``The clinic, it helps me a whole lot. And they treat you with respect,'' says the DuSable student whose eyes look up, down, beyond but not at her listener. Donna says she wants the baby although she's ``scared to have it. My friends make me scared,'' she says.
Living with her grandmother, the teen-ager tells that her own mother visits sometimes ``and stays for a while, then she goes away.'' Donna, who has plans to work while her grandmother cares for the newborn, has already started job hunting but no leads have turned up yet.
``It's [teen pregnancy] a problem of poverty, not a racial problem,'' says Judith Steinhagen, DuSable's white principal, who has held that post for nearly 12 years. A national survey from the Children's Defense Fund (CDF), in Washington, D.C., backs her up on this point, stating that US teen-agers who are poor and who lack basic academic skills - whether they're black, white, or Hispanic - have nearly the same rates of teen-age childbearing. The CDF report states that impoverished teens are four times as likely to have poor basic skills as teens with family incomes above poverty. And that teens with poor basic skills are five times as likely to become mothers before age 16 as those students with average basic skills.
``Many children born to children are years behind when they get to school age,'' Steinhagen says. ``You just can't make up for the experiences that children of older middle class parents have had by the time they come to school, especially in speaking and listening skills.''
She explains that, in many instances, the unemployed and the poor must hustle for food, shelter, and survival before they can afford time for skill boosting. Along with other educators, Steinhagen contends that low self-esteem plays a key role in teen pregnancy. So does the closed door to employment, a crisis constantly confronting young people trapped within ghetto borders.
There's no dispute, the DuSable area is in tatters, ranked as one of the country's highest concentrations of poverty with unemployment figures averaging 22 percent (the national rate is seven). The high school stands in the shadow of the Robert Taylor homes, a public housing development that stacks poverty skyward. Twenty-eight buildings, each rising 16 stories, house approximately 28,000 people whose average age is 15. The majority of DuSable's students come from these homes, and 79 percent of them live below the poverty level, many existing far beneath the government's cut-off line of $10,989 annually for a family of four.
According to clinic director Davis-Scott, 33 percent of the teen mothers nationwide have a second baby within two years. ``If the teen didn't drop out of school the first time, the potential for her dropping out the second time is even higher,'' Scott says.
Alfreda Jones knows all about this scenario. She has five children, none enrolled at DuSable now. In speaking about her youngest daughter, Mrs. Jones says, ``My young one, she got pregnant when she just got in the door [of DuSable]. She was 14. Had it at 15. Had another at 17. Maybe if they'd had birth control when she was there, she wouldn't have had the babies.'' The daughter, who dropped out of school, now lives on welfare and is trying to get her GED (General Educational Development) diploma.
Michael Ellis and Shirley Bims Ellis, who have a freshman daughter, Michele, at DuSable, are both in support of the clinic's birth-control efforts. They cite abstinence as the only real solution to teen pregnancy among unmarried youths.
``But at this particular time in this particular place, we are trying to meet the current problem practically,'' says Mrs. Ellis. ``Children simply can't care for babies either financially, mentally, or physically,'' she explains. ``We are black people trying to help ourselves. There is no way we can survive if we have children having children.''
Not surprisingly, opponents of the clinic disagree.
``They [the parents] are guilty of contributing to the delinquency of a minor. They're just as responsible as if their child broke a car window. The courts take children away from parents for all other crimes but not teen pregnancy,'' Rev. Crawford says. For teens over 16, the pastor says, ``they should marry and take care of their responsibility. They're old enough to legally have a job, and they're legally at the age of accountability.''
In the past 16 months, DuSable students have made more than 14,400 visits to the clinic. Of these, approximately 12,400 were for physicals, immunizations, first aid, and other medical services. Only about 14 percent were for contraceptives or counseling on sexual activity.
A registered nurse, Davis-Scott is also director of a similar clinic that opened this fall at Orr High School on Chicago's West Side, where teen pregnancy and infant mortality rates are high, and incomes are low. The population is principally black and Hispanic. As with DuSable, the Chicago School Board split over the contraceptive issue. But those members contending that the birth control role is inappropriate for schools lost ground. And Orr students - with written parental consent - can get their contraceptives behind the black door marked 109.