Pharmacies deter teens from Plan B, study shows

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 03/26/2012 ( 42 moms have responded )

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Even though it’s legal for 17-year-olds to get the so-called morning-after pill, a new study shows that pharmacy employees often dole out the wrong information, telling the teens they’re not allowed to have the drug.



An undercover survey found that many of the pharmacies that told girls they were too young to get emergency contraception offered correct information when a doctor called seeking the pill for a 17-year-old patient, according to a report in the latest issue of the journal Pediatrics.



“I was shocked that 19 percent of 17-year-olds were told they couldn’t get the medication at all,” said Dr. Tracey Wilkinson, the study’s lead author and a general pediatrics fellow at Boston Medical Center/Boston University School of Medicine.



Wilkinson’s study was aimed at evaluating the real-world availability of Plan B One-Step and other emergency contraception drugs, which are available without prescription to girls and women starting at age 17. Girls younger than 17 require prescriptions to obtain the medication.



Proponents say that using emergency contraception could prevent half of all unplanned teen pregnancies. Each year in the U.S., nearly 750,000 girls ages 15 to 19 become pregnant, and about 85 percent of those are unplanned, according to the Guttmacher Institute.



For the new study, researchers posing as either a 17-year-old girl or a doctor seeking help for a 17-year-old girl called every pharmacy in each of five U.S. cities asking about the availability and accessibility of emergency contraception.



All callers asked questions from a script. The first question was whether the pharmacy had the medication in stock -- 80 percent of the 943 pharmacies said they did. Next, the researcher posing as a teen asked if she could get the drug, while the researcher posing as the doctor of a 17-year-old patient asked if the patient could get the medication.



There was a huge disparity between the answers given to the teens and those offered to the physicians, with 19 percent of the 17-year-olds being told that they couldn’t get it under any circumstances, compared with only 3 percent of the physicians.



The next question was asked only by teen callers who had been told a 17-year-old could get the morning-after pill: “My friends said there is an age rule [regarding access without a prescription] -- do you know what it is?”



Pharmacy employees answered that incorrectly 43 percent of the time.



The researchers can’t say anything for sure about the motivation behind the misinformation because that wasn’t part of the experiment. It might be partly explained by the fact that the doctors in the study tended to get actual pharmacists on the phone while “teens” often got lower-level pharmacy employees who might have been less informed about the FDA rules. The researchers found that, in general, teens were put on hold more often and that they spoke less often to pharmacists.



“It’s a controversial topic," Wilkinson said. “It shouldn’t be, but it is. And anything with controversy heightens a person’s personal beliefs.”



Indeed, the topic has been so controversial that it forced a showdown in December over whether to make the drug available without prescription to girls younger than 17. Health and Human Services Secretary Kathleen Sebelius invoked her authority to overrule the recommendation of a Food and Drug Administration center and the agency's head, Commissioner Margaret Hamburg, who supported the move.



Wilkinson hopes the new study will raise awareness about the problem of pharmacists dispensing inaccurate information.



“This was disappointing,” she said. “I hope this study will instigate some sort of change on all fronts, for teenagers, pharmacists, staff and also clinicians.”




http://vitals.msnbc.msn.com/_news/2012/0...



WHAT? FFS.



I do not think there should be an age restriction. I think that is ridiculous. How many 14,15 and 16 year old girls are actually going to feel comfortable with going to the doctor to get a prescription for this? My inclination says not very many. Any teen that has the ability to become pregnant should have access regardless. The access should be anonymous. I understand, as a parent, we would like to have this knowledge but not all teens can go to their parents or if they can, may not want to, anyhow. They should not be left to feel stuck, EVER.



I know here in Canada you can go to a teen health clinic and be given the morning after pill, free of charge, without any questions. This is how it should be everywhere. IMO.



What are your thoughts? Should Plan B become available to all and not require a prescription? Should these pharmacies be required to be re-trained and explained that they need to be giving the accurate information?

MOST HELPFUL POSTS

Kate CP - posted on 03/27/2012

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I think the morning after pill should be available to all women of any age. Period.

