Plan-B OK for Teens?

[john5746]

The Problem

 

Plan B Over the Counter

 

This is a tough one for me. I fall on the side of allowing younger girls access to the drug. If they are old enough and unsupervised enough to get pregnant, then they should be allowed to take Plan-B unsupervised.

[Pangloss]

I'm not sure if the general public fully understands that Plan B is not the same drug as RU486. Folks here in ScienceForums may understand it, but I think there's a definite perception problem out in the general public that Plan B (which is actually a massive dose of hormones, if I remember correctly) is an abortion drug. I know there are some moral arguments related to the area of whether it constitutes an abortion if conception takes place but the embryo is prevented from attaching to the wall, but I think the distinction between this drug and RU486 is clear, the drug is (otherwise) safe, and that makes approving it a reasonable compromise.

 

I think we have to consider that ANY decision on this drug would have represented SOME kind of compromise. Women with low incomes and those living in rural areas face serious issues when dealing with laws that were set by people living far away and under very different circumstances. (And shall we review the awful statistics on adoption, folks?)

 

This is almost another subject, but I've been vacillating recently on abortion as birth control. I used to believe that the best compromise on the issue was to allow abortion, but only in cases of abuse or rape or other major complicating factors. And I'd be willing to bet that if you poll most Americans on the question "should abortion be used as a form of casual birth control", they would answer "no" in overwhelming numbers.

 

But in fact abortion has been used as casual birth control. Not as casual as taking birth control pills, but evangelization from the left has done its best to make sure that "women's health services" makes it as easy as humanly possible to get an abortion. As a result, millions of unwanted babies, babies that could not possibly have been adopted, were not born.

 

Now, is it possible that "the next Einstein" was in that batch? Sure, but that's the problem with statistics -- they don't work so well after the fact. He or she could just as easily be born tomorrow -- you don't know different. And in the meantime, there appear to have been multiple positive impacts on society by avoiding those unwanted births.

 

Don't get me wrong, I don't believe that this is the best resolution to the abortion issue. It would be far more progressive for us to cultivate a society in which people really do "plan parenthood" -- thoughtfully and intelligently. There may always be unwanted babies in this world, but wouldn't it be preferable if the number of those babies was less than or equal to the number of people who are willing and able to adopt them? That would be the best ultimate resolution of the abortion issue, in my view.

[Mokele]

Pangloss: I think the basic theme boils down to both side would prefer less/no abortions, but for different reasons. I certainly agree that a state where most pregnancies only happen when they're wanted would be vastly preferrable.

 

I disagree about the "casual birth control" part: abortion is highly invasive proceedure which is not exactly a fun time for all involved, and carries all the usual risks of any such invasive procedure (bad reactions to anaesthetic drugs, complications, infection, etc). Compound upon this that the individual must sort out the social crap going along with it, and it can hardly be regarded as casual. It's essentially a last resort, and we've all heard what happens when that last resort is eliminated, so I won't even go there.

 

I am optimistic, however, about some recent advanced in male birth control, specifically a plug inserted into the vas deferens that prevents any sperm from escaping, but is also removable; in effect, it's a totally reversible vasectomy. IIRC, it can also be done without incisions, on a totally outpatient basis. Given that guys can get quite paranoid about knocking up their partner, I suspect such a method would be widely used. Last I heard, it was in clinical trials.

 

Mokele

[mooeypoo]

I think the biggest problem with the "morning after pill" is that women -- specifically teens, whose notion of responsibility is bellow what we would hope to have with parents -- often take the notion as an insurance.

 

"I can get laid without worrying. Worse case, I take the morning-after pill."

 

In Israel, for instance, the Morning-After pill is indeed supervised - prescription only - that causes women to be more consciensious to their actions, knowing that it's not this little happy pill that fixes everything.

 

On top of that, the pill is not 100% sure, and not 100% safe, and from what I understood, it can also not work if a woman has already used one in the past (not sure, this is what a doctor in the sex-ed told us in highschool

 

So I think that the notion (even psychologically) that something like this is not too easy to get (like just buying it in a drugstore the next morning) will avoid throwing responsibility, and get women to think better about what they're doing (and men too, mind you..).

This pill should be given in cases of emergencies - true "slipups" - not be open to the public to be used as a replacement to birth control.

 

That's my 2 cents on this but then.. we don't have NEARLY as many teen pregnancies in Israel (I don't even think we have .5% of what america has), so I am not quite familiar with it being such a massive problem.

