While abstinence is a reliable way to prevent pregnancy and STDs, the reality is that many young people are sexually active. Sporadic or irregular sexual encounters, social mores that discourage young women in particular from "planning" to have sex, problems accessing family planning methods and services, and sexual coercion, all make it difficult for adolescents to commit to an ongoing method of contraception. For these young people, EC offers a valuable second chance to avoid an unplanned pregnancy.

Yet, from Africa to Latin America, from Europe to the United States, adolescent access to EC often emerges as an issue of heated debate. In the media and in policy arenas, questions arise specifically about youth and EC: Will the availability of EC reduce young people's perceptions of risk, leading to increased sexual activity? Could the availability of EC make it harder for girls to "say no"? Can adolescent women correctly understand product labeling for an over-the-counter EC product?

Fortunately, there is ample evidence that improving access to EC does not lead to increased sexual risk-taking behavior, increases in rates of sexually transmitted infection, or reductions in the use of on-going contraception. ICEC is creating an Annotated Bibliography summarizing the studies examining the impact of EC access on sexual behavior and ongoing contraceptive use. (Coming soon). Moreover, EC is safe for young people, 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.

Response

Reaching adolescents with emergency contraceptive information and services poses special challenges to programs. Young women may find it difficult to access relevant information about or services for emergency contraception because they:

• Are unaware of the availability of ECPs;
• Lack confidence or are embarrassed to visit a family planning clinic or pharmacy;
• Do not know of the existence of the clinic or pharmacy;
• Find the clinic hours inconvenient;
• Fear a pelvic examination; or
• Are anxious about judgmental attitudes of the providers and pharmacies.

Programs should work to ensure that clinics serving adolescents are youth-friendly (for example, by ensuring privacy and confidentiality, accessible facilities, reasonably priced services, and flexible hours particularly during evenings and weekends).

Strategies for expanding access to EC for adolescents include:

• Expand awareness of EC through media campaigns and other marketing and information strategies (hotlines, websites, advertising in youth-oriented publications or at events attended by adolescents, encouraging health care providers to talk to their clients about EC).
• Facilitate access to EC through pharmacy distribution and social marketing.
• Support legislation in favor of EC gaining over the counter (OTC) status to reduce health system barriers.
• Make EC available to victims of sexual assault through emergency rooms and police stations.
• Enact policies that recognize adolescents' right to access and use EC.

Additional Resources

ICEC member agency Family Health International has produced an excellent publication: Adolescents and Emergency Contraceptive Pills in Developing Countries. Download it here. PATH, an ICEC member, has created a Youth Friendly Pharmacy Implementation Kit, available in English and Spanish. CLAE, an ICEC Regional Consortia member, has created a fact sheet about Access to EC for Latin American Youth in Spanish. IPPF/WHR and ICEC are currently collaborating on an English translation.

EC Access as a Young Woman's Right

Young women, like all women, have a right to access a full range of safe family planning methods. The International Council on Population and Development has defined the rights of and responsibilities towards adolescents and sexual health, focusing on education and services for young women to help them prevent unwanted pregnancy and sexually transmitted diseases.

Information and services should be made available to adolescents to help them understand their sexuality and protect themselves from unwanted pregnancies, sexually transmitted diseases, and subsequent risk of infertility. This should be combined with the education of young men to respect women's self-determination and to share responsibility with women in matters of sexuality and reproduction. (International Council on Population and Development [ICPD] Programme of Action, 7.41, 1994)

Click here for text on internationally negotiated language, including ICPD, concerning adolescents and sexual health.

ICEC member organizations work internationally to increase support towards adolescent education on emergency contraception and access to this valuable family planning method. The following websites provide valuable information about issues concerning adolescent EC access.

Adolescencia de Reprolatina (Brazil)
Advocates for Youth (US, ICEC Member)
Anticoncepcione de Emergencia (ICMER, Chile)
Like it Is (Marie Stopes, UK and Australia)
Red Latinoamericana y Caribeña de Jóvenes por los Derechos Sexuales y Reproductivos (Latin America)

Visit our EC Links listing for more sites covering Emergency Contraception.