birth control
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Middle and high school students can't get a Coca-Cola or a candy bar at 13 Seattle public schools, but they can get a taxpayer-funded intrauterine device (IUD) implanted without their parents' consent.

School-based health clinics in at least 13 Seattle-area public high schools and middle schools offer long-acting reversible contraceptives (LARCs), including IUDs and hormonal implants, to students in sixth-grade and above at no cost, according to Washington State officials.

LARCs are associated with serious side effects, such as uterine perforation and infection. IUDs, specifically, can also act as abortifacients by preventing the implantation of a fertilized egg.

The state and federally funded contraceptive services are made possible by Take Charge, a Washington State Medicaid program which provides free birth control to adults who are uninsured, lack contraceptive coverage, have an income at or below 260 percent of the Federal Poverty Level -- or, in this case, to teens who don't want their parents to know they're on birth control.

In an email exchange with the Washington State Health Care Authority and CNSNews.com, a Take Charge spokesperson acknowledged that underage students are eligible for a "full array of covered family planning services" at school-based clinics if their parents meet the program's requirements.

Take Charge added that "a student who does not want their parents to know they are seeking reproductive health services is allowed to apply for Take Charge using their own income, and if they are insured under their parents' plan, the insurance would not be billed."

When asked if a sixth grader could get an IUD implanted without parental consent, Take Charge told CNSNews.com: "We encourage all Take Charge providers to offer long-acting reversible contraceptives (LARCs) in their clinics. A young person does not need parental consent to obtain a LARC or any other contraceptive method...If the young person is not choosing abstinence, she would be able to select a LARC and have it inserted without parental consent."

So while the students can't get a soda from the cafeteria due to the Seattle School Board's 2004 ban on junk food, they can get an IUD implanted at their school's health center without their parents' knowledge or permission.

According to the Washington State Medicaid website, health centers at four middle schools and nine high schools in Seattle participate in the Take Charge program. Other Take Charge providers are located in close proximity to schools.

"We have public health departments, community-based clinics, college and university clinics, pediatric clinics, private physician practices, and family planning clinics, like Planned Parenthood" as providers, Take Charge said in the email exchange. A total of 38 Planned Parenthood clinics participate in the Take Charge program.

Seattle school-based clinics participating in the program include Aki Kurose Middle School, Washington Middle School, Denny Middle School, Madison Middle School, Franklin High School, Nathan Hale High School, Roosevelt High School, West Seattle High School, Garfield High School, Ingraham High School, Rainier Beach High School, South Lake High School, and Chief Sealth International High School.

"Because we're at the school, which is so wonderful, we have access to the students, and they have access to us, pretty much any time," said Katie Acker, a health educator at two high school clinics run by Neighborcare Health, which participates in the Take Charge program.

"We will send them a pass for whatever class is easiest or best to get out of. Of course, there are always students who are like, 'I wanna miss IB Math!' We are not gonna pull you out of IB Math — how about ceramics instead?"

Washington State law grants any individual "a fundamental right of privacy with respect to personal reproductive decisions."

A 2014 Washington University study "document[ed] the activities of the reproductive health educator and trends in teen LARC uptake" at clinics participating in the Take Charge program in West Seattle High School and Chief Sealth International High School. School-based health providers, Neighborcare administrators, public health officials, and community partners were interviewed.

Researchers found that "school-based health providers often cited their lack of formal training not only in inserting or removing IUDs and contraceptive implants, but also with the procedures in general."

One health care provider who was interviewed reportedly commented: "It's still scary to begin putting them in. Scary meaning that we know the biggest complication risk come with the least experienced providers. So how do you take that leap and just go for it?"