Pediatricians Should Talk Emergency Contraception With Teens, Group Says

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Doctors should talk to teens about emergency contraception and provide them with prescriptions so they can be ready if they have unprotected sex or their birth-control method fails, according to a policy statement from the American Academy of Pediatrics.

“Pediatricians really need to talk about emergency contraception when talking to teenagers at the well-child visit,” says Cora Collette Breuner, MD, a lead author of the paper and professor of pediatrics at Seattle Children’s Hospital and the University of Washington. “They shouldn’t skirt around it. This is like talking about seat belts and texting-while-driving.”

Emergency contraception, which can prevent pregnancy, should also be discussed with teens in emergency departments, clinics, and hospitals, according to the statement, which is published in the December issue of Pediatrics. Emergency contraception, also know as the morning-after pill, contains the same or similar hormones as those in regular birth control pills (but at higher doses) and they can prevent pregnancy if taken in the day or days after unprotected sex.

Although teen pregnancies in the U.S. have declined over the past 20 years, the rate is still the highest in the developed world, at 34.3 births per 1,000 15- to 19-year-olds. Nearly 80% of these pregnancies are unintended.

Some 43% of teens in this age group report having had sex and about 10% say they’ve been forced to have sex. Yet awareness of the availability of emergency contraception appears to be low.

While emphasizing that the best way to avoid pregnancy is still effective birth control, the new policy statement recommends that doctors provide teenagers with a prescription for levonorgestrel 1.5 mg, sold as Plan B, Plan B One Step, or Next Choice. These products prevent pregnancy (they don’t terminate an existing pregnancy) and are effective if used within 5 days (120 hours) of unprotected sex, though they tend to be more effective if taken within 24 hours.

Right now, anyone younger than 17 must have a prescription from a doctor to get one of these products, although females 17 and over and males 18 and over can get emergency contraception without a prescription.

Levonorgestrel has fewer side effects than other forms of emergency contraception, namely ulipristal (Ella) or the Yuzpe method (taking extra birth-control pills), the group says.

One of the most common objections to increased access to emergency contraception–that teens would become more promiscuous–is unfounded, the pediatricians say.

“Several studies have shown that it doesn’t promote more sexual activity or more unprotected sex,” says Dr. Breuner.

The policy statement stopped short of advocating over-the-counter availability of emergency contraception for younger teens, although Dr. Breuner doesn’t rule this out down the line.

“We have to do this in a step-wise way,” she says.

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