Should Teens Have Access To Contraceptives?

Sexual relations place teens at high risk of unplanned pregnancy, as well as HIV and other STDs. Many teens, however, particularly those who are not married and fall under the age group (15 to 24), lack access to contraceptive information and services. It is high time for parents to communicate with their daughters/sons and advice them on sex education otherwise it would lead them to unauthentic sources and false information that may endanger their lives.^[1]

It is stressful and awkward feeling when you will start a conversation with your teen about their changing body and sex, but it is essential to do so. As a parent, you’re in the right position to answer the questions that teens would rather prefer to talk to their friends. For the questions which are left unanswered about sex and birth control among teens, they rely on friends or go online which usually leads to misinformation. Starting talk and having good communication can prevent spreading of misinformation and would build a good bond with your child and they won’t hesitate to ask about it in future.^[2]

Having ‘The Talk’ would be uncomfortable and difficult and possibly embarrassing for both parents and teens, But it’s nowhere near as embarrassing as finding out your 12-year-daughter to be pregnant or that your 14-year-old son is going be a baby’s daddy. So its good to be alert and done away with all your embarrassment rather than finding your son/daughter at this place. Tell them the biological process that how every species feels it and why do we feel it.

Answer their question with valid facts and don’t ignore them believing that they are kids because they would be a kid to you at one point but now they are mature enough to have sexual relations and it’s your responsibility to guide and teach them.^[3]

Contraception is the process of intentional prevention of conception by the use of several devices, sexual practices, chemicals, drugs or surgical procedures. Contraception facilitates physical relationship without fear of unwanted pregnancy and ensures freedom to have a baby when desired children.

In countries like India, there is a significant need for contraceptive methods which are women-friendly, accessible and provide significant privacy. HCPs and Physician also need to be very sensitive to the special needs of teens as they are at the vulnerable segment.

• Protection against unwanted pregnancy
• Need for protection against STDs/STIs
• Vulnerability of Adolescents

Whether single or unmarried, married and adolescents or teens, everybody faces serious physical, psychological and social consequences from unprotected sexual activity, starting from early and unwanted pregnancy and STIs including HIV/AIDS, unsafe abortion to childbirth. The consequences are terrible and affect their entire lives, especially in the case of girls and women.^[4]

1. Abstinence: This is the only way to prevent unintended pregnancy 100% is to not have sex at all till you turn to adult.
2. Contraceptives or Birth Control Methods:

1. Birth Control Patch:

   These patches consist of a combination of the hormones like progesterone and estrogen that prevents ovulation. If an egg is not released, there’s nothing for a guy’s sperm to fertilize which required a girl to be pregnant. This patch should be used to any of these regions: the Upper outer arms, hips, the abdomen, or upper torso — except breasts. She can put those patch on the first day of her menstrual cycle or the first Sunday after her menstrual cycle starts.

2. Birth Control Pill:

   These pills come in either a 21-day pack or a 28-day pack. Each pill is taken every day at the same time for 21 days. Depending on your pack, you will stop taking birth control pills for 7 days (as in the 21-day pack) or you will continue taking the pill that contains no hormones for 7 days (the 28-day pack). A woman stops taking the pills that contain hormones on her periods.

3. Cervical Cap:

   The cervical cap prevents sperm from entering the uterus by covering the cervix. For more protection, spermicide can be applied on the cap before inserting the cap over the cervix.

   NOTE: The cervical cap is not recommended for young women and teens because It would be hard to insert correctly. Inserting and removing a cervical cap need a girl to reach into her vagina and to the cervix with her fingers.

4. Condom:

   • The male condom is placed on the penis when it erects. Condoms keep semen (the fluid that contains sperm) and prevent entering the vagina.
   • The female condom is inserted into the vagina. The one side of the ring creates the open end of the condom. The condom then lines the walls of the vagina, causing a barrier between the sperm and the cervix. The female condom should be inserted up to 8 hours before intercourse.

5. Diaphragm:

   Using the diaphragm may be a good option for a young woman and teens who takes responsibility for protection before having sex. The diaphragms can be placed in up to 2 hours before having sex and should be left in place at least 6 hours after sex. The diaphragm should not be placed in for more than 24 hours. More spermicide must be used each time before sex while wearing the diaphragm.

6. Emergency Contraception:

   ECPs are available to young and teens too who had unprotected sex. Emergency contraception can be an option for the couples too in these cases:

   • a condom breaks
   • A diaphragm or cervical cap moves out of place
   • Birth control pills are missed for 2 days
   • ECPs are pills that must be taken up to 120 hours (5 days) after unprotected sex or within 72 hours (3 days) after intercourse.

7. Implantable Contraception:

   Girls or women who want to have long-term protection against pregnancy may use implantable contraception. Implantable contraception does not protect against STDs. Couples must use condoms along with the implant to protect against unwanted pregnancy and STDs. Doctors put implants under the skin of a girl’s upper arm and this tube would release hormones to protect against pregnancy for up to 3 years.

