Friday, December 19, 2014

How should I talk to my teen about plan B?

With Plan B available over-the-counter soon, Krishna White, MD, MPH, from Nemours/Alfred I. duPont Hospital for Children provides tips on how to talk to your teen about emergency contraception.

How should I talk to my teen about plan B?

ILE - In this May 2, 2013 photo, pharmacist Simon Gorelikov holds a generic emergency contraceptive, also called the morning-after pill, at the Health First Pharmacy in Boston. A federal appeals court has decided to permit girls of any age to buy generic versions of emergency contraception without prescriptions while the federal government appeals a judge´s ruling allowing the sales. The order Wednesday, June 5, 2013 was met with praise from advocates for girls´ and women´s rights and scorn from social conservatives and other opponents, who argue the drug´s availability takes away the rights of parents of girls who could get it without their permission. It is the latest in a series of rulings in a complex back-and-forth over access to the drug. (AP Photo/Elise Amendola, File)
ILE - In this May 2, 2013 photo, pharmacist Simon Gorelikov holds a generic emergency contraceptive, also called the morning-after pill, at the Health First Pharmacy in Boston. A federal appeals court has decided to permit girls of any age to buy generic versions of emergency contraception without prescriptions while the federal government appeals a judge's ruling allowing the sales. The order Wednesday, June 5, 2013 was met with praise from advocates for girls' and women's rights and scorn from social conservatives and other opponents, who argue the drug's availability takes away the rights of parents of girls who could get it without their permission. It is the latest in a series of rulings in a complex back-and-forth over access to the drug. (AP Photo/Elise Amendola, File)

Today’s guest blogger is Krishna White, MD, MPH, an adolescent medicine specialist at Nemours/Alfred I. duPont Hospital for Children. Now that Plan B will be available over-the-counter without any age restriction, we asked her about how to talk to your teen about emergency contraception.

What is Plan B?

Plan B is a form of emergency contraception (EC). It is essentially a backup method of birth control for preventing pregnancy after unprotected sex. Plan B can be used within 5 days (120 hours) of unprotected intercourse, though it works better the sooner it’s taken. Last month, the federal government announced that Plan B will be available over-the-counter (without a prescription), for anyone regardless of age or gender.

The medication in Plan B works by giving a strong short burst of hormones that changes the cycle and prevents ovulation. However, EC doesn't continue to protect against pregnancy during the rest of the menstrual cycle so a condom should be used until the next period starts. Plan B does not work if a woman is already pregnant. It will NOT cause an abortion.

Should you tell your teen about it?

I recommend telling teens about Plan B, not as a free pass to ignore contraception but as a viable option if they make a mistake. In fact, I often suggest parents consider stocking it in their medicine cabinet so it’s available if their teen needs it. 

According to the CDC, about 40 percent of sexually active teens did NOT use a condom during their last sexual intercourse and about 82 percent did NOT use birth control pills before the last time they had sexual intercourse. So despite what we teach, at home, at school, in the community, and in the doctor’s office, teens are still taking risks and making mistakes.

Should parents stress that condoms and other contraception should always be used first and this is only a backup to prevent pregnancy?

Of course.  Plan A is Abstinence or Always use condoms, Always listen to your parents and doctors, and Always use your hormonal birth control correctly.  But Plan A doesn’t always work so you need a Plan B. 

How can you approach it with your teen? Seems like you would talk to teen girls about it, but what about teenage boys?

Discussion of Plan B can be part of the ongoing “sex talk” which should start early and continue at an age-appropriate level as the child matures. I suggest talking to boys as well as girls about it because it takes two to make a baby and there is no gender restriction on who can purchase the medicine.  Also, it is often the guy who knows when a condom fails.  Knowing about the Plan B option can empower guys to speak up and play an active part in fixing a mistake. 


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The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

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Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Mario Cruz, M.D. Pediatrician, Associate Director of Pediatric Residency Program at St. Christopher’s Hospital for Children
Magee DeFelice, M.D. Division Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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