published Tuesday, May 7th, 2013

Opening 'morning-after pill' access to girls as young as 15 sparks debate

Pharmacist Simon Gorelikov holds a generic emergency contraceptive at the Health First Pharmacy in Boston. New rules permitting 15-year-olds to get the morning-after pill without a prescription are being debated by teens as well as adults, with some saying it will help kids who can't confide in an adult, while others say the lower age infringes on a parent's right to know what's going on.
Pharmacist Simon Gorelikov holds a generic emergency contraceptive at the Health First Pharmacy in Boston. New rules permitting 15-year-olds to get the morning-after pill without a prescription are being debated by teens as well as adults, with some saying it will help kids who can't confide in an adult, while others say the lower age infringes on a parent's right to know what's going on.
Photo by Associated Press /Chattanooga Times Free Press.
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MORNING-AFTER PILL CONTROVERSY

The Food and Drug Administration's decision in 2011 not to make Plan B One-Step available to girls younger than 17 was hotly criticized as a political move in the presidential campaign season.

In April, a federal judge ordered the FDA to label the drug as available to all girls and women of reproductive ages by May 6. The drug is produced by Teva Women's Health Inc. The FDA says its recent decision to make Plan B One-Step more widely available is separate from the April order.

It is unclear how the FDA's decision will affect the Justice Department's decision to appeal the judge's ruling by the Monday deadline.

While it is often confused with the "abortion pill," the FDA and other researchers have long insisted the morning-after pill will not end an existing pregnancy or harm a developing fetus. It can prevent ovulation or fertilization of an egg if taken soon after sex.

Still, some critics maintain that using the pill is a gray moral area if it prevents a fertilized egg from attaching to the uterus.

Sources: The Associated Press, U.S. Food and Drug Administration

The "morning-after pill" may be only 1.5 mg, but for both sides of the debate surrounding it, the tablet carries a lot of weight.

Advocates of making the pill more accessible to younger teens say the emergency contraceptive is crucial to lowering the rate of unwanted pregnancies.

But some local critics and concerned pharmacists say the pill's power can encourage choices that young teens aren't ready to handle.

On Tuesday, regulators with the U.S. Food and Drug Administration lowered the age limit for people buying Plan B One-Step emergency contraception and its generic counterparts from 17 to 15.

The FDA also decided to make the contraceptive available on store shelves alongside condoms and other widely used family planning products, instead of behind pharmacy counters.

The decision has been cheered by those who have long argued that the pill is safe for any female of a reproductive age to use. Some of those advocates say imposing any age limit is too restrictive.

But others are concerned that making Plan B One-Step more widely available encourages teens to become sexually active at younger and younger ages.

"What is the message we are sending our kids?" said Julie Baumgardner, president and CEO of Chattanooga-based family-advocacy organization First Things First. "I have a hard time seeing how this is in the best interest of our children. They may be teenagers, but they are still in their formative years. Why are we putting big, life-changing, adult decisions in the hands of children?"

Some local pharmacists echo the concern, saying they are reluctant to change how they distribute the pill.

Roy Phipps, a pharmacist at Kingwood Pharmacy in East Ridge, said the store stocks Plan B One-Step, but he does not plan to move it out from behind the counter any time soon.

"To me, it's not something just anybody and everybody should have access to," he said. "It is a contraceptive pill."

He said the store has been following the debate closely, saying "it concerns us, and it concerns our patrons."

Some local pharmacies don't carry the contraceptive. An employee at Belvoir Pharmacy in Chattanooga said the store has never carried the pills, but didn't say why. At Signal Mountain Pharmacy, owner Rick Gallaher says there just isn't a market for it among the age group of his clientele.

"It's not strictly a moral issue -- I've just never had demand for it," he said. "I can see both sides of the dilemma, though."

National retailers have not been precise about their plans or timelines for bringing Plan B One-Step out from behind pharmacy counters, saying they are waiting on the drug manufacturer to make changes to packaging.

Walgreens released a statement last week about the contraceptive, saying, "We are working with the manufacturer of Plan B on packaging and other issues related to the FDA's new guidance."

Target also said it was awaiting cues from government regulators and the drug company.

"We'll align our practices to ensure we're compliant with federal and state laws and regulations," said Target spokeswoman Jessica Deede. "However, I don't have anything to share about specific plans."


Tennessee is among 15 states with the highest teen birth rates, according to the National Center for Health Statistics. The teen birth rate in 2010 was 43.2 births per 1,000 teen girls. The highest rate was in Mississippi, with 55 births per 1,000 teen girls. Georgia's rate was 41.4, data show.

A 2011 Youth Risk Behavior Survey found the majority of Hamilton County high schoolers are sexually experienced, with nearly half of the students having had sexual intercourse.

That survey also found that 53 percent of female high school students in the county have had a sexual experience.

That's why Bea Lurie, president and CEO of Girls Inc. of Chattanooga., says "it's important to educate girls on effective methods of disease prevention and contraception so that if they do engage in sexual activity, they can protect themselves from pregnancy and disease."

Still, Girls Inc. -- which offers education and enrichment programs for girls between 6 and 19 -- has not taken a position on emergency contraception, Lurie said.

"Parents are the first and most important educators of their daughters," Lurie said in an email. "We believe that girls have the right to comprehensive, age appropriate resources and information and know that if we equip them with the facts and knowledge, they will make healthy choices in line with their personal and career goals."

Both Girls Inc. and First Things First say they encourage young people to choose abstinence as the best means for developing healthy relationships and achieving long-term goals. And both say parents need to be proactive about providing their children with clear, accurate information about sex.

Girls Inc.'s sex education curriculum, Preventing Adolescent Pregnancy, not only focuses on reproductive anatomy, but also addresses factors like media and peer pressure, self-esteem issues, personal values and boundaries, and assertiveness -- all which have bearing on girls' views of sex, Lurie said.

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