Birth Control At Harvard: Spreading The Word

It started out as a normal Wednesday night study break Twenty-two Wiggles worth students piled into their proctor's cramped living room at 10 p.m. to munch on Oreos and Cheese Doodles But along with the chips, the freshmen passed around birth control devices.

The event was an informal presentation by representatives of Peer Contraceptive Counseling, a group of undergraduates who, under the auspices of University Health Services (UHS), inform students on birth control methods, sexuality, and related health issues.

In an effort to increase awareness of their services, the group has began conducting a series of presentations like the one in Wigglesworth, collectively known as "Freshman Outreach" This was the third session this fall of the about 20 planned for this year.

Sitting in front of a table which displayed almost every common method of contraception, the counselors explain the use, effectiveness and possible side effects of each As they describe each object, including a plastic replica of the female genital affectionately dubbed "Patty Pelvis," they pass them around.

Although there were intermittent jokes and comments, the atmosphere was relaxed and most students listened carefully.

"People paid a lot more attention to this than to the first two orientation meetings I gave," said Proctor-Michael K. Fridkin '81 who said he signed up to host an outreach session because "these are the questions that people want to start asking now, but they're afraid to Sexuality becomes more relevant when people are separate from their families" He adds. "I doubt very many people have been given the opportunity to learn about contraception in at atmosphere where they feel comfortable asking the questions they most want to ask."

"You didn't really feel like people had to say funny things to break the tension," says Diane J. Klein '87, She adds, "I was reluctant to come, because I thought it would be reduced to innuendo and double-entendre, but it wasn't."

Dean of Freshman Henry C. Moses says he feels the outreach program serves an important purpose. "We've been trying to find a way to go and talk to freshman about contraception and sexuality for at least five years, since 1977 when all the freshmen lived in the Yard, male and female, for the first time."

The group asked all proctors to sign up to host presentations at a proctors' meeting with Moses early this fall. Twenty of the approximately 40 present agreed, according to Michele J. Orza '84, one of the counselors and the student coordinator of the counseling group.

Before their discussions of such methods as the condom with foam, the diaphragm, the Pill, and the IUD, the counselors were careful to stress that their group makes no assumptions about the sexual behavior of Harvard students "We're not assuming that everyone here is heterosexual, or that all of you are having sex or that sex includes intercourse," says Orza.

She and Ann Rusnak '85 proceed to outline facts and misconceptions about the different methods of birth control, taking care in each case to describe how to obtain contraceptives from UHS, and what exactly is involved in a visit for that purpose.

Occasionally, the counselors interjected unofficial information. "If you go to the UHS Pharmacy to buy condoms, the pharmacist will probably try to be funny and throw you by asking you what size you want." Orza warns.

"But don't worry," she adds. "One size fits all What he means is do you want a package of three six or 12."

One of the points that the counselors stressed was that contraception is not a concern solely for women. In illustrating how men can be actively involved in the use of such methods as the diaphragm, they called on Fridkin for help.

With a minimum of help from Orza and Rusnak, Fridkin showed, using Patty Pelvis, that men too can insert diaphragms.

Most of the intermittent questions came from the men in the room, several of whom commented later that they were quite impressed with the presentation.

"What was great was showing all these things you've heard about and seen pictures of, but haven't touched. I expected to be embarrassed, but I wasn't says Francis A. Evers '87, who is from Dublin, Ireland He adds. "In Ireland, you would never see that I thought I knew a lot I didn't know anything."

Scott B. Paton '87 agrees "I don't think you can really go beyond what they've done here," he said, adding. "There are probably a lot of people who think they know things, but they really don't Some people think not knowing implies they don't deal with contraceptives, so they don't have sex so they're losers Some people just don't want to learn They're crazy, but they don't." Asked whether he would recommend the group's services to friends he says. "Definitely It would be ridiculous not to."

At the end of the session, the counselors distributed a brief evaluation form, consisting of questions such as. "Was the information presented in too much detail. Too little?" All the students completed it anonymously and the counselors said that they have received almost entirely positive responses.

