Jul 6 2005
In complete contrast to the abstinence-only approach to sex education favored by religious groups and President Bush, an eminent group of pediatricians is saying that what todays' teenagers need is better access to birth control and emergency contraception.
These recommendations are part of the American Academy of Pediatrics' updated teen pregnancy policy.
Dr. Jonathan Klein, chairman of the academy committee that wrote the new recommendations says that though there may great enthusiasm in some circles for abstinence-only interventions, the evidence does not support that as the best way to keep young people from unintended pregnancy.
Dr. S. Paige Hertweck, a pediatric obstetrician-gynecologist at the University of Louisville, who provided advice for the report, also says that teaching abstinence but not birth control makes it more likely that once teenagers initiate sexual activity they will have unsafe sex and contract sexually transmitted diseases.
The 1998 policy contains the statement that "abstinence counseling is an important role for all pediatricians", but the new policy says that while doctors should encourage adolescents to postpone sexual activity, they should also help ensure that all teens, and not just those who are sexually active, should have access to birth control, including emergency contraception.
Wade Horn, the assistant secretary for children and families at the U.S. Department of Health and Human Services, said counseling only abstinence, preferably until marriage, is the best approach because it sends a clear, consistent message.
He says teenagers who are sexually active should have access to contraception, but making birth control available to teens who are not sends a contradictory message.
Horn fears the academy's recommendations confuse prevention and intervention.
He also says advising pediatricians to ensure that teens have access to emergency contraception is problematic for doctors and parents who morally object to the pills.
He criticises the report for lacking guidance on what to do when pediatricians' moral views differ from their patients' parents.
The academy's report has up to date figures at hand to back it's case, and cites government data from 2003, which says that more than 45 percent of high school girls and 48 percent of boys have had sexual intercourse, and even though teenage pregnancy rates have decreased in recent years, about 900,000 U.S. teens still get pregnant each year.
The authors also note that U.S. teen birth rates are higher than in comparable industrialized countries, which may be partly due to greater access to contraception in those countries.
The Medical Institute for Sexual Health, a nonprofit group that has worked on pro-abstinence programs with the Bush administration and faith-based groups, opposes the academy's policy shift and according to group founder Dr. Joe McIlhaney Jr., an obstetrician-gynecologist, it is not a "smart move'.
But Karen Pearl, interim president of the Planned Parenthood Federation of America, applauds the academy for making medicine "trump ideology".
Emergency contraception, sometimes called the morning-after pill, blocks ovulation or fertilization and can prevent pregnancy for up to three days after sex.
Opponents consider it a form of abortion because it is thought to also help prevent fertilized eggs from implanting in the womb.
Some pharmacists have refused to sell it.
Apparently emergency contraception was not mentioned in the old report because it was new and relatively untested.
Klein says the academy supports making morning-after pills available without a prescription.
The report is published in the current edition of Pediatrics.
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