[deleted account]

As Jen said, except for alcohol/drug abuse and or sexual nature. So, I looked deeper and came up with says it depends on the State and further says it "may" restrict the parent. It depends, then on the doctor.

---



New York and several other states have these limits. I don't have all the states yet but it is multiple ones.

Krista - posted on 03/27/2012

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From PlanB.ca



plan B is two pills which you take together. If taken within 72 hours, it prevents pregnancy by doing one of three things:



Temporarily stops the release of an egg from the ovary

Prevents fertilization

Prevents a fertilized egg from attaching to the uterus

plan B is not an abortion pill—if you take plan B you will not be terminating a pregnancy.



If you are already pregnant and take plan B, there’s no evidence that plan B will harm you or the fetus.

Mother - posted on 03/27/2012

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So, pharmacists will do this and then will question why abortion rates will rise. Stupid.

Sherri - posted on 03/26/2012

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Yes it should be available to anybody regardless of age without a prescription. Pharmacies should be required to re-train and be fined if misinformation is given.

42 Comments

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**Jackie** - posted on 03/27/2012

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Oh P.S....I do not believe that the Plan B is abortion...if you look at the definition and what it does...it is not the same.





This is coming from someone who has taken it, shamefully and regretfully, and who is indeed against abortion.

**Jackie** - posted on 03/27/2012

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Think of this....you're 14 and your parents don't even know you are having sex. You wouldn't even be sure who the father is if you had the baby and your only hope is to run down to the next town to a pharmacy where no one knows you and ask for the Plan B pill...your only way out. You're too young, you messed up, you can't handle this. The pharmacist gives you some bullshit answer why you can't have it and considering how naive you are and the fact that you didn't do any research on the Plan B pill on your family computer...you believe them.



Now what? You feel alone, defeated, scared, vulnerable and willing to do ANYTHING to get out of this situation.



Yeah you're right...this is a much better situation now that you've lied to the poor KID.

Mother - posted on 03/27/2012

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"Part of that is correct but the morning after pill also stops you from releasing an egg (ovulating). It is exactly the same as BC, in regards to how it works. "



----Are we sure this is correct? I was informed wrong then. I was told it stopped fertilization by killing off the sperm or stopping implantation.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 03/27/2012

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Part of that is correct but the morning after pill also stops you from releasing an egg (ovulating). It is exactly the same as BC, in regards to how it works.



Birth Control is suppose to stop ovulation, it also thickens the cervical mucus, thus not allowing sperm to enter. Then it thins the lining of the uterus wall. Which would make it hard to bare a fertilized egg. This is exactly what the morning after pill does, with the exception of thickening the cervical mucus.



I understand some people are stupid. However, it is these people that should not have the ability to provide or process any form of health care. Period.

Kate CP - posted on 03/27/2012

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Meme: A lot of people think that hormonal birth control is a form of abortion as well. I'm not saying I agree with it (I don't) and I'm not saying it's a correct assumption (it's not) but they "believe" that it is.



The reason why is because the morning after pill simply prevents implantation. The BCP (birth control pill) is supposed to stop ovulation but in some cases it doesn't. In those cases it usually prevents the egg from implanting in the uterine lining by tricking the body into thinking it's pregnant. People who believe pregnancy begins with fertilization and NOT implantation are of the assumption that any form of birth control that prevents a fertilized egg from implanting is a form of abortion.



Which, to me, is stupid. It would mean a single woman could have suffered hundreds of "miscarriages" because her fertilized egg never implanted.

Mother - posted on 03/27/2012

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"Well, Mother, you have to remember that some people think the morning after pill IS a form of abortion. "



---Seriously? It is unknown if conception has taken place, so in essence, it is the same as birth control. Isn't it??

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 03/27/2012

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Then they "need" to read the information on the side of the package. Or look up the definition of the morning after pill. ;)



It simply stops you from releasing an egg and makes slight changes to your womb. It does NOT kill anything. There is NO fertilized egg. Meh.



If any of them think it is a form of abortion, then they obviously need to go back to pharmaceutical school. If this is the case, then I would need to question where they got the pharmaceutical license from....a cracker jack box?



