Should young teens get advance prescriptions for Plan B?

Last year over 300,000 U.S. teenage girls gave birth a decrease over previous years, but still a rate higher than any other developed country. Now the American Academy of Pediatrics says pediatricians should routinely give teen girls prescriptions for emergency contraception, commonly known as the morning after pill, such as Teva Pharmaceutical s Plan B One-Step.

This pill can reduce the risk of pregnancy after unprotected sex (or if a condom breaks), and is more effective the shorter the interval between sex and its ingestion. It works best within 48 hours but can help up to five days later. It s available without a prescription to females 17 and over but younger girls need a prescription to get it. Health and Human Services Secretary Kathleen Sebelius, under pressure by the Obama Administration, overruled the Food and Drug Administration s move to make it over-the-counter for all in December 2011.

The pediatricians statement says that advance prescribing has been shown to increase the use of emergency contraception and also decrease time to use. Yet, studies have failed to show that it increases teens sexual activity or decreases ongoing use of contraception. The group advises that all adolescents, male and female, get counseling on emergency contraception and the availability of advance prescriptions in the context of a discussion on sexual safety and family planning regardless of current intentions for sexual behavior. ¦ Pediatricians should provide prescriptions/supply for teenagers to have on hand in case of future need.

I don t know about this, says ACSH s Dr. Gilbert Ross. This is sort of a case where the evidence and science clearly say one thing and my heart says another. While public health would benefit from having access to emergency contraception close at hand, routinely giving a prescription to all young patients just rubs me the wrong way.

ACSH s Dr. Ruth Kava says this is a complex issue, and wonders why the pediatricians would want to give prescriptions to all teen-aged girls, rather than just those who are sexually active, perhaps as part of a broader discussion of healthy sexual beliefs and habits.

So we again ask our readers what do you think about this? Please tell us by emailing morning@acsh.org, or leaving a comment on our blog.

We heard from some of you after yesterday s related post about allowing the contraceptive pill to be sold over-the-counter, as the College of Obstetricians and Gynecologists recently recommended. Former ACSH staffer Kathleen Meister says, This gets a little complicated because many women count on their health insurance to cover the cost of birth control pills, and health insurance rarely covers over-the-counter drugs. Of course, getting birth control pills would be less expensive if a woman didn't need a doctor's appointment to get them. But the cost of the pills alone might be prohibitive for some women.

Denis Green adds that in the UK, doctors are able to prescribe the pill to girls as young as 12, if they are sexually active.