I've been thinking lately about the sexual stupidity of my youth. The foolish chances I took. The silly expectations born of "uncontrollable passion" scenes in bodice-buster books. The deep need for approval as demonstrated by desire.
The trigger for these regretful ruminations was last Friday's landmark ruling on "Plan B," also known as "the morning-after pill." A federal judge ruled that it should be available over the counter to all ages. He not only overruled an Obama administration decision to require prescriptions for girls under 17, he derided that age limit as "scientifically unjustified."
That ringing endorsement prompted this disconcerting train of thought: "Wow, Plan B sounds amazingly safe. Wish they'd had it when I was young and stupid. Hey, wait. Does this mean that when my kids are old enough to enter the danger zone, I should stock some Plan B for them? If it's stocked on store shelves, does that mean we should stock it on our closet shelves?"
It felt outlandish and loving at the same time. I could already imagine the speech: "Please, please, please don't have unprotected sex. But if somehow you do, you don't even have to face me or talk to me. The Plan B is on the top shelf in the bathroom. Use it as soon as possible. And I hope when you're ready, we can talk."
If it's stocked on store shelves, does that mean we should stock it on our closet shelves?
Could that kind of tactic even make any sense? And mightn't it encourage irresponsible behavior? And is Plan B really that safe, or does it carry even minor risks?
I called over to the contraception and sexual education experts at the Planned Parenthood League of Massachusetts, who had — unsurprisingly — heartily praised last week's ruling.
First, their medical reassurance, from Dr. Danielle Roncari, the league's medical director:
"Emergency contraception, we know, is safe and highly effective. We also know from multiple research studies that it's safe for women of all ages to use, and that increased access to emergency contraception doesn't lead to increased sexual activity, it just leads to increased use of contraception.
We also know that it's a very safe medication. There's really virtually nobody that this medication isn't safe for, and we also know that teenagers are able to use it just as easily as adult women. Research backs this up."
Two additional safety points she mentioned: Plan B will not impact an existing pregnancy, so no pregnancy test is needed; and repeated usage is not unsafe either, though it is a concern because emergency contraception is not as effective as regular contraception – Plan B is up to 89% effective at preventing pregnancy, compared to daily birth control pills, which are up to 99% effective.
So, then, I asked, is this a good idea, to keep Plan B in the house?
"I think the more we can talk to our kids about sex, and the more we can talk to them about ways to prevent pregnancy and to prevent sexually transmitted infections, that's always a good thing," Dr. Roncari said. So "it's certainly not a bad thing for a mother to have it at home for her child. It's not harmful. But it needs to come along with a conversation, that it's not as effective as other methods of birth control, it does nothing to prevent sexually transmitted infections, and it really should be part of a bigger picture of accessing reproductive health care."
Bottom line: Condoms or Plan B are "definitely something to make available to your teenagers if they're not quite ready to go in to a clinic or a physician's office."
'It's not harmful. But it needs to come along with a conversation.'
Have you, I asked her, ever heard of this? Of parents stocking emergency contraception for their kids?
Not per se, Dr. Roncari said, but she did know of an obstetrician/gynecologist father who regularly left oral contraceptives on the table for his teenage daughters, "no questions asked..."
I sought more wisdom from Planned Parenthood's manager of parent education, Amy Cody. She first referred me to "Let's Be Honest," the parent education program that sets us up to be our children's primary sex educators. On Plan B, she said, we parents need to first learn more about emergency contraception ourselves — what is it? what does it prevent? — to talk with teens about it.
Parents often worry, she said, that "If I start talking, it's as if I'm giving a permission slip, I'm sanctioning it." But "in fact we're also giving our values and helping kids form those values." For example, she said, both boys and girls should hear about emergency contraception, because "we're talking about a relationship and shared responsibility."
Ultimately, she said, making Plan B available at home is "a very personal choice. A lot of parents ask me this question: 'Should I send condoms to my new freshman at college in the mail? How much should I help them? I want to make sure they have access.' We say to parents: 'This is very personal, this is a family decision. But having access is one of the best things for teens, because it's a deterrent [to contraception] if they don't have money or don't know how to get to the clinic. So if parents are willing to have condoms and emergency contraception available in their medicine cabinet, it's a benefit for teens to have access."
She emphasized, though, that as parents discuss emergency contraception with their teens, it should be clear that “Plan B is for when Plan A didn’t work, and I’m hoping you’ll come to me so that you have all the information you need, and you’ve thought through with your partner all of Plan A.”
Readers? So curious what you think — and, if you have teens, what you plan to do...Practical notes: Plan B comes as a single pill, and tends to cost about $50.
This program aired on April 10, 2013. The audio for this program is not available.