That would make BC a form of abortion too then. Since it dictates "when" you ovulate, just as the morning after pill. **sigh**



ETA:I am anti-abortion with very strict exceptions. I, however, do not consider the morning after pill abortion. I welcome it, so as to help lower the abortion rates.

Kate CP - posted on 03/27/2012

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Well, Mother, you have to remember that some people think the morning after pill IS a form of abortion.



Not saying that it's a correct or logical assumption, but that's their point of view.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 03/27/2012

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Well I guess it all depends on your child. Where my daughter has a severe disorder, I would be. She is not mentally apt to make certain, BIG decisions, especially at age 13. I still have to remind her to do the things she needs to do daily, like get out of bed.



I suppose it would be different for everyone. I am just saying if a parent wants to know about the child that they still fully provide for, there are ways. ;)



ETA:

I would also want to know if she was having treatment for mental health issues or alcohol/drug abuse. I would be able to seek the correct help she needed, much better than some doctor.

Isobel - posted on 03/27/2012

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I don't think it takes a really high level of sophistication to ask your doctor "do you have to tell my mom?"



I won't be having my child sign away their rights...even to me.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 03/27/2012

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They have to object. I do not know any children that are going to be educated on HIPAA or FIPAA. How are they going to know to object.



Although, after further research (and this is for the States, in Canada, we as a Guardian have access until they reach the age of majority), it says it depends on the State and further says it "may" restrict the parent. It depends, then on the doctor.



I am not disagreeing for the State Act. Sherri, asked a question, since she had a different experience with her 13 year old (at the time) and I was interested. ;)



Information may also be communicated to family and friends of the patient if they are involved in the patient's care, unless a patient has objected to sharing personal information. Parents, guardians, and medical powers of attorney can be spoken with as if they are the patient.



As Jen said, except for alcohol/drug abuse and or sexual nature. So, I looked deeper and came up with says it depends on the State and further says it "may" restrict the parent. It depends, then on the doctor.



However to make it easy, I would be having my teen sign the NIP form and be done with it (only needs to be signed once). I would then have access regardless.



I am also speaking from a parent actually going to the Doctor's office. Not calling a Health Insurance Company.

Isobel - posted on 03/27/2012

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Meme, your quote said "unless a patient has objected to sharing personal information." so obviously the child has the ultimate say.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 03/27/2012

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http://privacy.med.miami.edu/glossary/xd...



I believe that as long as you are the consenting parent and are required to agree to any health care required, even for mental health and STD's. You, the parent, are entitled to everything in your child's file.



Now, in regards to the morning after pill? It would more than likely not require a parent's consent. However, if a legal guardian asked to see their file, they may have access to it. Depending on the discretion of the health care provider and/or the State law. I have yet to see anything in regard to a specific age of 13.



Minors and HIPAA

Although parents will in general have access to their children's medical records, there are situations where your health care provider can restrict this access. For example, a pregnant teen doesn't need their parent's consent for treatment in many states, so you might not be able to request your child's chart to see if she had a pregnancy test.

State laws where you live will determine how much of your child's PHI you can get through HIPAA. In many states, minors can consent to treatment and testing for STDs and alcohol and drug treatment, so parents might not be able to access these records. A Pediatrician can also restrict a parents access if they think that it will harm the child. And you can't access your own or your child's psychotherapy notes.




So, it is a hit and miss scenario. All depends on where you live. I am inclined to say, it also includes how good of a relationship you have with your child's doctor. I do see a lot of "might", so I think if you pushed it, in a caring way, you would get what you were hoping for. ;)

[deleted account]

MeMe, you are correct in your quotation however, reproductive health/HIV, mental health and substance/alcohol abuse are separate areas and are treated differently. I'll get the info when I'm at work today. :)

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 03/27/2012

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Information may also be communicated to family and friends of the patient if they are involved in the patient's care, unless a patient has objected to sharing personal information. Parents, guardians, and medical powers of attorney can be spoken with as if they are the patient.



