A reader writes:

I agree with the new AAP policy and think it makes sense. In a situation where a Plan B prescription would be needed it’s better to act quickly. And if a teenager isn’t comfortable talking about it with a parent, the window of opportunity where it will still be effective could pass before they build up the courage to discuss it.

I think there are two main reasons why some parents may object to the AAP’s new policy on emergency contraception:

  • Parents (most people, in fact) don’t want to be told what to do by anyone.  They (rightly) feel a responsibility to be in complete control of their childrens’ affairs — medical or otherwise.
  • What if Plan B becomes Plan A for some young people?

My response to the first point is that parents shouldn’t delude themselves:  No matter how much you think you know about your teenager, you don’t know everything.  And there are parents who really don’t take the effort to even try to get to know what their kids are up to.  You can’t control everything.  And your teenagers don’t want to be told what to do anyway– especially by you!

The second point will be exploited by those who don’t think teens (or anyone else for that matter) should have access to contraceptives at all.  Plan B is emergency contraception.    It’s for when Plan A is in danger of failing (a broken condom, a forgotten pill or two or more, a depleted intradermal product, a sexual assault) that brings Plan B into the picture.  It’s the last line of defense, not a first resort.  As our reader explains, time is of the essence.  Plan B doesn’t cancel the need to prevent HIV and other sexually transmitted infections by using condoms.  It doesn’t liberate parents and doctors from the responsibility of educating and protecting young people.

National Public Radio explores some of the problems with the over-the-counter availability of Plan B:

Since 2009, emergency contraceptives have been available under what’s known as a split label. That means those ages 16 and under need a prescription for the product, which is really just a high dose of regular birth control pills. It is not the same as the abortion pill, RU-486.

But the split label also means that even those old enough to buy the product without a prescription must ask a pharmacist for it — and show ID. Moore says that’s not the ideal situation for a product that works best when taken as soon as possible: Plan B is most effective if taken within 24 hours of unprotected intercourse.

“Having Plan B on the shelf between condoms and pregnancy test kits is where it belongs, not behind the counter,” she says.

Plus, when it’s behind the counter, it’s not just younger women who may have trouble getting it. Last year, Oklahoma law student Hilary McKinney went to a nearby Target with her fiance after his condom broke. She sent him to the pharmacy counter to pick it up. But the pharmacist wouldn’t sell it to him.

McKinney returned to the counter and confronted the pharmacist, she says, “and she looked at me and said, ‘I can’t sell it to men. Who knows what they could be doing with it?’ “

Listen to (or read) NPR’s report here.

AAP’s Policy Statement regarding emergency contraception here.

The PediaBlog has discussed Plan B here and here.