Pediatricians Advising Teens About Emergency Contraceptives

While teenage pregnancy rates have reached a three-decade low, down by 40 percent since 1990, the fact remains that the US teen pregnancy rate is the highest in developed countries, with seven percent of all US teenage girls getting pregnant every year. According to the CDC, 40 percent of teens don’t use a condom, and that an alarming number of teens still use no contraception whatsoever.
 

The American Academy of Pediatrics  (AAP) is determined to reverse these trends with new recommendations on emergency contraception. It suggests pediatricians add frank discussions about next-day birth control medications such as Plan B and Next Choice to talks of abstinence, condom use and traditional birth control measures.
 

First introduced in the 1970s, several prescription and over-the-counter emergency contraceptives have since been approved for teen use. The problem has been that many teens and their parents are either unaware they exist or harbor unfounded fears about using them. Emergency contraceptives like Plan B work by inhibiting ovulation and disrupting the production of key cells a woman needs to conceive. These products work best if taken up to 24 hours after unprotected intercourse. They are available for all patients who have a prescription and can be purchased over the counter for girls over the age of 17. 
 

Dr. Cora Beurner, a professor of adolescent medicine and pediatrics at the University of Washington in Seattle, notes that the AAP has suggested doctors keep emergency contraception readily available for teens who need a prescription for Plan B or Next Choice for future use. “They can keep the prescription in their wallet and if they have the need for it, they could go anywhere," Beurner said. "This is a ‘just-in-case.'" AAP advises patients and pediatricians that emergency contraception should only be used for emergencies and not as a regular contraceptive.
 

AAP’s new policy statement suggests that doctors provide teens with levonorgestrel 1.5 mg.—sold as Plan B, Plan B One Step, or Next Choice—since no pregnancy test is required before use as with some other forms. Teens 18 and over can get levonorgestrel 1.5 mg. With something this important, cost shouldn’t be a factor. Dr. Breuner indicated that the cost of emergency contraception is about $80, with some clinics charging on a sliding scale based on ability to pay.
 

While the use of emergency contraception has no serious side effects, Dr. Beurner noted that parents often have reservations that a these pills will increase a teen’s risky behavior. Studies have shown no correlation between emergency contraception use and increased sexual activity. In a statement that’s sure to raise the ire of religious groups, the AAP added that pediatricians have an obligation to offer emergency contraception to their patients—even if they are morally against this approach. AAP advises pediatrics to provide teens with greater access to the emergency contraception, regardless of age, and to promote insurance coverage of emergency birth control.
 

Dr. Jill Maura Rabin, a professor of obstetrics and gynecology at Hofstra North Shore (LIJ School of Medicine),  notes that emergency contraception awareness is up among pediatricians. ''The timing is good, because I think we need a reminder on the topic," says Rabin. "We still have pharmacies uncomfortable filling the prescription [for teens]."
 

How do you feel about emergency contraception? About prescribing them to teens under 17? Do your moral convictions outweigh unwanted pregnancies for these young girls?
 

Photo courtesy of MorgueFile.com