Major Pediatric Group Throws Support Behind Emergency Contraception For Teens


Emergency contraception is safe and effective for teenage girls, and pediatricians should push for increased access to this type of birth control, regardless of age and insurance, according to the American Academy of Pediatrics. The organization issued a new policy statement on Monday.

"Emergency contraception should be available, and it should be available over the counter," Dr. Cora Collette Breuner, a professor of pediatrics at the University of Washington School of Medicine, told HuffPost. "Education should be provided in the pediatrician's office ..."

Currently, girls under the age 17 must get a prescription for emergency contraceptive pills.

Emergency contraception is the only contraceptive method that can help prevent pregnancy after intercourse, when taken within five days of unprotected sex or contraceptive failure. FDA-approved formulas of the drug, often called the "morning after pill," include Levonorgestrel, which goes by the brand names Plan B One-Step and Next Choice One Dose, and ulipristal acetate, brand name Ella.

Though the exact mechanisms differ, the pills work by preventing a woman's body from releasing eggs. Other available forms of emergency contraception include certain combinations of hormonal birth control, although this is considered an "off-label use," or implanting a copper IUD.

According to the new policy statement from the AAP, the United States' major pediatric organization, nearly 45 percent of 15- to 19-year old girls in the U.S. have had sex, and adolescents are at particularly high risk of skipping birth control pills or failing to use contraception.

"Cognitively, teens tend to be very concrete -- they make decisions based on 'right now'," Breuner said. "They can be impulsive."

Thus, one focus of the new policy statement is the importance of writing a prescription before it is needed. A 2010 review in the Journal of Pediatric and Adolescent Gynecology of seven trials concluded that advance prescribing decreased the time before usage, making the emergency contraception more effective, and did not increase sexual activity among teens.

"From a strictly scientific point of view, there's not much controversy -- the medicine is pretty safe and pretty effective," said Dr. John Santelli, a pediatrician and chair of the department of population and family health at Columbia University's Mailman School of Public Health. "To say that emergency contraceptive is controversial goes back to the fundamental issue that many adults in this country are uncomfortable with adolescent sexuality and sexual behavior."

In December, U.S. Department of Health and Human Services Secretary Kathleen Sebelius denied an application by Teva Women's Health Inc., the pharmaceutical company that manufactures Plan B One-Step, to make the drug available over the counter for all women of reproductive age.

Breuner stressed that the current scientific literature has not definitively shown that greater use of emergency contraception would affect rates of unintended teen pregnancy. In the U.S., teen pregnancy rates have been on the decline -- in 2011, nearly 333,000 babies were born to 15- to 19-year-old women, an all-time low in the age group -- but they are still significantly higher than those in comparable industrialized countries. Nonetheless, the new policy states that "all adolescents" should be counseled on emergency contraception in the context of discussions about sexual safety, regardless of whether teens are sexually active.

"As pediatricians, our job is to help make sure adolescents have healthy, productive lives with families that they plan," she said. "Our job is to [explain] that there are options out there. Knowledge is power."

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