New Birth Control Laws: Preventing Unplanned Pregnancy

Easy, confidential access to affordable birth control is essential if we’re going to decrease the rate of unplanned pregnancies. The dynamics of birth control access are changing, thank goodness. As we’ve heard about parts of the world simply telling women NOT to have babies (Hello, Ecuador) we really do have to think about how women and men prevent pregnancy when not ideal. And how we support women getting information they need to make the safest and most reliable choice. This can start way before teens are sexually active.
Things are changing here in the US. As of Jan. 1, 2016 women 18 and older in Oregon can get hormonal contraceptives directly from a pharmacy, without having to go to a doctor for a prescription first. Pharmacists who supply birth control are required to complete formal training before being allowed to write prescriptions. In addition, teens and women must take a 20-question health assessment before obtaining the prescription that details risks and family history. This is why I always want parents to tell their teen if there is a family history of blood clots, family history of migraines, etc. That way, they can answer correctly!
The good news, here in the US, contraception is covered by insurance and protected by Obamacare (Thank you, Mr. President). Birth control options covered by the Affordable Care Act include: IUDs, emergency contraception, implants, pills, patches & rings.
California has also passed similar legislation that will take effect in the coming months to make it even easier for women to access birth control. National work is ongoing as well to make birth control over-the-counter. More on that to come!
When it comes to teaching our teens about sexual education, we know the topic is fraught with contentious beliefs and cultural sensitivities, and we also know that it’s really hard to speak about certain topics openly. But over and over, we are told by our kids that it’s us – the parents – their trusted adult community – they want to hear from most. Even when they squirm in the seat, DO KNOW THEY ARE LISTENING. I’ve written about this before for parents preparing those kids going off to college.
But really, talking to your teens about how to protect their bodies from sexually transmitted diseases, unplanned pregnancies, or violence should start much earlier. Normalizing the conversation appropriately for kids as young as five is encouraged in many parts of the world. We can talk about how we time growing our families in age-appropriate contexts. I’m thinking of writing a post, in partnership with a health educator, about what to say to a 5 year-old, an 8 year-old, an 11 year-old, and a 15 year-old. Would that be helpful? Please leave a comment…
I also want to offer a few great resources, thanks in part to my friend, teen advocate and digital educator, Susan Williams (@estherswilliams) for other parents to use as additions to or as guides for helping their kids understand their bodies and their decisions when it comes to sex and relationships.
There are three initiatives underway that I believe are truly shifting how sexual education and access to the right care, contraception, and information is achieved. Being able to get the right information when you need it and then being shown how to act on that information is crucial to preventing unplanned pregnancies and reducing cases of STDs. For adults who love their (our!) kids, we also need resources to help guide how we talk about sex: 
Virtual Care: This is kind of amazing to me when I think back to what birth control access felt like as a teen in the late 1980’s and early 1990’s.  Feels like we live in the future: in Washington, Alaska, and Minnesota Planned Parenthood (<–watch their explanation) offers visits with a healthcare provider through their video conferences application (paid for by insurance!). For teens this can be done in the privacy of their own bedroom. Questions can answered immediately by a trained professional. STD testing is also offered with an unmarked testing kit that can be mailed to you. Also, birth control (the pill, patch, or ring) can be ordered online, and shipped to your home within a week. Talk about convenient and digital. Things are changing for our teens.
 
 
 
Bedsider is an online site that helps young women (age 18-29) find the birth control that works best for them. I use it in clinic all the time as a visual when talking about options (pretty, realistic photos). The site is simple to navigate and makes getting to know what birth control is out there not overwhelming. It’s a solid resource to send your kids to, or even to use as a conversation starter to talk to your kids about some of the topics addressed. Also, Bedsider has a fantastic tool where you can set reminders to take daily birth control (as a reminder, when you take birth control at the same time daily it increases the effectiveness). It also feeds you bits and pieces of fun, relevant information on sexual health and STD prevention. I get the text reminder every single day even though I don’t take daily oral medication. It’s that good. Sign up — or get your teen to sign up here: Pill & Patch Reminder.
 
 
Start-ups and States: The Southern Nevada Health District has launched the True Health Needs Knowledge (THNK) program to bridge the gap in understanding and access to sexual health services. You don’t have to live in Nevada to see it (of course!), the information on the site is presented in a way that is easy to understand for both you and your teen. There’s even an “anatomy page” which I LOVE! Talk about clarity. Teens want to be taken seriously and want to talk about sex in a serious way. The THNK program is an alternative to blind Google searches about pregnancy prevention & sexually transmitted infections & sexuality — and it provides you as the adult enough information to help your kids make informed decisions.
Regardless of when you decide to have these conversations with your children, remember that even as uncomfortable as it might be, they do want to hear the information from you.

QUICK TIPS FOR SAVVY CONVERSATIONS ABOUT BIRTH CONTROL:

What About Plan B?

• Plan B is emergency contraception.
• It’s available without prescription across the US.
• Similar to birth control but pills are at increased doses from daily regimen.
• Taken right after and up to  5 days after unprotected sex to prevent unplanned pregnancy. Something every teen should know about!

Health Risks Of Oral & Patch Hormone Birth Control

• Increased risk of blood clots, high blood pressure & stroke.
• What about “complex migraines”? Complex migraines may increase risks of side effects on the pill. Know if they run in the family.
• Increased risk factors on hormones: women age >35, women smokers, & those with a family history of stroke, heart disease, or blood clots.

Best First Line: Implants & IUDs

• IUDs last years before they need to be removed or replaced (5 years or 10 years, depending on the type).
• Don’t require daily attention (perfect for teens!).
• Research proves IUDs do not cause increase risk of infertility (like old reports indicated).
• Recommended by the American Academy of Pediatrics, The CDC & American Congress of Obstetricians and Gynecologists.
• Teens don’t always need pelvic exam before birth control — typically first internal pelvic exam is at age 21 years unless there are health concerns. Don’t let the freak-out about an internal exam keep teens away from health providers!

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