RT Journal A1 Fleszar JM, Hendee WR T1 SChool-based clinics' birth, fertility, and abortion rates-reply JF JAMA JO JAMA YR 1989 FD December 15 VO 262 IS 23 SP 3271 OP 3271 DO 10.1001/jama.1989.03430230043019 UL http://dx.doi.org/10.1001/jama.1989.03430230043019 AB In Reply.—  Dr Cullen is correct in pointing out that the impact of the St Paul program was measured in terms of a reduction in birth rate rather than fertility rate. However, program staff in St Paul do not believe that the dramatic reduction in births between 1976-1977 and 1983-1984 can be explained by an increase in abortions. This belief is reinforced by a decline in positive tests for pregnancy identified over this period.