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Pediatricians: Girls should get just-in-case Plan B

 

Girls need just-in-case birth control prescriptions, pediatrics group says

By NBC News staff and wire services

Pediatricians treating teenaged girls should consider writing just-in-case prescriptions for the morning-after pill, the American Academy of Pediatrics (AAP) said on Monday.

It's the second recommendation in a week from a major doctor's group that would make contraception more widely available to women. Last week, the American College of Obstetricians and Gynecologists recommended making all birth control pills available over the counter.

The Food and Drug Administration says emergency contraception - the so-called morning after pill - should be available to any woman who needs it without a prescription. But Health and Human Services Secretary Kathleen Sebelius overruled the FDA a year ago. Now, federal policy says girls under 17 need a prescription to get it.

AAP says many teenaged girls need emergency contraception, and their pediatricians should help make it easy for them to get it. "Studies have shown that adolescents are more likely to use emergency contraception if it has been prescribed in advance of need," the group said in a policy statement.

"Despite significant declines over the past two decades, the United States continues to have teen birth rates that are significantly higher than other industrialized nations," it added.

Morning-after pills can prevent pregnancy -- they don't cause abortions -- if they are used within five days of intercourse.

Dr. Susan Wood, who resigned her job as assistant commissioner for women's health at the FDA in 2005 in a dispute over the then-Bush administration's handling of the birth control issue, called the decision a significant one. "It's not often you see physician organizations saying that their patients are better off without the physician involvement," Wood told Reuters.

"We do hope that pediatricians read the policy statement and follow the recommendations," said Dr. Cora Breuner, a pediatrician at Seattle Children's Hospital who led the AAP panel that produced the recommendations. "The Academy prides itself on a devoted membership."

Emergency contraception for adolescents has been one of the most politically fraught areas in health care for almost a decade.

In 2005 the FDA declined to approve any over-the-counter sales of the Plan B morning-after pill, overruling its own advisory panel, as well as its own scientists. Last December the FDA reversed its stance when it approved over-the-counter sales with no age limits. When Sebelius overruled the decision, it meant many women must present proof of age to get the pills.

Virtually every medical organization with expertise in the area supports making emergency contraception available for sale to girls and women of all ages who might need it. The American Academy of Pediatrics, the American Congress of Obstetricians and Gynecologists, and the Society for Adolescent Health and Medicine joined forces to denounce Sebelius's action last year.

"The decision to continue restricting access to this safe and effective product is medically inexplicable," AAP president Dr. Robert Block said in a statement at the time. One of the reasons Sebelius gave for her decision was the worry that girls as young as 11 might get the pills and might not understand the consequences. But the pediatricians have said they do not share that worry.

Arthur Caplan, head of the division of medical ethics at NYU Langone Medical Center and an NBC News contributor, calls it a "remarkable and innovative idea."

"Having emergency contraception readily available will surely lead to fewer young women getting pregnant and fewer abortions. The battle over abortion should not hinder making this sort of safe and reliable emergency pill easily available especially to those who may be coerced into sex, forget to take their birth control or have a partner whose birth control method fails," Caplan said. "Improvements in medicine are shifting the arena for discussing reproductive ethics from abortion clinics and surgical procedures to choices made by individual women talking to their doctor, nurse, pharmacist and others whom they trust. Those on all sides of contraceptive availability need to come to terms with this new moral reality."

The most common form of emergency contraception is a high dose of a regular birth control pill such as Plan B and Plan B One-Step from Teva Pharmaceutical Industries Ltd or Next Choice from Watson Pharmaceuticals Inc. They generally sell for $10 to $80 and are most effective in the first 24 hours.

All work by preventing ovulation, not by stopping the implantation of a fertilized egg. "These are not abortifacients," said Breuner.

A 2006-08 survey found that 14 percent of sexually experienced girls had used emergency contraception, up from 8 percent in a 2002 survey. The most common reason given was condom failure, but 13 percent of the girls said it was because of rape.

A 2010 analysis of seven randomized studies of emergency contraception found that teens who had a morning-after prescription in were not more likely to have sex or less likely to use contraceptives.

"It's just common sense that requiring a prescription is a barrier," said Bill Alpert, chief program officer of the National Campaign to Prevent Teen and Unplanned Pregnancy. "If an august and respected medical group like AAP is suggesting providing emergency contraception to minors is OK, that is a big deal."

That is especially so when teens face other obstacles to getting emergency contraception. For instance, a 2012 study that had 17-year-olds telephone pharmacies asking about morning-after pills found only 57 percent of them correctly told the caller that she could get the drugs without a prescription.

Also, some physicians refuse to provide the prescriptions to teenagers, while others do so only in cases of rape, AAP's research shows, suggesting that the refusal "may be related to the physician's beliefs about whether it is OK for teenagers to have sex."

There are no good data on how many physicians write prescriptions ahead of time for emergency contraception. "But we do know that pediatricians don't even talk about it, let alone offer advance prescriptions," said Breuner. "We tend not to like bringing up stuff that's controversial."

by on Nov. 27, 2012 at 7:45 AM
Replies (11-20):
tooptimistic
by Kelly on Nov. 27, 2012 at 2:13 PM
1 mom liked this

Talk openly and often, really listen, and be there for your daughter.  :)  Let her know she can talk to you about anything.  

Quoting jlo1313:

While I completely agree with this statement, how do you "prevent" it or convince a 16 year old that they are not emotionally ready for sex?

