1 in 5 Pharmacies Hinders Teens’ Access to ‘Morning-After’ Pill: Study

MONDAY, March 26 (HealthDay News) — Nearly one in five U.S.
pharmacies gave out misinformation to researchers posing as 17-year-old
girls seeking emergency contraception, often saying that it was
“impossible” for girls to get the pill, a new study finds.

About 3 percent of researchers posing as physicians also received wrong
information about the availability of emergency contraception, also known
as the “morning-after” pill.

The findings show that 17-year-olds in need of emergency contraception
to prevent unintended pregnancy face significant barriers in accessing it,
the study authors said. According to U.S. federal regulations, girls 17
and older can buy emergency contraception without a prescription if they
show proof of age, while girls 16 and younger need a doctor’s
prescription.

“What we found was that emergency contraception was pretty available,
in that 80 percent had it on the shelf that day,” said lead study author
Dr. Tracey Wilkinson, a general pediatrics fellow at Boston University
School of Medicine and Boston Medical Center. “However, when teenagers
asked if they could get the medicine, they were [sometimes] told they
couldn’t get it at all, not with a prescription, not over-the-counter,
just simply based on their age.”

The study, published online March 26, appears in the April print issue
of Pediatrics.

In the study, researchers called all the commercial pharmacies in five
major U.S. cities: Austin, Texas; Cleveland; Nashville, Tenn.;
Philadelphia; and Portland, Ore. Each of the 943 pharmacies got called
twice, once by a “17-year-old girl” and once by a “physician.” Researchers
spoke to pharmacists, pharmacy technicians or unidentified pharmacy
staff.

Four in five callers were told the pharmacy had emergency contraception
in stock. However, 19 percent of 17-year-old callers were told that they
could not obtain emergency contraception under any circumstances, while 3
percent of physicians were told their 17-year-old patient could not obtain
it.

“Not just the callers posing as 17-year-olds, but the physicians were
given wrong information by the pharmacy workers about over-the-counter
access to emergency contraception,” said Dr. Deborah Nucatola, an ob-gyn
and senior director of medical services for Planned Parenthood Federation
of America. “This kind of misinformation can result in preventable,
unintended pregnancy.”

About 85 percent of the roughly 750,000 teenage pregnancies in the
United States each year are unintentional, the researchers noted.

Slightly more than half of workers in pharmacies that didn’t have
emergency contraception on hand said they could order the medication, but
about one-third offered no additional information about how girls or
doctors could get it. Also, the teen callers were put on hold more often
than doctors and talked less often to pharmacists, the study found.

Researchers do not know if any pharmacy workers intentionally misled
the girls, or if they simply don’t know the law.

In 2011, the Center for Drug Evaluation and Research of the U.S. Food
and Drug Administration (FDA) recommended that younger teens be permitted
to obtain emergency contraception without a prescription, but that was
overruled by the U.S. Secretary of Health and Human Services.

Emergency contraception is a high dose of progestin that prevents
pregnancy by delaying ovulation (when the egg leaves the ovary and travels
into the fallopian tube where it’s available for fertilization by sperm).
Some research suggests emergency contraception may make it more difficult
for sperm to get past the cervix and into the uterus, and may make the
uterus less hospitable to sperm.

Although the drug can be taken up to five days after unprotected sex,
it becomes less effective the longer women wait. For every 12-hour delay
in taking the first dose, the odds of pregnancy increase by 50 percent,
according to background information in the study.

Emergency contraception is not an “abortive” drug, Wilkinson said. It
does not affect an existing pregnancy or slow the transport of a
fertilized egg from the fallopian tubes into the uterus, she said.

The average cost for emergency contraception was $45, ranging from $15
to $70.

Wilkinson added that emergency contraception should not be confused
with RU-486 (mifepristone), which is used to terminate early pregnancies
and is given by physicians under supervision.

To clear up the confusion, Wilkinson urged more education of pharmacy
staff and said pediatricians and other health care workers must make sure
that adolescents know their rights.

“Clinicians might help prepare their patients for this by writing a
prescription as a backup to make sure they can access it when they need
it,” she said.

More information

Princeton University has more on emergency contraception.

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