Score one for Adolescents: Science Trumps Politics

We as a nation have a deeply conflicted relationship with sex, sexuality and our teenagers. We give our teens, especially the girls, mixed messages on every front. On the one hand we idolize nubile teenaged models in our magazines, dressed in provocative clothes, presented in inappropriately alluring postures. On the other, we continue to fund abstinence only programs and to restrict funding for programs that provide family planning services to teens. The Obama administration’s contradictory position on emergency contraception, against the backdrop of its stated goal of protection reproductive freedom for women, is a reflection of our societal ambivalence on this topic.
 
Last week the Obama administration decided not to appeal the decision to allow women and girls of all ages to purchase emergency contraception over the counter. It has been interesting, and not a little disappointing to watch this drama unfold in the political arena. President Obama first caved to political pressure on this issue in 2011, when he allowed his Secretary of Health and Human Services, Kathleen Sebalius, to over rule the FDA, for the first time in the history of the agency, on the issue of unrestricted access to emergency contraception. This in spite of overwhelming medical evidence that Plan B was safe and that availability did not increase risky behaviour among adult women or teens. It is worth noting that the American College of Obstetrics and Gynecology, the American Academy of Pediatrics, and the American Academy of Family Practice all support universal access to emergency contraception.

Nearly half of all pregnancies in the United States are unintended, and more than half of these occur in women not using any form of contraceptives or using their method incorrectly in the month that they conceived. Adolescents are generally less reliable than their adult counterparts in their consistent and reliable use of some form of contraception. The availability of emergency contraception as an over the counter product that can be obtained quickly and privately will give adolescent and adult women alike the opportunity to avoid unintended pregnancy in much greater numbers. Moreover, there is no evidence that making contraceptives or EC available to adolescents encourages them to engage in sexual activity. In fact, the increased availability of contraception is credited with much of the decline in teen pregnancies seen since 2008. The increased access to emergency contraception can only help to accelerate this trend.

Rather than bowing to political pressure, Judge Korman ruled in favor of science. In his original ruling he wrote that the “secretary’s [Sebalius] action was politically motivated, scientifically unjustified, and contrary to agency precedent”. The increased availability of emergency contraception to women and girls irrespective of age is victory for all of us. Bravo Judge Korman, and thank you.
 

References:

Belluck, Pam. Judge Strikes Down Age Limits on Morning-After Pill. New York Times, April 6, 2013.
Shear, Michael. Judge Refuses to Drop His Order Allowing Morning-After Pill for All Ages. New York Times, May 11, 2013.
Frost, JJ, Darroch JE, and Remez L, Improving Contraceptive Use in the United States, In Brief, Allan Guttmacher Institute, 2008, No. 1
On Emergency Contraception, the Administration Does a Disservice to Young Women – again. Media Center, Allan Guttmacher Institute, May 3 2013
Harper CC et al. The effect of increased access to emergency contraception among young adolescents, Obstetrics and gynecology, 2005, 106 (3) 483-491.