The American Academy of Pediatrics (AAP) this week recommended that its members provide emergency contraception or “the morning after pill” – to “teenagers in immediate need” and also write prescriptions in advance for emergency contraception “for teenagers to have on hand in case of future need.”
Related: Birth Control for Men? Why Not?
We reached out to Susan Wysocki, President at iWoman’s Health, to get her thoughts on whether advanced emergency contraception is a good idea. Here’s what she said…
In 1992, Dr. James Trussell and the late Dr. Felicia Stewart, authors of Contraceptive Technology, projected that widespread use of ECPs [emergency contraception pills] could prevent half of all unintended pregnancies and abortions in the U.S. each year. Unfortunately, that has not been the reality. In fact, in over 14 studies where the impact of ECPs has been examined, none have shown any benefit.
The issue isn’t that ECPs don’t work; studies clearly show that both the levonorgestrel products (Plan B and Next Choice) taken within 72 hours of unprotected sex alters the coarse of ovulation, thereby preventing conception. The levonorgestrel products are available over the counter to women 17 and older. The newest EC product, ullipristal acetate (Ella) is available only by prescription and can prevent ovulation up to five days. For the greatest efficacy in delaying ovulation, the EC products should be taken as soon as possible after unprotected sex.
So the lack of impact isn’t the efficacy of the products, it is something else.
That something else may be access to the products and being educated that these products exist and when to use them.
An “emergency” is not a good time to do the research about what to do or which pharmacies stock the medication or are open on a weekend. Advanced prescriptions, as the AAP has suggested, makes sense. It serves as a reminder that there is a second chance to prevent pregnancy. Advance prescriptions can also mean an adolescent (or women of any age) can get EC to have on hand “just in case.”
Last year, the Food and Drug Administration (FDA) approved emergency contraception
over the counter for all adolescents based on safety and findings that adolescents could follow the directions. Further, the FDA panel recognized that access to the over-the-counter product did not increase risky behavior among teens. The FDA’s approval was revoked by Department of Health and Human Services Secretary Kathleen Sebelius in an unprecedented move by the Obama administration.
Emergency contraception does not work if it is not used. It works less effectively if there is a time delay.
Not every pharmacy or pharmacist provides emergency contraception. Advanced prescriptions make common sense. The reality is that accidents and unprotected sex happens all the time. Let’s hope that pediatricians and other health providers for reproductive aged women of all ages take note and help give their patients information about this second chance to prevent an unwanted pregnancy.
Along with health care providers, moms and daughters (and sons) or a close family member can share this information, as well. I talked to my niece about emergency contraception early in adolescence. It was the perfect opportunity for me to tell her why I hoped she would never have to use it. As important, it was a perfect moment to tell her why I did not want her to have sex for a very long time. Discussions like mine with my niece convey how much we care about their future.
Plan B and Next Choice can be found in many drug stores by asking the pharmacist. Women can get a free medical consultation and next0day delivery of Ella at www.ella-rx.com.
As for the AAP, the organization says in its new policy statement published in the journal, Pediatrics: ”Despite significant declines over the past 2 decades, the United States continues to have teen birth rates that are significantly higher than other industrialized nations. Use of emergency contraception can reduce the risk of pregnancy if used up to 120 hours after unprotected intercourse or contraceptive failure and is most effective if used in the first 24 hours.”
Related: What Unintended Pregnancies Cost Us
Currently, emergency contraception like Teva Pharmaceutical’s Plan B One Step, is available to adolescents 17 and younger only with a doctor’s prescription in most states, but females 17 years or older and males 18 years or older can obtain emergency contraception without a prescription in every state the Academy says “adolescents are more likely to use emergency contraception if it has been prescribed in advance of need.”
The Academy’s recent recommendation seeks to skirt a federal ban on over-the-counter sales of emergency contraception to girls under 17 and to educate physicians on the use, safety and efficacy of these pills. The U.S. Food and Drug Administration in December 2011 rejected a move to allow emergency contraception to be sold over the counter to girls younger than 17.
The American Congress of Obstetricians and Gynecologists also recommended that oral contraceptives be available over the counter.
Tell us: What do you think? Should teens of all ages have access to “just in case” emergency contraception?
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