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AAP: Give guidance on emergency contraception


Pediatricians should counsel teenagers about emergency contraception before they need it and issue advance prescriptions for contraceptive medications as part of routine care, says a policy statement from the American Academy of Pediatrics (AAP) directed at reducing the rate of unintended pregnancies among adolescents.

The policy statement calls for routine anticipatory guidance on emergency contraception for adolescent girls and boys and for families of disabled teenagers in the context of sexual behavior, safety, and family planning, whether the visits occur in the office, clinic, emergency department, or hospital. Advanced prescribing for emergency contraceptive medications should be part of this guidance.

Emergency contraception reduces the risk of pregnancy if used up to 120 hours after unprotected sexual intercourse. In most states, adolescents aged younger than 17 years need a prescription to access emergency contraception. Studies have shown that teenagers are more likely to use emergency contraception if they know about it and have a prescription for it in advance of consensual or forced intercourse or contraceptive failure.

Pediatricians should advise their teenaged patients that emergency contraception does not replace long-term contraceptive methods for the prevention of pregnancy. Also, it does not protect against sexually transmitted infections, so patients should contact their physicians to schedule follow-up testing or treatment.

The policy statement acknowledges that many practicing pediatricians and pediatric residents are not counseling adolescents about emergency contraception and have not prescribed it in advance of need, perhaps because of their personal values or the belief that improved access to emergency contraception increases risky behavior.

The AAP reminds pediatricians that it is their duty to inform patients about treatment options, even if they personally object, or to refer patients to other physicians who will provide the services.

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