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Emergency Contraception, Teens, and Politics

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The United States has more unintended pregnancies than any other developed country in the world.  About one in three adolescents become sexually active by 15.  Teen pregnancies are difficult for the families involved and have widespread societal ramifications as well.  Education is key.  I have no problem with encouraging abstinence as well;  I certainly do not want to think of my 11-and 15-year-old daughters becoming sexually active anytime soon.  But we also must face the reality that many adolescents will become sexually active and at risk for pregnancy.

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Emergency contraception is effective and should be available to all women who need of contraception after sexual contact that puts them at risk for an undesired pregnancy.  This is all the more important for teens who often do not have the resources to cope with the consequences.

The most common emergency contraception is levonorgestrel, a progestin type of hormone.  It can be effective for up to five days after sexual intercourse.  It is not an abortifacient–meaning it does not cause miscarriage–and it is safe.

The American Association of Pediatricians and the American Congress of Obstetricians and Gynecologists advise that emergency contraception be made available to all women.

So, why is it that emergency contraception can be purchased without a prescription by women older than 17 but not by younger adolescents?   “A strong showing of bad faith and improper political influence” was the assessment of Judge Edward Korman of the District Court of Eastern New York.  Earlier this month, the court overturned the Obama administration’s ban against women under 17 purchasing over-the-counter emergency contraception without a prescription and directed the FDA to lift it within 30 days.  You can read more about it in the New York Times, or read the decision here.

I have always been an advocate for providing emergency contraception to women of all ages, especially before they need it, because the need for it is unpredictable.  Boulder Gynecology freely provides prescriptions for emergency contraception at well women or other unrelated visits.  Having it in a safe place accessible on a weekend (when most doctors’ offices are closed) makes it more likely to be used.

I would encourage sexually active women involved in heterosexual relations to become familiar with a useful  website about emergency contraception: http://ec.princeton.edu.  This not only gives accurate information about the drug but also informs women where they can access it in their area.  Cost can be another obstacle; the brand names available at pharmacies are quite expensive, often with a price of $60 to $80.  Nonprofit women’s health centers can often provide the generic at low cost.

For more information about emergency contraception see the American Association of Pediatrics policy statement.

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About the Author:

Dr. Lepine earned her medical degree from the University of California at San Diego and completed her residency at the same institution in 1994. After residency, she pursued her interests in public health and international medicine through a fellowship in the Epidemic Intelligence Service at the Centers for Disease Control and Prevention. Education and advocacy for women, particularly the under-served, has always been at the heart of her work. She has participated in both public health and clinical work in the developing world, including Rwanda, Kenya, Mexico, Bangladesh, Honduras, and Nicaragua.

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