 

 

~moo

[Pangloss]

I disagree about the "casual birth control" part: abortion is highly invasive proceedure which is not exactly a fun time for all involved' date=' and carries all the usual risks of any such invasive procedure (bad reactions to anaesthetic drugs, complications, infection, etc). Compound upon this that the individual must sort out the social crap going along with it, and it can hardly be regarded as casual. [/quote']

 

Like I said, it's not as casual as the pill, but you have to bear in mind that most of what you're talking about is unknown to a first-timer. If they haven't thought about sex enough to take preventive measures, then it's unlikely they understand what kind of drama they're in for when they decide, after the fact, that they need an abortion.

 

In fact, so familiar is this scenario that it's a perfect example of what Peter Wollen (in "Signs and Meaning in the Cinema") called an "Index" scene. The young, nervous girl standing in front of a building with a "Women's Health Services" sign on it is comparable to the familiar shot of a woman lying in bed in the background with a male hand in the foreground leaving cash on the nightstand, or the close-up of the gunfighters' faces as they stare each other down.

 

So really those points are kinda irrelevent -- they may prevent a RETURN visit (by at least convincing the person to get the pill), but they aren't going to stop that initial instance.

[Pangloss]

There's something that I don't understand about this, so maybe someone can clarify it for me. They say that this pill is something like 65% effective. Um... how do they know? Is that some sort of laboratory test, or does it mean that 35% of the women who took it in a clinical test got pregnant anyway? Because you may not get pregnant even if you DON'T take this pill, so how do they know that that 35% is strictly failure on the pill's part, rather than a simple biological "miss"?

[Mokele]

I think the biggest problem with the "morning after pill" is that women -- specifically teens, whose notion of responsibility is bellow what we would hope to have with parents -- often take the notion as an insurance.

 

So? Everyone knows it's not perfect, and even if it was, so what?

 

Attempting to control people's level of sexual behavior by controling their access to contraceptives is every bit as ethical and effective as encouraging people to learn how to swim by banning life-boats, life-vests and other such floatation devices.

 

Like I said, it's not as casual as the pill, but you have to bear in mind that most of what you're talking about is unknown to a first-timer. If they haven't thought about sex enough to take preventive measures, then it's unlikely they understand what kind of drama they're in for when they decide, after the fact, that they need an abortion.

 

Um, an abortion, like any other medical procedure, requires informed consent. That means the doctor has to sit down and tell the prospective patient *exactly* what will be done, the risks involved, potential pain, everything. Nobody has an abortion without being fully breifed on precisely what happens during the procedure and all of the potential medical consequences.

 

Also, how do you know they haven't thought enough about sex to take preventative measures? Condoms break, St. John's wort (a common herbal remedy) can interfere with birth control pills, and sperm are tough little bastards who can survive a lot (there have been reports of pregnancy from non-vaginal sex due to a small amount of semen accidentally getting in or on the female sexual organs).

 

They say that this pill is something like 65% effective. Um... how do they know? Is that some sort of laboratory test, or does it mean that 35% of the women who took it in a clinical test got pregnant anyway? Because you may not get pregnant even if you DON'T take this pill, so how do they know that that 35% is strictly failure on the pill's part, rather than a simple biological "miss"?

 

Well, we know that, unprotected, sex will result in pregnancy X% of the time. If sex follower by the pill resulted in less pregnancies, Y%, and this difference is statistically significant, we can say that the pill reduced pregnancy by (Y-X)/X %. To pull numbers out of my ass, if the base rate is 60%, and a contraception method reduces it to 10%, then the sucess rate of the method is 83%. At least, that's how I suspect they figure it.

 

Mokele

[Pangloss]

That would make sense, thanks. That sure makes that an iffy number, though.

[john5746]

Well' date=' we know that, unprotected, sex will result in pregnancy X% of the time. If sex follower by the pill resulted in less pregnancies, Y%, and this difference is statistically significant, we can say that the pill reduced pregnancy by (Y-X)/X %. To pull numbers out of my ass, if the base rate is 60%, and a contraception method reduces it to 10%, then the sucess rate of the method is 83%. At least, that's how I suspect they figure it.

 

Mokele[/quote']

 

Pearl Index

 

Yeah, I think it is probably something like the Index above. Essentially what Mokele was saying, with the menstrual cycles and other factors taken into account.

 

As Pangloss said, iffy numbers. If repeated enough, should be reliable though.

[Mokele]

If repeated enough, should be reliable though.

 

Hence the large sample sizes of most medical studies. Makes me damn glad I can do direct experiments, thus getting by with smaller samples and less data.

