The new policy is designed to make it easier for sexually active girls to access birth control, in the hope that doing so will reduce the abortion rate.
In young women under the age of 19, there are about 40,000 unwanted pregnancies a year in Canada, half of which end in abortion.
"This is a strategy to reduce the number of unwanted pregnancies. It's a practical solution to a real problem," Dr. Yves Lamontagne, president of the Quebec Order of Physicians, said in an interview yesterday.
He seemed bemused by the suggestion that some parents might object to teens having access to the pill without parental knowledge, saying public health must take precedent over morality. "Maybe we're more progressive here in Quebec, but we have to use our heads and acknowledge that teenagers are having sex," Dr. Lamontagne said.
Gyslaine Desrosiers, president of the Quebec Order of Nurses, agreed, saying this is a health issue, full stop. " Young people, and girls in particular, feel it's easier to discuss sexuality with a nurse. . . . They want a conversation and practical advice."
Ms. Desrosiers stressed that nurses, like doctors, will only prescribe birth-control pills where appropriate. "This isn't an open bar. It's a consultation with a health professional."
In Canada, unlike many parts of the United States, teens do not require parental consent to obtain birth control. In fact, the Society of Obstetricians and Gynecologists of Canada recommends that anyone older than 14 be given a prescription, if it is medically appropriate.
But Mary Ellen Douglas, national organizer of the Campaign Life Coalition, said parents should be alarmed by the fact their children will have ready access to birth control in a school setting. "That this is given out without their consent, I think is outrageous," Ms. Douglas said in a telephone interview from Kingston, Ont. "They don't give these young people any credit that they control themselves."
Decisions on whether parental consent is required for girls younger than 14 are made on a case-by-case basis, and that informal rule will apply for nurses as well.
About 1,000 Quebec nurses who work in schools, youth centres and community clinics will now have the power to prescribe birth-control pills. The change came about as the result of Bill 90, Quebec legislation that encourages health professionals to work in teams and share activities.
Technically, nurses are being provided with a "collective prescription" from physicians. This is similar to the delegation of authority to pharmacists so they can prescribe the morning-after pill to women.
Francine Locat, a nurse at Montreal's Édouard-Montpetit High School, said the change is long overdue. "It's something we as nurses have wanted to do for a long time."
Under the new policy, nurses can write a three-month prescription for a low-dose contraceptive, one with 35 micrograms of estrogen or less. To have the prescription renewed, the teen will have to see a doctor and have a gynecological examination, but that process will be facilitated by the nurse.
Teenage girls interviewed yesterday outside FACE (Fine Arts Core Education), a high school in downtown Montreal, welcomed the change, saying they would feel much more comfortable discussing sexual-health issues with the school nurse than having to make a doctor's appointment.
"It's easier," said 16-year-old Jasmine Arbour. "It puts us in a better situation."
Abby Lippman, co-chair of the Canadian Women's Health Network, said the change in policy is sensible and good health practice. "The more readily available you can make birth control for women and girls, the better off they will be. . . . It's unfortunate this policy doesn't exist across Canada."
Dr. Lippman stressed that oral contraceptives are "just one piece of the puzzle. We've got to do a better job of sex education for boys and girls."
