The American Academy of Pediatrics issued a new policy statement that says doctors should let their teenage patients know about emergency contraception and write them a prescription for it in advance as part of a public health strategy to reduce teen pregnancy.
The policy statement addresses the “promiscuity” concerns opponents have to making emergency contraception more widely available to teens, dismissing it outright. “We have no data showing that…Because of the adolescent mind and brain, teens don’t think in the abstract. They don’t think, ‘I need to be careful because I might have sex tonight.’ They can make impulsive decisions,” says Dr. Cora Collette Breuner, a professor of pediatric and adolescent medicine at the University of Washington and one of the statement’s lead authors in TIME magazine.
“People say that if you make this available that kids will have more sex and less protected sex, and that is not true,” Breuner said. “Seven studies showed that is not true.” Roughly 42 percent of 15- to 19-year-olds report having had sex, and 10 percent of them say they were forced into it, the statement noted.
Breuner and her colleagues reviewed the safety and effectiveness of three emergency contraception methods: Plan B or Next Choice (levonorgestrel) and ella (ulipristal acetate), which affect the hormone progesterone, and combination oral contraceptives. Many pediatricians do not know enough about how emergency contraception works to discuss it with their patients, Breuner said. Some doctors won’t prescribe it because of biases but they should refer patients to someone who will, she added. This policy statement is designed to foster those conversations and get the ball rolling on access.
School nurses and health clinics also can play an important role in educating teens about emergency contraception, Breuner said. “If we are going to do anything about reducing our teen pregnancy rate and make it not the highest in the developed world, we need to provide more education to family and children,” Breuner said.
The teenage impulsive decision-making process coupled with the fact that access to emergency contraception varies means teens are at best confused about how and when to access emergency contraception. In most states teens younger than 17 must obtain a prescription from a doctor to access emergency contraception. According to the AAP, teens are more likely to use emergency contraception if it has been prescribed in advance which would go a long way toward reducing teen pregnancy rates.
The statement recommends pediatricians begin discussing EC proactively with teens at pediatric well visits starting at age 12. Authors of the study compare discussing EC to doctors discussing drug and alcohol use, smoking, asking about depression or suicidal feelings and urging their teen patients to wear helmets while biking, says Breuner. “This is not about saying a 12-year-old should be given a prescription for emergency contraception,” she says. “We are recommending that pediatricians start talking about some of the things that promote happy and healthy living for teenagers. This is about prevention.”
Anti-abortion opponents will not like this latest policy statement as many believe emergency contraception to be an abortifacient– a point the authors of the statement also specifically and categorically reject. But like the recent recommendation by ACOG to make the birth control pill available over the counter, it is good to see the medical community take an affirmative stand in defense of public health after the relentless attacks on family planning by the religious right.
Photo from Florian via flickr.