October 26, 2012

When Emergency Contraception is Ill-conceived

I went to a meeting this week at New York City’s Department of Education. All parents and guardians, no matter where they live, should know about it.

I was there with some people from NYC Parents’ Choice Coalition to ask questions about a program in which emergency contraception(EC) is dispensed without parental consent. The point of the meeting was not to debate, but to gather information.

Thirteen high schools in New York City give out EC, also called Plan-B, and the morning-after pill. If taken within three days after intercourse, EC decreases the chance of pregnancy by interfering with ovulation, fertilization, or implantation.

A girl over 17 can buy EC over the counter; younger girls need a prescription.

We gathered lots of facts about the program. Right now, I want to focus on these:

  • Girls in grades 9-12 get EC from the school nurse.
  • The girl doesn’t need to disclose anything about her sexual relationship, if she’s not comfortable doing so.
  • It is up to the student whether or not to tell her parents.
  • Every student can get EC, unless her parents opt out by returning a form that’s sent home in the mail and with the student.
  • The goal of the program is to decrease teen pregnancy, but that can’t be measured. So the program’s success is measured by the number of girls who use it.

There’s a lot here that’s troubling, don’t you think? I’ll be blogging more about this, but for starters:

  1. Sexual activity, pregnancy, and contraception are serious health matters. Parents, not schools, are responsible for decisions related to the welfare of their minor child. Schools undermine parental authority when they are complicit with a student’s wishes to hide important health issues from her parents.
  2. It cannot be assumed that EC decreases teen pregnancy. In fact, some studies indicate it may increase it, along with STDs, by increasing sexual activity.

    It’s not difficult to imagine how that could happen:

    She: No, I don’t want to… I could get pregnant.

    He: No you won’t. We have school tomorrow, and you can get one of those pills after history class.

  3. The success of the program is measured by how many students use it. But the more sex students have, the more girls will need EC. This just isn’t sound thinking.
  4. It is highly likely that many parents never hear about the program. The girl who is most likely to need EC is also the girl who is most likely to not deliver the letter.
  5. A common side effect of EC is headache. But girls who return to the nurse for Tylenol can’t get it without parental consent!

A majority of New Yorkers think schools should not be dispensing EC (see results of poll here: nycparentschoice.org). As a physician and parent, I stand with them. I believe this program is flawed, and if you’ll pardon the pun, ill-conceived.

Parents, you may not be aware that a similar program is in the works for your daughter’s school. I encourage you to find out. Stay tuned for more blogging on this issue.

6 comments

  1. John Wigg - reply

    Dear Dr Grossman,

    EC sounds uncomfortably like the pharmaceutically-modulated sex-for-recreational-purposes-only sponsored by the state in Aldous Huxley’s novel, Brave New World. Huxley’s novel ends with the suicide of the only genuinely altruistic character in the story.

    Sex for its own sake, is, I suspect, a likely cause of suicidal ideation amongst some young women, who are left emotionally empty or addicted by sexual intercourse which comes without the real “two-becoming-one” for which human sexuality is both biologically and psychologically “hard-wired”.

  2. Mandy - reply

    Mr. wigg, perhaps you could refrain from “suspecting” anything when you base your suspicion on no data, research, statistics, or even personal experience… Since you are a man. Of course, I’m assuming, but my assuming makes sense since I have something to go off of, like your name.

    While nicely written, your comment in all too insane. Obviously the implication that sex leads us young women to suicide is the biggest crock of bologna. That and Sex is not hard-wired in us for connection, it is hard-wired in us to reproduce. Our logic trumps our animalistic nature through logic. Our emotion to love may as well. It doesn’t mean love equates sex.

    All of that said, the idea on topic does seen a bit tricky. Part of me thinks it is fantastic to reduce teen pregnancy, but abuse of it seems possible, as well. I don’t think the problem is not telling the parents simply because some parents disown or abuse children for their decisions, and it endangers the child to Divulge their business. They will still be having sex whether they have the pill or not. But perhaps it should be left to Planned Parenthood to provide them.