The group was formed seven years ago by several women students with the help of a supervisor according to Nadja B Gould, the UHS clinical social worker who supervises the program now

"There was a feeling among women students that there weren't enough resources for women to talk to women about health, sexuality, and reproductive issues," she explains, adding. "In 1978 or '79 we started having male counselors, we're interested in having more men "She adds that usually whenever there is a man on duty there is a woman staffer with him.

Although only one of this year's eight counselors is male, there has traditionally been a closer ratio last year, four of the 12 were male.

UHS Director Dr. Warren E.C. Wacker says that the most valuable aspect of the program not only is its learning experience for counselors but also. "For consumers, there are a lot of people who are rather shy about talking about these things with adults. In some instances, they can't even know what to ask. They're less embarrassed to talk to a peer."

It was Could's idea to bring the counselors' experience to freshman dorms last year. She says she was inspired by the health educator at Dartmouth, who offered to bring Dartmouth students to Harvard to demonstrate their presentation.

"They did something called a "road show," Orza says, explaining. "Some things were in bad taste. They got into things like flipping diaphragms across the room There's such a thing as having a sense of humor, and there's such a thing as going too far."

The peer counselors have evidently given a great deal of thought to their approach as well as their tone when presenting information.

"One of the things that impressed me was their absolutely matter of fact attitude," says Senior Adviser Shaller who hosted one of the first outreach sessions last spring and who says he plans to have another one sometime this year.

"I was pretty skeptical about them last year. I didn't know what sort of thing they were going to do," he recalls adding, that the presentation was "as value neutral as any presentation of that sort could hope to be. They were so matter-of-fact that anyone would have felt absolutely stupid trying to cut up during it."

Shaller also says the relaxed atmosphere of study breaks is helpful for these discussions. "With a group it takes pressure or inertia away from people who would otherwise have to go themselves. It takes a lot more admission of some thing to haul yourself up to the third floor of UHS than just going to these meetings, where you can pretend you just want cookies"

Although no counseling experience is necessary for potential advisors, the selection process is thorough A prospective counselor first has to meet at least two other counselors, who may then recommend him or her to Gould, who interviews all candidates "You just have to be a good listener, be willing to learn, care about the issues and be non judgmental." Gould explains Counselor Rebecca A. Schliefter '84 agrees, saying. "Ninety-five percent of it is just genuine interest

Once a counselor is accepted, he or she attends weekly meetings with the others and with Gould, which UHS support staff visit frequently. The support stall includes doctors and nurse practitioners who update and amplity current information.

Periodically the counselors take an informal quiz, corrected among the group, to be sure they haven't forgotten anything. In addition, they often rely on other or on literature to confirm their information

"People aren't machines; they're not expected to rattle off answers. You're allowed to look in a book, ask someone to call you back, talk to a nurse practitioner." Rusnak says.

The service is available to students who drop by the office or call between 1 p.m. and 5 p.m. Mondays through Thursdays. The counselors said that the clients are about equally divided between callers and visitors.

The counselors do not introduce themselves, nor do they ask the names of their visitors. In the Friday group meetings, the staff discusses issues that have arisen during the week, but they never discuss individual cases.

Although they do not discuss the numbers of clients, the counselors say that most of them are women. "We see mostly women on duty, because I think, unfortunately, around here birth control is seen as a women's issue," says Rusnak, adding "but it's really a couple issue. Both people need to get involved."

One counselor who wished to remain anonymous says. "It's really wonderful when couples come in together. It increases the open atmosphere you're trying to achieve with a partner."

None of the counselors says he or she has difficulty being in a position to advise peers.

"Actually, people are more comfortable talking to their peers," says Brainard She adds. "You're not seen as being in a power position, as a medical professional would be that's the whole point of peer counseling."

"The program's asset is that it's [made up of] students who are sympathetic to other students' needs and will sit down and talk without an appointment," says another counselor who wished to be anonymous.

