Friday, 27 April 2012

Contraceptive Pill for young teens – sometimes rules need to be broken

A recent NHS report has suggested that the contraceptive pill should be available at pharmacies, without prescription and to girls under 16.

This has unsurprisingly triggered wide debate, spanning religious, moral, social and medical views. The age of consent in the UK is 16, so to promote contraception to under 16’s is seen by some as condoning illegal acts. Let’s get real here – it’s 2012, the ‘permissive society’ is now ‘society’. Behaviours, attitudes and social stigma have changed radically over the past few decades. Unpalatable as it may seem to some, teenage sex is now a genie long ago released from the bottle.

I find this quite a difficult debate to comment on as my maternal instinct is screaming ‘no’! But the healthcare commentator and pragmatist within takes a wider perspective. A straw poll in the office produced diametrically opposing different views. Interestingly, but again, not surprisingly, the mothers of young children were horrified that the NHS seems to condone under-age sex, removing a GP’s influence, and most importantly the exclusion of a parent’s involvement in contraceptive decisions for their teenage daughters. But we mustn’t forget that so many of these young girls at risk of early pregnancy are sadly lacking positive role models in their home.

On the pro side, avoidance of unplanned pregnancies in young girls is a worthy goal.  The teenage pregnancy rate in England is one of the highest in the Western World and 50% of conceptions in the under 18’s in England since 2009 have led to abortions. If this trauma and personal dilemma can be reduced, surely this must be a good thing? Another pro is access. If a 13 year old is intent on having sex, there won’t be much that will stop her.  So if she can easily and confidentially obtain contraception from her local pharmacy rather than jumping through hoops to get an appointment with her GP, surely this must also be a good thing? Pharmacists are highly trained, extremely knowledgeable healthcare experts and will seriously take the responsibility of ensuring that young patients understand the implications of their decisions.  To encourage youngsters to take a proactive approach to contraception is a vital aim.

On the other hand, the contraceptive pill is a powerful medication with potentially serious side effects (but less serious than the risks associated with pregnancy) so pharmacists must be diligent in ensuring that the pill recipients fully understand the side effects to look out for. Sadly the ‘safe sex’ message has been widely ignored, hence the high teenage pregnancy rate, so I suspect that offering the pill to youngsters won’t increase their risk of sexually transmitted disease significantly.

And here’s the point. This increased access should not be introduced in isolation of a targeted, continuous educational programme.  This approach should help to reduce to unplanned pregnancies and subsequent chaotic socio-economic, emotional and personal fall-out. On-going educational programmes are already aiming to teach the benefits of waiting before coming sexually active at such a young age. STD’s, unplanned pregnancy and abortion should be seen not as an occupational hazard, but a horror to be avoided if at all possible. By giving the youngsters the information to make informed choices and easy access to contraception, then we are doing our very best to get this right.

Some rules really are made to be broken.


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