  3. Katie - reply

    Actually, when we engage in sexual intercourse, our bodies release a chemical known as oxytocin which creates feelings of attachment and trust. It is released when kiss, hug and cuddle a loved one. It is also released during breast-feeding and childbirth. We are made for love and connection, it is in our biology.
    We are human beings, and to equate us with animals is just inaccurate and misleading. The philosopher Aristotle once said “The human being is a rational animal”. What makes us human beings is that we have the will and the intellect. We can choose to do good or evil, we are able to have control over the passions. Aristotle also said “We are masters of our own actions from the beginning right to the very end”. Sexual desires stem from our need for love, not just because we have some animalistic urge to reproduce. To say that takes away the sacredness and value of the human body. We can create, we can do math, science, dance, sing, read, write, etc. No other species on the planet can do those things. You won’t find a bird doing calculus or a goat choreographing a ballet routine. The Latin phrase ‘ad altiora nautus’ is often used in philosophy to describe the human person. It means ‘having been born for higher things’.
    Sex is more than just a biological function for a human being. It binds us to another person. Thomas Aquinas said that we are an inextricable unity of body and soul. Therefore, what joins two bodies also joins two souls and. We are more than our passions and desires. Contraception takes away from that and it increase male irresponsibility. It allows men to use women’s bodies as objects for their person gratification. It absolves them from having any responsibility for their actions and frees them from the commitment of a relationship. In addition, contraception is detrimental to women’s health not only in that it can make committed relationships difficult, but it puts their physical health at risk. I am all for women’s empowerment, but contraception seems to be having the opposite effect. It has led us farther and farther away from what we truly want deep down inside, which is committed and loving relationships; the kind of love we were made for is one that has both eros (physical, fleshy (sexual) love) and agape(selfless, self-giving love). There is a natural alternative to contraception called Natural Family Planning (NFP) that has proven to be just as if not more effective than contraception (Yet it is not taught in sex education). It is NOT the rhythm method! People who use it have reported happier relationships, and increase in respect for themselves and for their partner, as well as an increase in the quantity and quality of sex. I am not making this up; there is scientific evidence of this. I included a number of links with further information. They include secular/ scientific, philosophical and theological evidence for the things that I have said.
    I also feel the need to respond to your comment that teens are going to have sex any way and there is nothing that we can do to stop it. I am a 17 year old girl, currently in high school and I have never had sex or hooked up with anyone and I don’t plan on doing so until I am married. While a number of my peers do hook up and are not virgins, the majority believe in waiting to have sex until they are in a committed relationship. I see how they are left unhappy, lonely and hurt by boys who treat them like they are pieces of meat. But what can we expect from a culture where pornography is ubiquitous and women are degraded and treated like objects. I am sick and tired of watching my friends get hurt by boys and by being hurt by boys myself. This behavior is not genetically predestined, but is learned behavior. We learn from our experiences and the culture that surround us. Women deserve better than this. We need parents to set an example and to take a stand against the lies of sex education. I went to public school, was forced to sit through sex education and I can say first hand that sex education that we have now fails students. We are not taught values, abstinence is looked at like a joke and the information is hardly scientifically accurate or complete. When there is an injustice going on you need to take a stand against it. It is quite offensive that people think that teenagers can’t control themselves enough to remain abstinent. We need to focus on changing our culture and the messages that media is putting into the heads of young people, rather than continue to let us suffer.
    Dr. Grossman, you will never know how much what you’re doing means to me. Thank you, you have given me hope. Never stop doing what you’re doing.  Mr. Wigg, I very much appreciated your views of sexuality. Mandy, I mean no disrespect and I apologize if I come across as rude in my response. I respect your ideas and what you have to say.

    http://ruhealthyruhappymd.com/better-solutions/family-planning/#.UxPRcVLaqbQ

    http://www.myfemininemind.com/2012/07/things-your-doctor-may-not-have-told_25.html

    http://io9.com/5925206/10-reasons-why-oxytocin-is-the-most-amazing-molecule-in-the-world

    http://www.psychologytoday.com/basics/oxytocin

    http://www.pbs.org/thisemotionallife/topic/connecting/connection-happiness

    http://www.janetsmith.excerptsofinri.com/

    http://www.ncregister.com/daily-news/the-sexual-revolutions-predictable-results

  4. Sonia - reply

    I am a biochemist, I answer young girl’s questions in Yahoo in Spanish, and I am really upset when I see how they use over and over the postday pill, thinking it is as healthy as chiclets . no side efffects. There is gross ignorance about it. And we’ll see hormone problems in young girls 10 years from now, due to this. They never consult a gynecologist, thay take it when there is no risk of pregnancy, they know nothiong about when they get pregnant… but they have a lot of porno information.

    It does not make sense. There is gross restriction that young people should not smoke tobacco, but no problem with marijuana. They should be careful with weight problems and restrict the urge to overeat, but no problem with sex, no restrictions in this area.

    It is not political correctoin. It is not LOIGICAL!

  5. Schwadevivre - reply

    Dr Grossman would you care to identify the “studies” that show EC increases the chances of pregnancy? I’m sure you would not be referring to fraudulent and misleading information from the violent and destructive anti-abortion/prolife/forced pregnancy groups.

  6. Frank - reply

    “The girl who is most likely to need EC is also the girl who is most likely to not deliver the letter. [Parents can opt their students out of this program by sending a letter to the school.]”

    Why would the girl deliver the letter? Can’t the parents afford a stamp? Or make a phone call?

    Well I’m sure they’ll be much happier when their little “virgin” comes home with a bun in the oven courtesy of the local baggy jeans lothario. But hey. Suit yourself.

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