Emergency Contraception and Teens
Supporting the Used of Emergency Contraception without a Prescription:
Advocating for Access to Women 16 and Under
Adriana Puga
Collaborative Health and Human Services 302, Section 01
Professor Natasha Oelhman
October 31, 2011
i
Emergency Contraception and Teens
ii
Table of Contents
Table of Contents ...................................................................................................... ii
What is Emergency Contraception?...........................................................................3
Why U.S Food and Drug Administration Deny the Access to Emergency
Contraceptives to Women 16 and Under ...................................................................3
Emergency Contraception Can Help Reduce Teen Pregnancy Rates and Abortions4
Education and Awareness on Emergency Contraceptives.........................................5
Conclusion .................................................................................................................7
References ..................................................................................................................8
Appendix ....................................................................................................................9
Emergency Contraception and Teens
3
What is Emergency Contraception?
Emergency contraception is a method used by women to prevent pregnancies, after they
had unprotected sex or after their birth control method failed. This contraceptive is also known as
the morning after pill. Emergency Contraceptives (EC) prevent or delay the release of an egg
from a woman's ovaries. This method prevents pregnancy in the same way as regular birth
control pills. Also, it is possible that emergency contraceptives to prevent a woman's egg from
joining with a man's sperm (fertilization), and make it hard for the fertilized egg to implant
correctly in the womb. This birth control method can be used to prevent pregnancy up to five
days (120 hours) after unprotected sex (Vorvick. 2011). But it is more effective when it is taken
in the first 72 hours after unprotected sex (Planned Parenthood, 2011). Many people confound
this contraceptive with the abortions pill but it is not an abortion pill. If pregnancy already exists,
this pill does not affect pregnancy and does not harm the fetus (The Emergency contraceptive
website, 2011).
There are different types of Emergency Contraceptives (See Appendix for list of different
emergency contraceptive pills), but the most common and available without a prescription for
women17 and older are Plan-B and Next Choice (generic version). According to Vorvick (2011),
Plan B One-Step is a “single tablet that contains 1.5 mg of levonorgestrel. Next Choice is taken
as two doses, which each contain 0.75 mg of levonorgestrel. . Both pills can be taken at the same
time or as two separate doses 12 hours apart.” Some of the side effects are nausea, stomach pain,
tiredness, headache, dizziness, breast tenderness, vomiting, diarrhea, or menstrual changes such
as spotting or bleeding prior to a period. The next period could be heavier or lighter, or earlier or
later. If the period is more than a week late, women should get a pregnancy test since this
contraceptive is only about 90% sure that will prevent pregnancy if it is used correctly. Both of
these medications have the same side effects in woman from all ages.
In August 2006 the U.S Food and Drug Administration approved selling emergency
contraceptives without a prescription to women 18 years old and older. In April 2009 the Food
and Drug Administration approved that women 17 years old and older can have access to
emergency contraceptives without a prescription but they should provide a government issued
identification to proof their age. The U.S Food and Drug Administration should allow women of
the age 16 and younger to buy Emergency Contraceptives without a prescription to prevent
unwanted pregnancies and abortions.
Why U.S Food and Drug Administration Deny the Access to Emergency
Contraceptives to Women 16 and Under
Unfortunately the FDA does not provide a specific reason why women 16 years old and
younger do not have access to EC without a prescription. This agency provides contradictory
reasons; they provide scientific information that shows that it is safe and effective in women
younger than 17 years old. Studies show that the use of Emergency Contraceptives among
women 16 and under is safe and effective it will not have major side effects, and it has the same
effects as other older women (Harper, Cheong, Rocca, Darney, & Raine, 2005). This is one of
Emergency Contraception and Teens
4
the studies that showed that it is safe for women from all ages to use emergency contraceptives
when they need it. Additionally, other studies show that “young teenagers understood the
instructions as well as did older women. Although the numbers of young adolescents in these
studies were admittedly small; no important differences in comprehension emerged” (Grimes,
2004). Young women are able to understand how to use EC as older women who have access to
this contraception. Yet this agency says that “pharmacists would be unable to enforce the
prescription requirement” (United States District Court Eastern District of New York, 2009).
