LOS ANGELES — Doctors should give underage teens prescriptions for emergency contraceptives such as Plan B before they start having sex instead of waiting until a young patient's “plan A” goes wrong, the American Academy of Pediatrics said in a new policy statement.
The academy said doctors also should counsel teens on the options for emergency birth control as part of a strategy to reduce teen pregnancy, which, although it's declined over the past 20 years, is still higher in the U.S. than anywhere else in the developed world, according to federal data.
The academy issued its new position paper online Monday.
From 1991 to 2010, the birthrate among Americans ages 15 to 19 dropped 44 percent. That put it at 34.3 births per 1,000 girls, according to the Centers for Disease Control and Prevention.
But that's still about five times France's teen birthrate and 2½ times Canada's, according to U.N. data.
It's also higher than the rates in China and Russia.
All in all, nearly 80 percent of teen pregnancies in the U.S. are unintended, occurring after unprotected sex or “underprotected” sex — when the contraceptive method of choice fails.
“That's tragic, really,” said Dr. Cora Breuner, a physician at Seattle Children's Hospital who helped write the new policy statement. “We really can do better. By providing more education and improving access to contraception and more education about family planning, we can do better.”
It's a pressing issue, Breuner added, because babies born to teens fare worse than their peers, on average. They are more likely to do poorly in school and suffer behavior problems such as truancy and early sexual activity.
Emergency contraceptives such as levonorgestrel, if taken within three to five days, can prevent pregnancy by stopping the ovary from releasing an egg or by stopping sperm from fertilizing an egg.
The drugs also may change the uterine lining, perhaps thwarting a fertilized egg from taking hold, according to the National Library of Medicine, though whether the drugs have this action is a subject of continuing debate.
The possibility draws opposition from those, such as the Roman Catholic Church, who believe a fertilized egg is a new life begun at conception.
Emergency contraception pills are most effective when they're used within the first 24 hours after unprotected sex, Breuner said, and teens are more likely to use them if they're readily available. That's why it's imperative to give teens prescriptions ahead of time, she said.
On the other hand, the drugs are not meant to be used to prevent pregnancy on a regular basis, another concern if their availability is widened. Sold under the brand names Plan B and Next Choice, levonorgestrel's potential side effects include nausea, vomiting, diarrhea and an untimely menstrual cycle.
Young women 17 or older already can buy emergency contraceptives over the counter, often for about $50, though the price varies. Younger teens need a prescription, and some pharmacies require parental consent, according to the Emergency Contraception Website, a joint project of the Association of Reproductive Health Professionals and Princeton University's Office of Population Research.
There are no state or federal requirements that parents of teens be notified when their children seek contraception, the website says.
Many pediatricians don't prescribe emergency contraceptives for patients ahead of time. That, said the policy paper, might be because of doctors' beliefs about whether it's appropriate for teens to be sexually active.