This is according to the HIPAA act in the US. Any parent can seek an under-age child's record as long as the child has not objected. They do not require having signed a consent for the release of the records, only need to object to it. I do not believe many, if any children would know about HIPAA especially before the age of 17. If my kid objected, there would be some serious issues. ;)

[deleted account]

"Are you sure this is for all of the US?? Why I ask is because when my son who is 13 had to go to mental health for his ADHD I had to be there. They would not see him without me present and I was given all files. He signed nothing and wasn't even offered not too. "



I can double check at work tomorrow if it's NYS only or US but we're told in the call center that if there's no auth on file, no info is to be released at all.

[deleted account]

MeMe, I know what you're saying but I'm going with our legal team at work and this is a big big issue that we have to go over.

Sherri - posted on 03/26/2012

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@Jen In the US, this would be an absolute violation of HIPAA laws. After age 13, you cannot release the protected health information to anyone (including parents) in regards to reproductive health, mental health and substance/alcohol abuse.



Are you sure this is for all of the US?? Why I ask is because when my son who is 13 had to go to mental health for his ADHD I had to be there. They would not see him without me present and I was given all files. He signed nothing and wasn't even offered not too.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 03/26/2012

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Here we have FIPPA. Although, I believe we can still see our child's files.



Laws governing access to minors’ health records are murkier than those related to patients’ access to their own files. Parents and legal guardians can view files for very young children. But once minors are old enough to make informed decisions about their own care, they have the sole right to see their file and grant access to it. However, in many provinces, including B.C., no law spells out the age at which those rights shift from the parents to the child.



The law in Nova Scotia takes several approaches to minors. The Age of Majority Act

specifies that a person reaches the age of majority at age 19 years. This age is

referenced in the FOIPOP Act as well, which states that the “legal custodian” of

someone under the age of majority may exercise any power in the Act where, in the

opinion of the public body, it would not constitute an unreasonable invasion of the

privacy of the individual. The Hospitals Act does not deal with the age required to

consent, and practice has been for the hospital to make a judgment as to the patient’s

ability to consent.

No health information Act in Canada has an unqualified age cut-off for consent.




Nope, we're good in Canada. We could view our child's record as long as they were not of the majority age.



Honestly though, what 13,14,15 and 16 year old knows about HIPPA or FIPPA? I am compelled to think, none. As a parent, if I was concerned for whatever reason, I would be getting the file regardless of who I had to get it from or who I had to involve. They live under my roof, I pay their medical bills, I have that right.



ETA:

Our docs here often do not know what drug goes with what, well they know but they do not bother. They prescribe and it is the pharmicists job to discover whether a drug does not go with another we are taking. This is why we have a database in our pharmacies, they keep track of what each person takes. It alerts them if there is a counteractive one.



As in a blood disorder, yes, our doctors here would take care of that knowledge.



And I hear you Ruby. My daughter has severe ADHD, she is 13.5. I am sorry but she could not make a consenting decision on her own, yet. 13 is WAY too young.

User - posted on 03/26/2012

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Yes, it is a disgrace that pharmacies would give out incorrect information.



Yes, for the majority of women and teens who take the morning after pills there is no major harm done to the woman.



However, I believe that medications like these should only be provided by a prescription from the family doc or OB/GYN. The reason is, women who have the same blood disorder that I do have a very high risk of DVTs from any amount of hormones that are found in these types of pills. I am sure there are other illness/chronic disorders/etc that would be disastorous to take these same pills with. Teenagers do not understand that bad things can happen to them. My daughters probably think that I am over-reacting however, I do feel they would listen to their doctors who know their history and their family history as to whether it is safe for THEM.



As a side note to Jens post above: My oldest daughter uses the 'mental health system' and i was insistent that she signed those waivers because they only way we can help her grow up to a resposible safe adult is to know what is going on with her long standing issues AND this is necessary to keep the rest of the family safe from anything she may be going thru. We love our daughter immenseley and unless you have been through the experience of a child who was tramuatized and ended up with PTSD with physosis, it is not just about that individual child when there are other vulnerable children in the household. I think that HIPPA had good intent but I believe it to be a totally wrong to apply to this at 13 years old and above because as the parents who have to house and make sure these children are safe have a right to now what is going on. I don't know how you feel about it but your reply just sparked a pet peeve of mine =)

[deleted account]

"All I was getting at is needing to go to a doctor means your parents "could" ask to see your file, being underage and such. It also means the doctor could notify your parents."



