In 2011, the secretary of Health and Human Services, Kathleen Sebelius, overruled the Food and Drug Administration (FDA), which had decided, based on scientific evidence, that Plan B, or the morning after pill, would be safe and appropriate “for all females of child bearing potential.” Ms. Sebelius unilaterally decided that only women 17 years of age and older would have access to the drug without a prescription. Then, in April 2013, federal judge Edward Korman of the United States District Court of the Eastern District of New York, found “no coherent justification” for the prior mandate, and ordered the FDA to make Plan B available to all women without any age restrictions. Next, the FDA adopted a new position and set the age limit for non-prescription access to Plan B at 15 years. Finally, the Justice Department has appealed the federal court ruling that would make Plan B available to women of all ages.
Federal law has variations amongst the states, some of which have stipulations about treating minors with issues related to reproductive health. In New York State for instance (even as young as 12), if you are pregnant, you are considered an emancipated minor in regards to your pregnancy and thus all pregnancy related healthcare visits can be undertaken without parental consent and are confidential; the same rule applies to treatment regarding sexually transmitted diseases (STDs).
Now, whether you agree or disagree with the use of Plan B in and of itself, the product will remain completely legal and available to young girls (less than 15) with a doctor’s prescription. The only thing that is in debate is how young a girl must be in order to acquire it over-the-counter, just as easily as condoms, a soda, or a pack of M&Ms.
Let us take a step back and face the reality that adolescents are risk takers. They have adult sized hormones raging in a not-still-a-child but not-yet-adult body that can result in some very undesirable consequences. Case in point, this is why the number one killer of adolescents are accidents (unintentional injuries). Furthermore, more adolescents are having more sex than you may think—among U.S. high school students in 2011:[i]
• 47.4% had ever had sexual intercourse.
• 33.7% had had sex in the previous three months and of these 39.8% did not use a condom; 76.7% did not use birth control.
• 15.3% had sex with four or more people during their lifetime.
• Additionally, nearly half of the 19 million new cases of STDs each year are contracted by people aged 15-24 years.[ii]
• More than 400,000 teenage girls aged 15-19 years gave birth in 2009.[iii]
The figures above clearly detail that adolescents are having intercourse and some are having a lot of intercourse. The question then arises: Are adolescents adults, and are they capable of making adult decisions? If allowed to purchase over-the-counter Plan B, it would certainly seem so. Thus, using that train of logic, why not then allow all 15-year-olds to vote? Buy liquor? Enroll in the military? Drive with an unrestricted license? Work full-time without limitations? Pregnancy is certainly an adult responsibility, so should a minor be given the power to prevent that adult burden? Would the existence of a freely available “safety net” incentivize more risk-taking behavior?
Not only are adolescents taking adult-sized risks, but they are also taking these risks without the proper maturity to deal with the consequences of their actions. Being an adult is not a prerequisite for having sex; carrying and raising a child requires mature parent(s), and a well-developed sense of responsibility, not only to mention the appropriate social, economic and familial support mechanisms. Should we as a society cast judgment on those “irresponsible” young ladies who seek out Plan B or face the reality that a 15-year-old carrying and then raising a child may not be such a good idea? Is there any support for the argument that if a 15-year-old girl who seeks out the morning after pill is indeed being responsible by seeking out Plan B in the first place? Consider these facts:
• Children of teen parents are 50% more likely to repeat a grade and are less likely to graduate from high school than children of older parents.[iv]
• Children of teen mothers are more likely than those born to older mothers to experience adolescent childbearing, homelessness, juvenile delinquency, and incarceration.[v]
• Children of teen parents have more health problems than children born to older parents, and they receive only half the level of care and treatment.[vi]
• Children born to teen mothers are more likely to be abused, abandoned or neglected.[vii]
• Children born to unmarried, high school drop-out teen mothers are 10 times more likely to live in poverty than those born to married women over the age of 20.[viii]
If, as a society, we repeatedly witness adolescents taking the elevator up to the top of a building and then jumping off, we have a few options. We can ignore the “troubled” teens, fling our noses in the air and declare them all to be “heathens”, but that would not help or save all the potential jumpers. We can call an ambulance to take the injured away when they fall; we can install a net to catch them when they jump, or we can build a wall to prevent them from jumping in the first place. In this analogy, I equate the ambulance as abortion, the net as Plan B and the wall as contraception. But there is also a fifth option: not allowing the youngsters to take the elevator in the first place (abstinence), which is much easier said than done—this is exactly where good parenting, guidance counselors, and the appropriate social networks all come into play to prevent any adverse consequences from happening in the first place.
Dr. C.H.E. Sadaphal
[i] CDC. Youth Risk Behavior Surveillance: United States, 2011. MMWR 2012;61(SS-4).
[ii] Weinstock H, et al. STDs among American Youth: Incidence and Prevalence estimates, 2000. Perspectives on Sexual and Reproductive Health 2004; 36(1):6-10.
[iii] Hamilton, BE et al. Births: Preliminary Data for 2009. National Vital Statistics Reports 2010; 59(3).
[iv] National Campaign to Prevent Teen Pregnancy. What Docs Should Know About: The Impact of Teen Pregnancy on Young Children. Retrieved October 13, 2006, from http://www.teenpregnancy.org/resources/reading/pdf/tots.pdf
[v] Maynard, R.A., (Ed.). (1996). Kids Having Kids: A Robin Hood Foundation Special Report on the Costs of Adolescent Childbearing, New York: Robin Hood Foundation.
[vi] Maynard, R.A., (Ed.). (1996). Kids Having Kids: A Robin Hood Foundation Special Report on the Costs of Adolescent Childbearing, New York: Robin Hood Foundation.
[vii] George, R.M., & Lee, B.J. (1997). Abuse and Neglect of Children. In . In R.A. Maynard (Ed.), Kids Having Kids: Economic Costs and Social Consequences of Teen Pregnancy (pp. 205-230). Washington, DC: The Urban Institute Press.
[viii] Haveman, R.H., Wolfe, B., & Peterson, E. (1997). Children of Early Childbearers as Young Adults. In R.A. Maynard (Ed.), Kids Having Kids: Economic Costs and Social Consequences of Teen Pregnancy (pp. 257-284). Washington, DC: The Urban Institute Press.