 

Mokele

[Sisyphus]

That's my 2 cents on this but then.. we don't have NEARLY as many teen pregnancies in Israel (I don't even think we have .5% of what america has)' date=' so I am not quite familiar with it being such a massive problem.

 

[/quote']

 

Really?! That's an interesting discussion in itself: why is the level of teen pregnancy in the United States so high compared with other industrialized nations? My guess would be that it's chiefly related to poor education (specifically abstinence "education"), but that big of a discrepancy has got to have other big factors as well.

 

Also, my OT $0.02: I don't see the "too casual" issue as too much of a problem. As others have said, its much more troublesome and less effective than birth control pills, so why would anyone use it unless there was a legitimate "accident?" The other possibility is they weren't responsible enough to use birth control at all, in which case they probably shouldn't be having children... anyway, it's better than having to get an abortion, right?

[swansont]

I think the biggest problem with the "morning after pill" is that women -- specifically teens' date=' whose notion of responsibility is bellow what we would hope to have with parents -- often take the notion as an insurance.

[/quote']

 

That's often put forth as an argument, but from what I've seen, it's pure conjecture. There's no actual evidence presented, and in fact studies have found no correlation between promiscuity and access to contraception.

[Mokele]

Not to mention that it simply treats promiscuity as some sort of universally bad thing, which is nothing but imposing a particular morality on everyone. So what if it increases promiscuity? IMHO, that's a good thing.

 

Mokele

[Pangloss]

That's often put forth as an argument, but from what I've seen, it's pure conjecture. There's no actual evidence presented, and in fact studies have found no correlation between promiscuity and access to contraception.

 

For what it's worth, there is a reported study being touted about that allegedly suggests a correlation along the lines of what Mooey is saying. If I remember correctly, it just shows no drop in teen pregnancy in Europe since the introduction of Plan B (which could mean anything). I have yet to see a source on this study, it's just being quoted by all the conservative pundits on the talk shows.

 

Even if it's true, it's a pretty heavily a pretty heavily spun piece of evidence. But it's possible I just mis-heard this, so if anyone has further details on it please pass them along for discussion.

[CPL.Luke]

it really is silly to suggest that such a basic instinct can be subdued merely by with holding contraceptives. People have sex, and if there are no contraceptives present they will still have sex.

 

I am still in the teenage age group and I don't konw of anyone who has sex on a first date.

 

besides I could point out a number of studies which have shown that graduating high school seniors rarely have had more than 2 sexual partners. (and who could call that promiscuous)

[swansont]

it really is silly to suggest that such a basic instinct can be subdued merely by with holding contraceptives. People have sex, and if there are no contraceptives present they will still have sex.

 

That's one of the problems, though — you have a group of people who legislate based on how they want you to behave, not how you probably will behave. (funny, though, that we have police and the military, based on how people will behave, and not on how we want them to behave)

 

besides I could point out a number of studies which have shown that graduating high school seniors rarely have had more than 2 sexual partners. (and who could call that promiscuous)

 

I can think of some groups...

[swansont]

For what it's worth' date=' there is a reported study being touted about that allegedly suggests a correlation along the lines of what Mooey is saying. If I remember correctly, it just shows no drop in teen pregnancy in Europe since the introduction of Plan B (which could mean anything). I have yet to see a source on this study, it's just being quoted by all the conservative pundits on the talk shows.

 

Even if it's true, it's a pretty heavily a pretty heavily spun piece of evidence. But it's possible I just mis-heard this, so if anyone has further details on it please pass them along for discussion.[/quote']

 

I haven't heard the argument, but, as you say, it could mean anything. Including the possibility that it has a very small effect in countries where the teen pregnancy rate is already 4-5 times smaller than in the US.

[Pangloss]

That is an excellent counter-point. Sadly I've never seen that point made in refutation to these cable news pundits. Their heads would probably explode.

[blackhole123]

Well im a teen and i have a solution.

 

DONT HAVE SEX WHILE YOU ARE A TEEN!!!

 

If i can be responsible so can you. You can cry all you want and blame peer pressure but you made the decision and you have to deal with the consequences. And people get mad at the government after they've messed up and say that they should have to help them.

[Sisyphus]

That is an excellent counter-point. Sadly I've never seen that point made in refutation to these cable news pundits. Their heads would probably explode.

 

No, they'd say, "Don't spin your statistics at me!"

 

 

If i can be responsible so can you. You can cry all you want and blame peer pressure but you made the decision and you have to deal with the consequences. And people get mad at the government after they've messed up and say that they should have to help them.

