September 7, 2005
The American Academy of Pediatrics (AAP) is supporting over-the-counter access to emergency contraception for teens and young adults, and encouraging doctors to talk with their sexually active patients about it.
Ensuring that teens have access to birth control - including emergency contraception - is an "essential component" of sex education, the AAP said. That education, along with encouraging abstinence, is the best way to prevent teens from getting pregnant and contracting sexually transmitted diseases, the AAP added.
Emergency contraception uses the same hormones found in some birth control pills to stop the ovulation process. It is usually prescribed within 72 to 120 hours (3 to 5 days) after unprotected sex or in cases where regular methods of birth control fail. (For example, if a condom breaks or a girl forgets to take her birth control pills.)
Preven and Plan B, two brands of emergency contraception, have been available by prescription since the late 1990s. In the last 2 years, the U.S. Food and Drug Administration (FDA) has been considering whether to make the pills available over the counter, a step the AAP has supported.
"Emergency contraception has tremendous potential to reduce unintended pregnancy rates in teens and adults," the AAP said in its statement. In addition, research shows that making this kind of birth control available doesn't increase the rate of unprotected sex among teens, the AAP said.
For the FDA, the issue has been access by younger teens. The agency has delayed its decision on emergency contraception for now, saying that although over-the-counter sales to girls 17 years old and over would be safe, access should be restricted to younger teens, and the FDA still has questions about how to enforce these restrictions. Meanwhile, some states have already opened up access to emergency contraception, allowing pharmacists to prescribe it.
The AAP laid out its position on emergency contraception in a new policy statement that will appear in the October edition of the journal Pediatrics. The AAP has other policy statements on other forms of contraception. The AAP said it wrote this one to clear up any misconceptions about emergency contraception, and to guide pediatricians on how to prescribe it.
The AAP urged doctors to educate their sexually active patients about emergency contraception during annual check-ups and discussions about their sexual health. Currently, only 20% to 25% of health care providers are broaching the topic, the AAP said.
Here are some of the other key points of the AAP's new policy:
- Emergency contraception is not the same thing as abortion. It does not disrupt the growth of an embryo that's already implanted in the lining of the uterus. It can prevent the ovaries from releasing an egg, prevent an egg from being fertilized by sperm, and prevent a fertilized egg from attaching itself to the wall of the uterus.
- Emergency contraception works best if it's taken as soon as possible after unprotected sex. It is available by prescription from a doctor, many community health centers, branches of Planned Parenthood, and in hospital emergency departments.
- Preven and Plan B, the two medications that have been approved by the FDA, are safe and effective for teens to use. Preven contains the hormones progestin and estrogen. Plan B, which contains the hormone progestin, should be the first choice because it has fewer side effects (such as nausea).
What It Means to You
If your child is sexually active, it's important to make sure that he or she has the facts about birth control and emergency contraception. Along with encouraging abstinence, it's the most effective way to prevent your teen from getting pregnant or contracting an STD, according to the AAP.
It isn't always easy to talk about sex and birth control with your kids. But it's important to make sure that they get accurate information that can help them make healthy choices about becoming sexually active. Here are a few tips on how to broach the topic:
- Many schools start sex education in the classroom in the fifth or sixth grade, addressing topics like birth control, STDs, and pregnancy. Know what your child is learning in school and be open to continuing the dialogue and answering any questions at home.
- Always be honest. You can always start with less detail and add more as your child becomes more curious - but lying or avoiding tough questions can easily backfire. And remember, it's OK to say "I don't know" and get back to your child later, or to look up the answer together.
- Present the facts but also give your child a sense of where you stand. Teens, especially, may seem uninterested in your values - but they are taking in more than you think they are.
- Don't think that only moms should talk to girls and dads should talk to boys. Everyone has a role to play in supporting a child's healthy sexual development.
- Keep in mind that your child may not feel comfortable approaching you with his or her questions about sex. That's OK. But it's important to make sure that there is an adult that he or she trusts - like a teacher, a school counselor, a school nurse, or a doctor - and can approach with these questions.
If you have questions about birth control, emergency contraception, or how to talk with your child about sex, it's a good idea to talk with your child's doctor. Lots of parents find that this is a tough issue to tackle. And your child's doctor may be able to offer a helpful perspective and some good resources.
Reviewed by: Steven Dowshen, MD
Date reviewed: September 2005