This justification is not enough for individuals and organization that advocates for more access to
EC among teens. They want a more convincing justification that convince them why women
younger than 17 should not be allowed to buy EC without a prescription.
In the other hand, many people and organization advocating for access to EC believe that
the decision was taken by a political issue and not as a public health issue. According to Grimes
(2004); In January 2004, 49 Republicans in the U.S. House of Representatives wrote to the
President Bush opposing to the access to EC without a prescription because they believe that this
contraceptive method will increase sexual practices among teens. Even though studies have
showed that this contraceptive does not increase promiscuity, many people think that it will be
increase if EC are available without a prescription to teens. The FDA’s own advisory panel, a
group of scientists and medical professionals, voted 23-4 in favor of switching emergency
contraception to non-prescription status without age restrictions, but their advice, and the advice
of the FDA professional staff was ignored by FDA political leadership (More & Wood, 2010).
More and Wood in their article showed that professionals agree that there is no need of
prescription and age restriction for EC but it seems that their opinions and studies were ignore
and the decision of this restriction was take more on political views.
Other barrier that women younger than 17 faces is that most of them do not have a health
insurance and they cannot afford to pay doctor’s visit since many of them depend on their
parents. Also, many clinics that provide EC may not receive teens in their office because they
need to be accompanied by one of their parents, and most of them do not want their parents to
know that they have started to be sexually active. For these reasons teens “may avoid seeking
health care because of a perceived lack of confidentiality” (Waller & Bryson, 2007). This can
limit the access to EC since there is a window of only 72 hours to take EC for more
effectiveness.
Emergency Contraception Can Help Reduce Teen Pregnancy Rates and
Abortions
Emergency Contraceptives should be available without a prescription to women younger
than 17; considering that the United States faces higher teen pregnancies and abortions than other
developed countries. Approximately our country is “nine times higher than in the majority of
other developed nations” (Hagan, 2011). According to the Guttmacher Institute (2011), there is
about 750,000 teen pregnancies that occur each year, 82% of this pregnancies are unintended.
This statistics show that many teens get pregnant every year and most of them did not plan to be
pregnant. Many of these teen mothers have to face many negative consequences such as social,
economic, psychological, and physical consequences. According to World Population Awareness
Emergency Contraception and Teens
5
(2011), “[ teen girls] who bear children early are often robbed of an education, their ability to be
gainfully employed, and they often become dependent on men who not necessarily good
husbands or good fathers, or they live as single mothers with their children.” Young women who
have children tend to have lower education, most of them cannot find a good job where they can
get enough money to support their children; and many girls end up marring men who are not
responsible enough to take care of the children and the mother or many have to race their
children by their own because the father do not want to take any responsibility with the children
and the mothers.
Additionally, there are about Eighteen percent of U.S. women obtaining abortions are
teenagers; those aged 15–17 obtain 6% of all abortions, teens aged 18–19 obtain 11%, and teens
younger than age 15 obtain 0.4%. (Guttmacher Institute, 2011). The Guttmacher Institute shows
that there is a high percentage of teen women who opt to have an abortion. The reason for this
decision could be because many of them are not ready to become a parent or they know that they
are not going to have the enough money to raise children by their own or with their partner.
Abortion can cause serious health problems to the teen women and in some cases it could cause
the death of the teen if the abortion is not practice correctly. Some of the risks that teen women
have are “infertility, ectopic pregnancy, spontaneous abortion (miscarriage) or birth defect, and
little or no risk of preterm or low-birth-weight deliveries”( Guttmacher Institute, 2011). Teens
who decided to have an abortion may face health problem in the future.