 

Generally the debate centers not on whether the government should help them, but on whether the government should allow them to help themselves. Or alternately, whether the government should "help" them by artificially making the consequences much, much worse, thereby discouraging the "crime," despite the fact that there's no evidence at all such measures reduce the instances of this "crime."

[mooeypoo]

Really?! That's an interesting discussion in itself: why is the level of teen pregnancy in the United States so high compared with other industrialized nations? My guess would be that it's chiefly related to poor education (specifically abstinence "education"), but that big of a discrepancy has got to have other big factors as well.

I agree, this must be a prime factor. I don't know about the rest of the world, but Israel has a relatively excellent education (and, surprisingly, sex-ed . Also, the fact that Israel works in a somewhat "socialistic" way -- Education is demanded by law, and is free (almost) -- AND the fact that in Israel, there are no "public" vs "private" schools in lower grades (only universities have private and public schools, and very very few elementry schools - perhaps 5 in the entire country) makes the education not "seperated" into the-more-money-you-have-the-better-you-are-educated thing.

 

But.. again.. I'm only guessing. I don't presume to know American education, I am just throwing guesses out of my general knowledge of American's education system and my knowledge of the Israeli one.

 

 

btw, Swanson and Mokele: If that's what researches show, then I won't argue. I was assuming, out of my own logical thinking. What you say sounds reasonable aswell, though I would also say that the fact there is an "easy solution" MIGHT get teenage girls to think lightly about the consequences.. but again, I will not argue with researches, that's what they're here for

 

~moo

[swansont]

Well im a teen and i have a solution.

 

DONT HAVE SEX WHILE YOU ARE A TEEN!!!

 

If i can be responsible so can you. You can cry all you want and blame peer pressure but you made the decision and you have to deal with the consequences. And people get mad at the government after they've messed up and say that they should have to help them.

 

If it works for you, fine. Nobody is advocating that you have to have sex. But why is it your business if someone else chooses to have sex? And what if the person had not chosen to have sex, and was assaulted?

 

This isn't a case of getting mad and demanding help from the government. This is a case of keeping the government's big, fat nose out of personal lives, i.e. keeping government from being an obstacle by regulating something they need not regulate.

[insane_alien]

i think that if you taught kids in sex ed by just telling them the facts instead of goin "OMGz0R tHis is TEH EVILz0r5!!!!0ne!!1" then kids might not be as compelled to do it as early as possible. my sex education at school was basically 'don't do it ever, even when your a grown up'

[john5746]

This is a quote from the link I provided in the opening post.

 

The primary reason that teenage girls who have never had intercourse give for abstaining from sex is that having sex would be against their religious or moral values. Other reasons cited include desire to avoid pregnancy, fear of contracting a sexually transmitted disease (STD), and not having met the appropriate partner. Three of four girls and over half of boys report that girls who have sex do so because their boyfriends want them to.

 

Teenagers who have strong emotional attachments to their parents are much less likely to become sexually active at an early age and less likely to have a teen pregnancy.

 

 

Teens who have been raised by both parents (biological or adoptive) from birth, have lower probabilities of having sex than youths who grew up in any other family situation. At age 16, 22 percent of girls from intact families and 44 percent of other girls have had sex at least once. Similarly, teens from intact, two-parent families are less likely to give birth in their teens than girls from other family backgrounds.

 

Teen Pregnancy in decline

 

Summary: 1/4th of the decline is due to abstinence and 3/4ths is due to more effective birth control - long term hormonal treatments.

 

Europe vs America

 

This article is basically saying Europe is more open in discussing teen sex, which results in "smarter" sexual habits. More discussion leads to better education - who would have guessed?

 

 

I think this all boils down to the breakdown of the family unit, the teen culture and attitudes towards sex. The family isn't talking about it, MTV is saying do it, everyone's doing it, if you ain't you are a loser. Promiscuity to me means having multiple partners. This increases the liklihood of transimission of sexual disease. Why are Americans more promiscuous? I think they are having sex for the wrong reasons.

 

In regards to birth control, it appears to me that the effectiveness of the method(including ease of use) is important. Having condoms all over the place won't help if no one uses them. Having pills readily available won't help if people can't remember to take them or are afraid of being caught.

[CPL.Luke]

In regards to birth control, it appears to me that the effectiveness of the method(including ease of use) is important. Having condoms all over the place won't help if no one uses them. Having pills readily available won't help if people can't remember to take them or are afraid of being caught.

 

[oppinion] I've heard that argument made about condoms in that it can be embarassing to walk into a convenience store and grab a pack of condoms. However if your not mature enough to buy something that essential on your own, because your worried about what the person at the counter would say. Then your not ready to have sex.