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The American Academy of Pediatrics (AAP) on Monday recommended that doctors talk to their adolescent patients about emergency contraception and offer advance prescriptions of Plan B, also known as the morning-after pill, to girls younger than 17.
"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," reads the group's new policy statement, which will be published in the December issue of the journal "Pediatrics." "Adolescents are more likely to use emergency contraception if it has been prescribed in advance of need."
Susan Wood, the former assistant commissioner for women's health at the Food and Drug Administration, called the AAP decision "significant."
Read on to find out more about this pressing topic.
"It's not often you see physician organizations saying that their patients are better off without the physician involvement," she pointed out.
As a woman, this totally makes sense to me: A 2010 analysis of data from seven different studies found that having a prescription for emergency contraception did not increase teenagers' sexual activity or decrease their use of regular contraceptives. And if schools are avoiding real sex education, and states are determined to drive Planned Parenthood out of business, charging doctors with the task of educating and protecting their patients may be the best way to reduce teen pregnancy rates. Plan B — which scientists say does not prevent implantation or cause an abortion — works best if it's taken within 24 hours of unprotected sex, though it can be effective as long as 120 hours after. It's easier to get to a pharmacy to fill a prescription that you already have than it is to tell your parents that you need to make a last-minute appointment with your doctor — let alone why.
As a parent of teenage daughters, though, I'm having a tough time with the idea.
"In an ideal world, we don't want to have these conversations with our daughters-in an ideal world we don't even want to think about them having sex," writes Dr. Claire McCarthy, a pediatrician based in Boston. "All of us parents want to think that this happens to other people's kids, not ours. Other people's kids have sex, other people's kids don't use contraception. Ours are smarter and more, um, moral than that."
But the reality is that about half of kids age 15 to 19 say that they've had sex at least once. While the AAP acknowledges that abstinence and "effective contraceptive use" are the best ways for teenagers to avoid pregnancy, the group also points out that teens often use contraceptives incorrectly. Kids who have taken abstinence-only pledges are just as likely as non-pledgers to have sex — and they're less likely to use contraception when they do. And about 10 percent of all sexually active teens say that they were sexually assaulted.
It's that 10 percent that tips the scales for me. It's easy to give the "Sex Has Consequences" lecture, and I can tell my kids, "If you're not comfortable discussing contraception, then you're not ready to have sex" until I'm blue in the face, but I know what it's like to have someone force their way into my body — and I can't imagine making it more difficult for a teenager in that situation to get help.
Parents, what do you think? Should pediatricians give kids prescriptions for emergency contraception before they need it?
— Lylah M. Alphonse
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