In the US, this would be an absolute violation of HIPAA laws. After age 13, you cannot release the protected health information to anyone (including parents) in regards to reproductive health, mental health and substance/alcohol abuse.



I know this for a fact, I have to live by at it work. The child would need to sigh a legal waiver allowing parents to have access, including claims information from the insurance company.

Isobel - posted on 03/26/2012

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because denying them birth control will turn back time and make them not be sexually active...ugh

Christina - posted on 03/26/2012

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they dont want teens to have it but they want to bitch that we are over populated. huh go figure that one

Krista - posted on 03/26/2012

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Here you don't even need to ask the pharmacist. I was at Zeller's today and saw it in amongst the condom section.

Isobel - posted on 03/26/2012

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You don't need a prescription for the morning after pill here, you just ask the pharmacist for it and they give it to you.

Tracey - posted on 03/26/2012

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You can spend your daughters entire teenage years telling them to be safe and make good choices but all it takes is a few drinks to let their guard down and a split condom and then what do they do?

I don't know the rules about getting this in UK but if my daughter was in trouble I would rather she had access to it either from a pharmacist or the doctor.

Krista - posted on 03/26/2012

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I think that's absolutely horrible that pharmacies are misleading these girls, particularly when it comes to such a time-sensitive situation!!! Plan B has to be taken as soon as possible after unprotected sex, or its efficacy wanes DRASTICALLY. So what happens if these pharmacies give a girl the wrong information and she winds up only getting Plan B later...or not at all?



Terrible, horrible and wrong. The powers-that-be need to crack down HARD on this and make sure that people are being given correct information. If it were MY daughter, and I found out after the fact that she'd tried to get Plan B, but had been erroneously told she couldn't have it? I'd lawyer up so fucking fast their heads would spin.

[deleted account]

ha i forgot parents could ask about it. but word gets around anyway. your dad's coworker's wife saw your daughter at the health department, all hell breaks loose...but then again that's assuming the teen would be worried about what mom and dad thought. at the same time, though, makes me think they're worried anyway since they're going behind mom and dad's backs to get the pill.



i still don't necessarily agree with it, but i'm all for women's rights most of the time so i'm not saying it shouldn't be made available, just that i don't want to think about how many young girls are having unsafe sex. it makes me sad, lol.

Lady Heather - posted on 03/26/2012

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The day all teenagers abstain from sex is never going to happen. It's a fine ideal, but dude - how many unwanted pregnancies do we have to deal with in the mean time? Ideals don't happen. They just don't. In an ideal world no adult would require MAP either, right?



I know for a fact that a teen is more likely to go to a teen clinic than a regular doctor because I did as a teen. The clinics were all free and there was no chance you were going to happen upon a parent or friends parent. You didn't have to worry about the doctor blabbing to a parent. I'm told that in the US they have these things called co-pays. What if the teen has no cash for the co-pay to see the doc to get the scrip? What if they have no insurance at all? There have to be ways to access this stuff. I do think a medical professional should be invilved because it is a medication. But it shouldn't be difficult to obtain.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 03/26/2012

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Jaime---sure, make it available, what's it matter, chances are they'll still be embarrassed walking into the pharmacy or health department to order it and pick it up so i don't see much difference between that and going to a doctor's office to get a prescription. even if it is made available, that doesn't mean they won't get odd looks from the pharmacists because people are just like that.



All I was getting at is needing to go to a doctor means your parents "could" ask to see your file, being underage and such. It also means the doctor could notify your parents. Being able to go directly to the pharmacy, means it would be anonymous. There would be no need to order it, it would be readily available to them. No need for an explanation from the teen, just ask for it and have the pharmacist quickly explain it and they are on their way to hopefully get out of a bad situation.