Quoting tooptimistic:

Isn't the plan B pill really expensive?  (I could be wrong)

If you are under 17 you really shouldn't be having sex.  You are just not emotionally ready.  If you are though, you really need to be on birth control.  If the bc fails, or something happens having access to plan B is a better idea than an unwanted pregnancy.



Its.me.Sam.
by Gold Member on Nov. 27, 2012 at 2:17 PM

yeah you cant 'prevent' it.  you just have to have open dialogue and honesty and availability.  and then you have to HOPE they really DO come to you BEFORE they start engaging in sexual activity.  but being open and honest and available doesnt guarantee that they WILL come to you.  if only it were that easy lol. 

Quoting tooptimistic:

Talk openly and often, really listen, and be there for your daughter.  :)  Let her know she can talk to you about anything.  

Quoting jlo1313:

While I completely agree with this statement, how do you "prevent" it or convince a 16 year old that they are not emotionally ready for sex?

Quoting tooptimistic:

Isn't the plan B pill really expensive?  (I could be wrong)

If you are under 17 you really shouldn't be having sex.  You are just not emotionally ready.  If you are though, you really need to be on birth control.  If the bc fails, or something happens having access to plan B is a better idea than an unwanted pregnancy.




tooptimistic
by Kelly on Nov. 27, 2012 at 2:59 PM
1 mom liked this

You are right.  :)

If the don't come to you before, hopefully they will soon after.  

I have an amazing relationship with my oldest (22) and we can talk about anything.  I try not over react, and to really listen.  I know it doesn't always work, but it a good foundation.  He was born a she.. and at first she thought she way gay.  She was able to tell me, and I was able to listen.  I tried to help her though her feelings and peoples reactions.  We talked alot.  Then she told me she was he.  It is amazing he felt safe enought to say something.. and I am glad I was able to listen.  Its hard for kids like him.    The sucide rate is high, because people don't listen and they don't feel safe.  :)  I am happy to listen, and happy he is talking.

I am thinking it is the same with straight kids..  :)

Its.me.Sam.:

yeah you cant 'prevent' it.  you just have to have open dialogue and honesty and availability.  and then you have to HOPE they really DO come to you BEFORE they start engaging in sexual activity.  but being open and honest and available doesnt guarantee that they WILL come to you.  if only it were that easy lol. 

Quoting tooptimistic:

Talk openly and often, really listen, and be there for your daughter.  :)  Let her know she can talk to you about anything.  

Quoting jlo1313:

While I completely agree with this statement, how do you "prevent" it or convince a 16 year old that they are not emotionally ready for sex?

Quoting tooptimistic:

Isn't the plan B pill really expensive?  (I could be wrong)

If you are under 17 you really shouldn't be having sex.  You are just not emotionally ready.  If you are though, you really need to be on birth control.  If the bc fails, or something happens having access to plan B is a better idea than an unwanted pregnancy.





cjsbmom
by Lois Lane on Nov. 27, 2012 at 2:59 PM
2 moms liked this

 I agree. I don't believe in taking care of oops accidents after the fact. If anything, I think it might encourage kids to be more irresponsible because they'd know they had an "out."

I think prevention is a much better means for dealing with teenage pregnancy rates. Make birth control and sex education more readily accessible. That's how you prevent teen pregnancy.

Quoting tooptimistic:

Isn't the plan B pill really expensive?  (I could be wrong)

If you are under 17 you really shouldn't be having sex.  You are just not emotionally ready.  If you are though, you really need to be on birth control.  If the bc fails, or something happens having access to plan B is a better idea than an unwanted pregnancy.

 

Numom61507
by Member on Nov. 27, 2012 at 3:06 PM
1 mom liked this

My pediatrician would NEVER agree to this.. Why not give potential murderers "just in case" body bags as well? You're only encouraging the behavior. I think it's a bad idea. 

Then again, in NYC you can get Plan B at school if you're over 14. Don't ask for a large soda though. THAT will negatively affect your health, you know. *eye roll*

Carmel63
by Bronze Member on Nov. 27, 2012 at 3:10 PM

I think it is a great idea, and plan to send my daughter off to college with a prescription.

lga1965
by on Nov. 27, 2012 at 5:48 PM

 

Quoting tooptimistic:

Isn't the plan B pill really expensive?  (I could be wrong)

If you are under 17 you really shouldn't be having sex.  You are just not emotionally ready.  If you are though, you really need to be on birth control.  If the bc fails, or something happens having access to plan B is a better idea than an unwanted pregnancy.

 I agree!!!  But , in case of emergencies, I'm in favor of Plan B. A teen should not be having sex , getting pregnant What a disaster.

You have brains in your head. You have feet in your shoes. You can steer yourself any direction you choose. You're on your own. And you know what you know. And YOU are the one who'll decide where to go...”
― Dr. Seuss, Oh, the Places You'll Go!
meriana
by Platinum Member on Nov. 27, 2012 at 7:07 PM

Rather than giving kids the idea that it's their body, therefore their choice what they do, giving them all the information about bc, where to get it, how to get it, whether or not they need parental consent, etc. etc. and kind of leaving it at that, the schools should also be spending some time on respecting their bodies, it's functions and on the value of self-control.

The focus in so many areas these days seems to be on freely expressing one's sexuality and the idea of self-control seems to have gone out the window.

kailu1835
by Ruby Member on Nov. 27, 2012 at 8:03 PM

And here we have medical professionals selling out to pharmaceutical companies.

stormcris
by Christy on Nov. 27, 2012 at 10:47 PM

I think it is a good idea. 

There are many young girls who are raped and never report it. Heck there are many grown women who act the same.

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