If women younger than 17 are able to have access to emergency contraceptives without a
prescription many of them will not face pregnancy because this contraceptive helps to prevent a
woman's egg from joining with a man's sperm and make it hard for the fertilized egg to implant
correctly in the womb. If there are not pregnancies there will not be abortions, this means that if
teen pregnancy rates are reduce automatically abortions will be reduce. Probably, emergency
contraceptives will not end with teen pregnancies but they will be reduced. This type of
contraceptive can help save the lives of many teen women since many of them will have the
opportunity to have a better education, a better job, and a better life since they will not have to
worry about taking care of a baby. Additionally, this will prevent that many women to practice
abortion and will help them to reduce the risks they have after having an abortion.
Education and Awareness on Emergency Contraceptives
Emergency Contraception should be accessible to women 16 years old and younger to
prevent pregnancies and abortion among this population. All adolescents need to know that there
is another birth control method that they can use after they had unprotected sex. In high schools
and junior highs students are always educated in how to prevent a pregnancy before they start
having sex, they are recommended to use birth control methods such as condoms, birth control
pills and other variety of birth control methods that can prevent pregnancy. Unfortunately, they
are not thought that there is another birth control method that they can use after they had
unprotected sex. All adolescents should be educated in the how to use EC appropriately since
there is a limited time for this contraceptive to be effective. They are not educated about this
method because they do not have easy access to EC. In the figure below (Figure 1) shows that
there is a low percentage (28%) of women who know that Emergency Contraceptives are
available in our country. Also, this figure shows that women have little knowledge of how
Emergency Contraception and Teens
6
emegerngy contraceptives work, how they need to be taken correctly, and how effective they are.
This graph shows that there should be more awareness of emergency contraceptives because
many women have little knowledge of it, how they work and how they can be use.
Note, The data on women who had heard ofEmergency Contraception is adapted from “Survey
of Americans on Emergency Contraception” by Kaiser Family Foundation, 1997, Most
Americans under 45 years old today have heard of emergency contraceptive pills, and awareness
has increased slightly in recent years. Very few women, however, have used this option, retrieve
from http://www.kff.org/womenshealth/1352-contraception_2.cfm?RenderForPrint=1
Fortunately there are clinics that provide emergency contraceptives to teens. One of the
clinics that provide this type of contraceptives to teens is Planned Parenthood; they provided this
to lower cost or not cost for some adolescents. Planned Parenthood provides confidentiality to all
the patients regardless of their age. So teens that need this type of contraceptives can go to one of
these clinics and can obtain it without letting their parents or other people know that they got it
or any other type of contraception. These clinics are available in the entire country. They have
very accessible schedules so teen women can go to visit one of these clinics. Planned Parenthood
provides affordable sexual and reproductive health care for millions of women, men, and teens.
Emergency Contraception and Teens
7
Unfortunately many teens do not know that they have access to emergency contraceptives
in the Planned Parenthood clinics because many of them think that this contraceptive is available
only for women 17 and older. We need to create more awareness to let all teens that they have
another option to prevent a pregnancy in case they have had unprotected sex.
Conclusion
Emergency Contraception is a birth control used by women to prevent pregnancy after
they had unprotected sex or after their birth control method failed. There are two common brands
of emergency contraceptives available without a prescription for women 17 years old and older.
They are Plan-B and Next Choice which is the generic version of Plan-B.
This contraception is not available to women 16 years old and younger. Many studies
have shown that this medication is safe and effective in young women. FDA decided to put
restriction on emergency contraceptives because many believe that teens will not understand how
to use this contraception and that the availability of this medication will increase promiscuity
among adolescents. The restrictions should be made base on scientific research and not in what
people believe. If more teens have access to emergency contraceptives the teen pregnancy rates
and abortions will be reduce since the United States face a high rate of teen pregnancies and
abortions more than other developed countries. If there is not pregnancy there will not be
abortion.
