Emergency contraception is an important option for young women. For many adolescent girls, protection against pregnancy can be a matter of life and death, as complications from adolescent pregnancy and childbirth are a leading cause of death among adolescent girls ages 15-19 in low- and middle-income countries.
While abstinence is a reliable way to prevent pregnancy and STIs, the majority of people become sexually active as adolescents. Unfortunately, young women often lack information about and access to ongoing family planning methods and services, face social mores that discourage them from “planning” to have sex, and experience difficulty negotiating contraceptive use. These factors make EC a particularly critical option for young women by offering them a valuable second chance to avoid an unplanned pregnancy.
Moreover, many early sexual encounters are nonconsensual: Up to one-fifth of women in developing countries report that their first sexual encounter was coerced or forced, and occurred before the age of 15. Early marriage also contributes to premature sexual experiences. One in three adolescent girls in developing countries (excluding China) is married before age 18. Among married adolescents who do not want a pregnancy, many do not use any contraceptive method.
Combating Myths About Adolescents and EC
Adolescent access to EC is an issue of heated debate in almost every region of the world, founded largely on myths about EC’s safety, suitability for young women, and effects on behavior.
Some people who oppose young women’s access to EC say that it reduces adolescents’ perceptions of risk, leading to increased risk for STIs and pregnancy. However, ample evidence shows that improving access to EC does not lead to increases in STIs or unintended pregnancies. Studies have also shown that adolescents are more likely to start using a regular method of contraception after EC use.
Other arguments used against providing EC access to young people claim that it is unsafe for adolescents or that adolescents cannot understand EC product labeling. Evidence does not support these assertions. EC has been found to be safe for young women, with no contraindications and minimal side effects. Professional groups such as the American Academy of Pediatrics, Society for Adolescent Medicine, and the World Health Organization support access to EC for all women, including young women. Finally, research also shows that teenagers understand EC product labels just as well as adults and can correctly assess whether to take EC and how to take it correctly. (Click for more information on EC safety and non-prescription access to EC.)
Responding to Young People’s Need for EC
Young women may find it difficult to access relevant information about or services for emergency contraception for many reasons: they may be unaware of the existence of ECPs; be unable to purchase ECPs over-the-counter and required to first obtain a prescription from a doctor; lack confidence or be embarrassed to go at a family planning clinic or pharmacy; have concerns about lack of privacy and confidentiality; find clinic hours inconvenient or locations inaccessible; lack the funds needed; be anxious about judgmental attitudes of the providers and pharmacies; or believe incorrectly that ECPs may cause an abortion.
Clinics, pharmacies, and other providers serving adolescents should work to ensure that their facilities and services are youth-friendly. They can do so by offering privacy and confidentiality, accessible locations, reasonably priced services, and flexible hours, particularly during evenings and weekends.
Other strategies for expanding access to EC for adolescents include:
- Advancing legislation to make EC available over-the-counter (OTC) for people of all ages.
- Ensuring that is EC available at no cost to victims of sexual assault in emergency rooms and police stations.
- Launching media campaigns and other marketing strategies to increase public awareness (examples include websites, social networking, text messaging services, hotlines, advertising in youth-oriented publications, and publicity at events attended by adolescents).
For additional information, see the following resources and websites:
- FHI360’s publication, Adolescents and Emergency Contraceptive Pills in Developing Countries
- PATH’s Youth Friendly Pharmacy Implementation Kit, available in English and Español
- The Latin American Consortium for EC’s fact sheet about Access to EC for Latin American Youth (in Español)
- ECafrique’s report on EC and Young People (in English and Français)
- Adolescencia de Reprolatina (Brazil)
- Advocates for Youth (United States)
- Anticoncepcione de Emergencia / Instituto Chileno de Medicina Reproductiva (Chile)
- Marie Stopes International’s Like it Is (UK and Australia)