Yes, I agree, it is important as a parent to educate your children on safe sex. Although, it is not always going to happen. Some teens do not have parents that will educate them. Some parents do not feel comfortable talking to their kids about sex. Some teens don't care and do it anyway. ;) Sometimes the method of contraception fails. This is just a method of allowing them hopefully get out of a bad situation.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 03/26/2012

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Rebecca 3---



Great idea. I concur. They should have it behind the counter. Here in Canada, anything new must be explained by a "real" pharmacist. Having it behind the counter would definitely allow for explanation by a legally trained "drug dealer". ;)

[deleted account]

maybe parents should focus on making sure their kids make good choices and teach them safe sex so that there aren't so many teens needing this sort of thing.



sure, make it available, what's it matter, chances are they'll still be embarrassed walking into the pharmacy or health department to order it and pick it up so i don't see much difference between that and going to a doctor's office to get a prescription. even if it is made available, that doesn't mean they won't get odd looks from the pharmacists because people are just like that.

Lady Heather - posted on 03/26/2012

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I think this is idiotic. How a bunch of teenagers having kids or an abortion instead is better, I don't know. Medical professionals need to do their job or find a different one.

Mrs. - posted on 03/26/2012

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I think it should be made available, without a script, but be put behind the counter at the pharmacy with other over the counter meds/treatments that pharmacists might need to include information with (like B12 injections, needles, etc). Hopefully, that way, the pharmacist can tell the young lady what the side effects will be and what to do if there is any adverse reaction.



I think it should be available to any one having sex...I mean, why is it right for a 17 year old, but not someone who is 16 and a half? What's the difference? Both of the girls need to cover their asses, the only difference is a couple months. Those couple months could mean the difference between having to go through with an unwanted pregnancy or an abortion.



As far as the actual pill goes, I'm super sensitive to most drugs and didn't have a crazy reaction to it (I took it once in my early twenties, when you still needed a script for it). Yeah, you get cramping and stay in bed for like a day...but what do you expect? (This is why I think a pharma should be filling in the girl about these things, I know I had one tell me as much and it made it less scary)



Pharmacists assistants can sometimes be a bit slow and misinformed. I've had the worst experiences with them telling me something completely ignorant before and I have to "inform" them of what the real information is. I generally think those people need more training, but have accepted that I always request to speak to a real pharmacists is my question is important (you know beyond, can you hand me that saline solution over there?). Of course, young girls may not know that this is the best person to talk to and assume they are all pharmacists because they wear white robes. That's why I think a pharmacist should be required to explain all the side effects without requiring scripts. I think that is the ideal.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 03/26/2012

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I am thinking of all the teens that DO have sex before 17. There are many of them. What are they to do? They either go to a doctor and feel scared, embarrassed, worried OR allow the pregnancy to become fertile. I mean, think of the possible health risks there. To be pregnant at age 14,15 or 16. Boy, that would be some hard lessen learnt. I would much prefer them have access to the morning after pill than to seek abortion. I do not believe in abortion and it could have some serious side affects. They actually have to place an instrument inside you for an abortion. The morning after pill stops you from releasing an egg and changes the womb environment and you only need to swallow it. Of course it is not 100% but it is estimated to be 90% effective.



I would much prefer them to have a safe way out, if they needed it. According to what I have read this pill does not have severe side affects. Those side affects that are mild, occur in less than 10% of women. You now only need to take one pill, as opposed to the "older" version of needing two.



Is it dangerous to use?

Not at all. If anybody tells you that it has 'lots of side-effects' or 'makes you dreadfully sick', don't believe them.

An older form of PCP used in the 1990s did often cause severe nausea, but today's post-coital pills cause very little trouble.

Personally, I have never seen any severe side-effects from either type of PCP. But you can find more details about possible side-effects from the package leaflet.




http://www.netdoctor.co.uk/sex_relations...

[deleted account]

i personally don't think a teen younger than 17 should be having sex at all (i didn't until a couple months before my 18th birthday) but that's just me and my opinion and not necessarily how i was raised, but what i think based on teen psychology.



i don't necessarily agree with making Plan B free and available to all ages either, just because of the possible health risks and side effects. i know one friend who took it had migraines, cramping, bloating, and vomiting, at the very least. it was very painful for her. i took it once and never had problems, but this was when i was older, after i'd had my daughter, and it was $42. insane...i do not think it should cost so damn much for one pill...ugh...



i do think the pharmacists need to get their information straight, though. that's not right that they don't know what they're talking about, or that they are intentionally misleading these teens because they don't agree with it.

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