If teen pregnancy rates and abortions want to reduce there should be more awareness of
emergency contraceptives because there is little knowledge of this contraceptive among younger
women. They need to be more educated about this contraception because it is very important to
let them know that they have another option of birth control if they had unprotected sex. It is
important because many pregnancies will be prevented and adolescents will have the opportunity
to have a better life without worrying about how they are going to support a child when they do
not have the necessary economic, mental, and physical support to raise a child. Emergency
Contraception should be available to women 16 years old and under because it will help to
reduce teen pregnancies and abortions among this population.
Emergency Contraception and Teens
8
References
Grime, D. (2004). Emergency Contraception: Politics Trumps Science at the U.S. Food and Drug
Administration. 104, 2,doi:10.1097/01.AOG.0000135804.89369.59
Guttamacher Institute. (2011). Facts on American teens’ sources of information about sex. Sex,
pregnancy and abortion. Retrieved from http://www.guttmacher.org/pubs/FB-Teen-SexEd.html
Guttmacher Institute. (2011). Facts in induce abortion in the United States: Incidence of
abortion. Retrieved from http://www.guttmacher.org/pubs/fb_induced_abortion.html
Harper, C; Cheong, M; Rocca, C; Darney, P; Raine, & Tina R. (2005). Obstetris and
gynecologist: Original research [Abstract]. The effect of increased access to emergency
contraception among young adolescents, 106, 483-491. doi:
10.1097/01.AOG.0000174000.37962.a1
Moore, K., & Wood, S. (2010). America's women: still waiting for the president to restore
science to Its rightful place. Retrieved from
http://www.rhrealitycheck.org/blog/2010/03/23/americas-women-still-waiting-presidentrestore-science-rightful-place
Planned Parenthood. (2011). New 3Rs. Teen pregnancy: We can do better. Retrieved from
http://www.plannedparenthood.org/mbpp/new-3rs2886.htm?__utma=1.834408172.1316244335.1316494852.1316623730.3&__utmb=1.6.1
0.1316623730&__utmc=1&__utmx=&__utmz=1.1316623730.3.3.utmcsr=nytimes.com|utmccn=(referral)|utmcmd=referral|ut
mcct=/2010/01/27/us/27teen.html&__utmv=-&__utmk=65758254
United States District Court Eastern District of New York. ( 2009). Annie Tummino against
Frank M. Torti, active comissiones of the Food and Drug Administration. Retrieved from
http://ec.princeton.edu/pills/PlanBDecision.pdf
Vorvick, L. (2011). Emergency contraception overview. Retrieved from
http://www.umm.edu/ency/article/007014.htm
Waller, L., & Bryson, W. (2007). Can emergency contraception help to reduce teen pregnancy?.
Access to Emergency Contraception. Retrieved from http://www.jaapa.com/canemergency-contraception-help-to-reduce-teen-pregnancy/article/136968/2/
Worl Population Awarenes, ( September 28, 2011). Teen Pregnancy. Retreieved from
http://www.overpopulation.org/teenpreg.html
Emergency Contraception and Teens
Appendix
Emergency Contraception in United States of America
Dedicated Products / Anti-Progestin
Take 1 pill within 120 hours after unprotected sex:
ella
Dedicated Products / Progestin Only
Take 1 pill within 120 hours after unprotected sex:
Plan B One-Step (available from a pharmacist without a prescription)
Take 2 pills within 120 hours after unprotected sex:
Next Choice (available from a pharmacist without a prescription)
Plan B (available from a pharmacist without a prescription)
Oral Contraceptives used for EC / Progestin-Estrogen Combined
Note: in 28-day packs, only the first 21 pills can be used
Take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later:
Ogestrel
Take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later:
Cryselle
Enpresse
Jolessa
Levora
Lo/Ovral
Low-Ogestrel
Nordette
Portia
Quasense
Seasonale
Seasonique
Trivora
Take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later:
9
Emergency Contraception and Teens
Aviane
Lessina
LoSeasonique
Lutera
Sronyx
Take 6 pills within 120 hours after unprotected sex and take 6 more pills 12 hours later:
Lybrel
10