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Pediatrics group says morning-after pills should be prescribed in advance to teen girls

The morning-after pill should be prescribed in advance to teens just in case they one day need it, says the country's leading medical society of pediatricians.

The American Academy of Pediatrics said Monday that emergency contraceptives like Plan B and Next Choice can be used to curb a U.S. teen pregnancy rate which, while declining over the past two decades, still surpasses that of other developed countries.

"Adolescents are more likely to use emergency contraception if it has been prescribed in advance of need," the academy's Committee on Adolescence wrote in the statement, which was published online Nov. 26 in Pediatrics and will also be in the December print issue. "Pediatricians have an important role, through their interactions with adolescents, to address the major public health objective of continuing to reduce adolescent pregnancy in the United States."

Emergency contraceptives are indicated for use following sexual assaults, unprotected intercourse, condom breakage or slippage, or missed doses of hormonal contraceptives such as the pill, patch and ring.

In all U.S. states, females 17 and older and males 18 and older can obtain emergency contraception without prescription from a doctor or pharmacist, while those under 17 need a script.

The statement's authors note that about 34 out of every 1,000 15 to 19-year-olds give birth and nearly 80 percent of pregnancies in adolescents are unintended. While both hormonal birth control pills and condoms are very effective at reducing pregnancy chances, both methods require strict adherence or else they aren't effective, the committee notes. Missing birth control is a situation where emergency contraceptives could help reduce unwanted pregnancy, according to the committee.

The morning-after pill is most effective if used in the first 24 hours but can be taken up to 120 hours after unprotected intercourse.

"Studies have shown that adolescents are more likely to use emergency contraception if it has been prescribed in advance of need," wrote the committee. "However, a majority of practicing pediatricians and pediatric residents do not routinely counsel patients about emergency contraception and have not prescribed."

Increased access to contraceptives was a major reason the American College of Obstetricians and Gynecologists (ACOG) announced last Tuesday it wants birth control pills to be sold over-the-counter. The group argued that practical limitations of taking the pill every day could be curbed by making the pill more readily available. That could also reduce health risks to both mom and newborns and cut health care tax dollar burden, the group said.

In its new statement on morning-after contraceptives, the pediatrics academy said it aims to educate doctors about available emergency contraceptives, and to encourage routine counseling and advance prescriptions of emergency contraceptives as a public health strategy to reduce unwanted pregnancies.

The statement also encourages pediatricians to push for better insurance coverage and increased access to emergency contraception for teens regardless of age.

Though this may create an ethical dilemma for some physicians and pharmacists, the academy said pediatricians have a duty to inform their patients about relevant treatment options and have a "moral obligation" to refer patients to other doctors who will provide and educate about those services.

Steven Mosher, president of the anti-abortion rights organization the Population Research Institute, of Front Royal, Va., told WebMD the new policy from the academy "is a violation of parents' rights and is also not in the best interest of the teenagers themselves."

Last December, the U.S. Food and Drug Administration was preparing to lift an age limit on Plan B One-Step emergency contraceptives which would have made the pills available over-the-counter. However Health and Human Services Secretary Kathleen Sebelius stepped in and blocked the move, because girls as young as 11 are physically capable of having kids, and data did not sufficiently show girls that young could properly understand how to use the product with adult guidance.

Dr. Robert Block, president of the American Academy of Pediatrics, said at the time, "The decision to continue restricting access to this safe and effective product is medically inexplicable."

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