Erica Ives, MFT, CEDS (Certified Eating Disorder Specialist) QUOTED:
Efforts to end teen pregnancy gaining
Written by Zack Burgess
Sunday, 02 December 2012 15:55
In September, the Department of Education started giving morning-after pills and other
birth-control drugs to students at 13 New York area high schools through a program
called CATCH — Connecting Adolescents To Comprehensive Health. Now it looks as if
the idea is becoming a national agenda.
Wading into the incendiary subject of birth control for young teenagers, the American
Academy of Pediatrics (AAP) last week called on the nation's pediatricians to counsel all
of their adolescent patients about emergency contraception and make advance
prescriptions for it available to girls under 17.
Because current federal policy bans over-the-counter sales of the pills to girls under 17,
having a prescription on hand could help younger teens obtain emergency contraception
more quickly than if they have to contact a physician only after they need it.
Considering that teenage pregnancy is a huge problem in African American and poorer
communities throughout the country, this is a very interesting measure.
“The morning after pill may continue to keep our teens from becoming more
knowledgeable and educated because it is a ‘quick fix,’” said Erica Ives, a licensed
marriage and family therapist. “They don’t have to think about the potential
consequences of their behavior — including how it may affect them two days after, six
months after or even years later.”
Ultimately, how will this affect teenage pregnancy? Equally important, how do African
Americans and communities across the country feel about such a momentous
Calling the AAP decision "significant," Susan Wood, former assistant commissioner for
women's health at the Food and Drug Administration (FDA), said, "it's not often you see
physician organizations saying that their patients are better off without the physician
Needless to say, the announcement has been controversial with some religious groups.
"Since when should the physicians take over the responsibility of what parents should be
doing?" asked Michael O'Dea, founder and executive director of Christus Medicus
The nonprofit foundation provides consulting services to health plans which wish to
avoid payments to physicians and hospitals for providing abortions, sterilization,
contraception and other services it considers inconsistent with biblical teachings.
"Parents are the primary educators of children, not physicians or the government," O'Dea
said. "This is a violation of parents’ rights to be the primary educator of their children."
The United States Conference of Catholic Bishops, which represents the country's
Catholic Church leadership, called the recommendation "tragic."
"It is a very sad day when physicians think that ‘good medicine’ is to attack an
adolescent girl's healthy fertility with potent drugs just to prevent a possible pregnancy,"
said Theresa Notare, assistant director for the Conference's Natural Family Planning
"This recommendation becomes tragic when we consider that the recommendation is
built upon overriding a parent's rights over their own children," she said.
Whether pediatricians heed the recommendation remains to be seen.
"Some pediatricians are already doing this," said Dr. Melissa Kottke, director of The Jane
Fonda Center for Adolescent Reproductive Health at Emory University and medical
director for the teen services program at Grady Memorial Hospital in Atlanta, where it is
common practice to provide Plan B, "a morning after pill,” in an advanced fashion.
"Pediatricians who primarily take care of adolescents may already be comfortable with it,
but what this recommendation does is provide encouragement and support for
pediatricians who take care of the full spectrum of pediatrics."
Dr. Cora Breuner, a pediatrician at Seattle Children's Hospital who led the AAP panel that
produced the recommendations, said pediatricians in general have preferred not to talk
about emergency contraception, let alone offer advance prescriptions.
"We tend not to like bringing up stuff that's controversial," she said.
Emergency contraception for adolescents has been one of the most politically fraught
areas in healthcare for almost a decade.
In 2005 the U.S. Food and Drug Administration declined to approve any over-thecounter sales of Plan B, overruling its panel of outside experts as well as its own
scientists. Last December the FDA reversed that stance and moved to approve over-thecounter sales with no age limits. But Health and Human Services (HHS) Secretary
Kathleen Sebelius overruled it, ordering that for girls under 17, the pills remain available
only by prescription.
"Emergency contraception is an important backup method for all teenagers," says a
policy statement issued by the American Academy of Pediatrics. "Advanced provision
increases the likelihood that teenagers will use emergency contraception when needed,
reduces the time to use and does not decrease condom or other contraceptive use."
Such medications as Plan B and Next Choice work best when taken soon after
“It’s unfortunate that in this country where we have all these contraceptive methods
available, unintended pregnancy is still a major public health problem,” said Dr. Kavita
Nanda, an OB/GYN and scientist with the North Carolina nonprofit FHI 360, formerly
known as Family Health International.
Last December, over the objections of its own Food and Drug Administration, the
Obama administration declined to fully overturn a Bush Administration policy from 2006
that limited access to the drugs without a prescription for those under age 18. (In 2009
the age was lowered to 17.)
“If the teenager is only thinking about pregnancy and is clearly aware that she has
immediate access to this form of contraception, the mindset is more likely to be…’why
should I use a condom or take the pill every day?” said Ives. “Sexually transmitted
diseases become secondary.”
Nationally, the teen birth rate fell somewhat less dramatically — 15.5 percent — from
1998 to 2009, according to the Centers for Disease Control and Prevention.
In 2009, around 410,000 teenage girls, ages 15 to 19, gave birth in the United States.
That's a 37 percent decrease from the teen birth rate in 1991. Then, 61.8 births per
every 1,000 females was a teen pregnancy. The rate has now dropped to 39.1 births per
1,000 women. Yet according to the United Nations, the rate of teen pregnancy in the
United States is nearly nine times higher than in the majority of other developed nations.
In a press release attached to the new Vital Signs report, Dr. Thomas R. Frieden, the
director of the CDC, wrote that despite the steady reduction in teen pregnancies over
the last two decades, "still far too many teens are having babies."
"Preventing teen pregnancy can protect the health and quality of life of teenagers, their
children, and their families throughout the United States."
The Vital Signs report looked at data from 1991 to 2009 and found that in addition to
the steady decrease in the rate of teen pregnancies, there's also been a decrease in the
percentage of high school students even having sex.
Still, roughly 1,100 teenagers give birth every day. According to the CDC, that means
one of every ten new mothers is a teenager. The CDC said that the majority of teenage
mothers are African-American and Hispanic; with respective birth rates nearly double
that of white teenagers. Combined, all teen pregnancies cost taxpayers about $9 billion
a year, while 70 percent of girls who get pregnant drop out of school.
“Many young females avoid taking birth control because of lack of education,” said Ives.
“Working with so many young women with poor body image, disordered eating, and
eating disorders. Many already have difficulty respecting and honoring their bodies. If an
individual views the morning after pill as similar to an abortion, the effects could be
devastating. Adolescent development, physical, emotional, and psychological, is difficult
enough to endure.”
The Chicago Tribune contributed to this report.
Zack Burgess is the Enterprise Writer for The Tribune. He is a freelance writer and Editor
who covers culture, politics and sports. He can be contacted at zackburgess.com and
followed on Twitter @zackburgess1.