Pediatricians should actively counsel teens about “emergency contraception” and even provide them with prescriptions or products ahead of time, to ensure they have the pills if they need them, the American Academy of Pediatrics says in a policy statement released online Monday.
AAP members also are urged to advocate lifting the age restriction for these products. Currently, girls 16 and younger need a prescription to obtain the “morning-after pill,” as these products are sometimes called.
Products such as Plan B, Plan B One-Step and Next Choice are most effective in preventing pregnancy if taken within 24 hours of unprotected sex, but they can work even if taken five days later.
Several of the AAP’s policy positions were stated “softly” in its 2005 emergency contraception policy, said Dr. Cora Collette Breuner, a member of the trade group’s Committee on Adolescence.
The new language is stronger, she said, because it went through more than 15 AAP committees — including those on safety and child abuse — for more than a year. The result is a “well-thought-through, researched and supported document,” said Dr. Breuner, who is an attending physician at Seattle Children’s Hospital and professor of pediatrics at the University of Washington School of Medicine.
The recommendation that pediatricians proactively consider giving “advance” prescriptions or actual emergency contraception products to patients stems from research showing that teens will use the pills if they have them, said Dr. Breuner. The goal, of course, is to encourage sexually active youths to use regular birth-control methods, she added.
The National Campaign to Prevent Teen and Unplanned Pregnancy supports wider access to all birth-control products, said Bill Albert, its chief program officer.
Parents and others may understandably have concerns about emergency contraception for younger teens, but those concerns seem “to be in conflict with the best science that we know,” he said.
There seems to be “no real evidence to suggest that making contraception, including EC, available to teens, or more readily available to teens, encourages them to begin having sex, have sex at a younger age, or have more sexual partners,” he said.
In contrast, Wendy Wright, vice president for government relations at the Catholic Family and Human Rights Institute, applauded Health and Human Services Secretary Kathleen Sebelius for deciding in December last year to keep requiring a doctor’s script before a young teen can obtain emergency contraception.
Mrs. Sebelius “hit the nail on the head,” Ms. Wright said.
There are too many questions to be answered, she said, such as what is the proof that younger teens are mature enough to be using these products. Also, what protections are being put into place to prevent girls from sexual exploitation if they could get these products easily, she asked, noting that some girls begin to menstruate as early as age 10.
The AAP’s new policy, which will be published in the December issue of Pediatrics, examines several emergency contraception products, and their safety, side effects and efficacy.
The products were designed for situations in which women had unprotected sex; were sexually assaulted; experienced condom failure during sex; or had sex after failing to take their regular birth-control pills or renew their contraceptive injectables, patches or rings.
The American College of Obstetricians and Gynecologists also endorses emergency contraception without a prescription. It recently issued a policy statement calling for all oral contraceptives to be sold without a prescription.