8. Intrauterine Devices:

   IUDs are a good birth control option available for girls and women. An IUD can cost you from $0 to $1,300 depending on the type of IUDs.The IUD is effective as soon as it is put in and it lasts a long time. A copper IUD works for 10 years. Progestin IUDs work for 3 to 5 years that too depend on the brand.

9. Fertility Awareness:

   Here the trick is knowing your ovulation period when it happens. Fertility awareness is an unreliable way to prevent pregnancy Over the course of a year, 24 out of 100 couples who use fertility awareness end up having an accidental pregnancy

10. Spermicides:

    Spermicides are available without a prescription in supermarket and drugstores. They must be placed in the vagina 10 to 15 minutes prior to sex to give time to dissolve and spread. Read the instructions carefully given on leaflets. ^{[5] [6]}

The World Health Organization (WHO) reports 16 million adolescents with age group (15-19) give childbirth each year, specifically in low and middle-income countries. Many are desired while others are mistimed; 23 million adolescents should have access to use contraception but are not. Early, mistimed pregnancy results in high maternal mortality and morbidities. Social consequences limit the potential of young women and teens, as we live in a society where girls are to be faced and blamed for all the consequences. A “never before” opportunity to prioritize the contraceptive needs and rights of adolescents has emerged, and we need to act swiftly and decisively.

• Ambivalence about pregnancy
• The unexpected and unplanned nature of the sexual activity
• Fear of medical procedures and side effects
• Fear of judgemental attitudes of providers
• Fear of opposition from partner or parents
• Restrictive laws with poorly implemented policies
• Lack of knowledge about using Contraceptives methods
• Concerns regarding safety and side effects

Adolescents do not have proper knowledge from where to get contraception or may not afford services, but when there is an easy way to use, uptake may be restricted by the stigma around non-marital sexual activity, pressures to illustrate fertility and overall lack of assistance to make choices.

• The program must be conducted against the adolescent’s diversity
• To ensure adolescent access to all contraceptive methods
• To forgo separate services which are adolescents “youth-friendly”
• To partner with pharmacies and drug stores as sources and supply of contraception
• To support all Physician and health workers to provide youth-friendly care and services.

To further bend the curve, strict laws and adherence to policies must be enacted. It has been observed in places where adolescents having access to contraception, adequate information, and supported by the socio-cultural environment, exhibit low rates of unwanted pregnancy. Adolescents can and do make responsible decisions when they have access to tools and resources.^{[7] [8]}

• Contraceptive counselling has great potential as a strategy to guide teens intended for sexual relation but mistimed to unwanted pregnancy.
• It is a method of birth control that they can use correctly and consistently over time and prevent from STDs/STIs.
• It also highlights the potential value in decision-making approach to enhance the process of method selection, allow the correct use of an available method, and meet women’s overall reproductive health needs.^[9]

Parental contacts discourage teens from seeking contraception, even though they are sexually active. Confidentiality can be one of the factors for teens decision making whether or not to seek contraception.^[10]

Physicians should prescribe the contraceptives to the minor with all adequate information that is usually provided to adult and must be recorded in the medical record such as:

• A full case history must demonstrate that the physician has considered the “total situation” of the minor.
• A record should be maintained of the emergency” need. The physician must highlight if pregnancy would cause a serious health hazard.
• The minor must be aware of the problems and the consequences of the procedures recommended, including the side effects of contraceptive pills. She has to sign the consent form so, stating it important. ^[11]

About one-third of teen pill prescriptions are advised for non-contraceptive reasons which may be to ease pain or irregular periods, acne and other conditions.

In a study of young women, oral birth control use was associated to cause signs of depression in 16-19 year-olds than in their peers who didn’t take the pill. The relationship was not quite evident at ages 19- 25. ^[12]

1. CHOICE project

   When given with structured counselling that discusses the most effective methods provided with no cost, 71.5% of adolescents in the CHOICE cohort preferred a LARC method.

2. Education for Adolescent Pregnancy Prevention

   Adolescents who participate in sexuality education programs delay sex initiation and have increased the use and access to condom and contraceptive.^[13]

Times have changed and nowadays young people are more exposed to a whole lot of things, which is a fact we all know. Every parent wished to have their child to refrain till they are fully grown up but this is no longer the case now, we need to equip them with all means that work, to ensure a safe future.

Society is evolving, parents should raise children with moral value but not at the cost of fighting to one problem and opening doors to another one, let’s fix societal issues but do not neglect our moral values. ^[14]

Teens should have access to all the contraceptives methods like adults. Placing barriers on teen access to contraceptive result in a harmful effect on the health and welfare of young women because it increases the risk of unintended pregnancies. The society has to pay the enormous cost to teen pregnancy.

Teens should have a constitutional right to privacy and confidentiality that support their decision to get contraception, a right that society should acknowledge. There are a lot of people having opposite ideas and views regarding access of contraceptives to teens, but at this point in time, it could be one of the best solutions to combat teen unwanted pregnancies and STDs.

References:

Also Read:

• How Do Oral Contraceptives Work & How Safe and Effective is it?
• What Are Emergency Contraceptives, Know its Types, Effectiveness, and Misconceptions