She adds, "Contraception is a serious issue, and should be taken seriously. But with the tax on UHS with so many people using their services, they don't really have the time to sit down and talk about emotional fears and concerns, especially the emotional side of these issues. Our office is a place where people can take the time."

Jill E Nichols '87, who attended an outreach session in Grays Hall two weeks ago, says, "It's good that it's students doing it, it's more likely for students to listen to other students, rather than being talked down to or preached at."

Her roommate Jennifer I Gordon '87, comments that "they seem to be comfortable, accepting, and non-judgmental."

Several counselors stressed the importance of the "human" aspect of counseling in their own experience as well George A Small '84, who in tends to got to medical school, says there's so much implicit emphasis [in medical school] on going to class and working in a classroom, impersonally, that a med student might get a skewed impression of what it means to be a physician Any chance to work with people through counseling, or perhaps a religious organization, is a way to get a more realistic view of people."

The most difficult aspect of counseling, several counselors say, is that they do not give advice, they merely dispense information. And sometimes this is a problem for clients.

"There are times when you can't help people." Rusnak says, adding. "You can give people information, but you can't make the decisions, even though there are times when people want you to make their decisions yourself. It's frustrating to have to step back, we're not going to do that."

Orza elaborates on the difference between information and advice. "I think some things are very straightforward, like how do you put in a diaphragm? Or, what are the side effects of the Pill? But with the grayer areas, like, should I be involved in this sexual relationship? I do feel uncomfortable: I don't give advice. I listen a lot, I try to make the person find their own answers."

"It's really dangerous for people to pretend they have all the answers. It's important not to be on a power trip, to be humble."

Some people do press the counselors for advice, however, and one staffer says. "If they press you, it's probably because they're really confused. That's all the more reason not to give them advice."

The most rewarding aspect of counseling, most agree, was helping people to understand the issues better, and to find their own answers.

"The best thing is getting people to deal with the fact that they're sexually active, and feel comfortable with what they're doing," one women says, adding. "A lot of people pretend to themselves that they're not sexually active. But by seeking contraception, they're admitting that they are, and [facing] the risk of getting pregnant."

But she says that for all the people who do seek counseling, there are more who are reluctant to ask for help "I wish people wouldn't guess so much about birth control issues. There's never been a stupid question It's hard not to pick up the phone."

Rusnak adds. "No question is ever ridiculous Just because we go to Harvard doesn't mean we should know everything."

All of the counselors cited the low profile of the counseling group as a major problem. "I don't know how we're perceived: I wish we were perceived, says one member.

Orza, who was the author of the health and sexuality survey distributed to all undergraduate women earlier this fall, says she expected the responses would help explain why the group is "under-utilized."

Some counselors suggest that the fact that their office is located under the roof of UHS might deter some students from visiting, particularly if they are worried about confidentiality, and don't want to be seen seeking advice about contraception. But this situation will be ameliorated "probably before next semester," according to Orza, who says that the group will have a new office, separate from UHS, elsewhere in Holyoke Center.

There was no clear consensus on what the counselors felt their image among the community is.

"That's tough," says Brainard, explaining. "It depends on with whom you're speaking. The way people view us depends on their view of sex. If they're against it, they think we're somehow promoting it. That's not the case at all we just give information: it's important to have that information available."

But once people become aware that a certain student is a peer counselor, they approach him or her outside of the office much more frequently.

"This service is badly needed." Rusnak says, adding. "People should be able to talk about it wherever they need it I don't need an office to be a counselor." She adds that she has even made a point of letting others know she is available for information.

"I'm in Bio 109 ["Issues in Women's Health"], and I've done some talks there in sections, and some women have come to talk to me outside of class With office hours, we're not always accessible Off-duty, as many if not more men as women come to talk."

She adds that despite the common opinion that Harvard students "know everything," this knowledge does not extend to contraception.

"As educated in certain areas as this community is, in others they lack exposure, and birth control is one of them People in our society are assumed to be so bright and savvy that they're intimidated, they don't want to admit that they don't know something about birth controlGraphic by Thomas A Houpt