Skills for Educators
Teaching Youth about Emergency ContraceptionProviding information is an important element in any educational effort to reduce sexual risk taking behavior. Although information alone won't change behavior, some basic knowledge of risks and possible consequences is essential. Young people are particularly at risk for unintended pregnancy since they are less likely to use protection and are often less experienced with birth control methods. For these reasons, they need to know about EC — what it is, how to use it, and where to get it.
This section includes guidelines for providing knowledge about EC and tips for how to address the controversy about EC.
Guidelines for providing knowledge about emergency contraception
- Select information that will most likely impact behavior.
Youth will find information about emergency contraception easier to understand and more relevant to their lives if they are given only the most critical information. Facts about emergency contraception that are most important for educators to convey are:
What is EC?
Just like regular birth control pills, an emergency contraceptive pill prevents pregnancy in one of two ways: It stops the egg from being released, or it changes the lining of the uterus so the fertilized egg can't attach and grow.
When might I need EC?
It's called "emergency contraception" because it should only be used for emergencies. For example, you might have a contraceptive accident; your condom might break or leak, or you might miss taking two or more of your regular birth control pills within a week. Emergency contraception may also be needed if you didn't use protection at all. In extreme cases, it may be needed because you were forced to have sexual intercourse. In any case, you need to act within 120 hours, and emergency contraception pills (ECPs) are more effective the earlier they are taken.
How can I get EC?
For youth under 17, a health care provider must be used to prescribe a Copper-T IUD or the correct dose of Emergency Contraceptive Pills (ECP) and explain how to use them. For women 17 and older, pharmacists in all states are allowed to dispense Next Choice®, Plan B® or Plan B One‑Step® without prescription. However, pharmacists in Maine, New Hampshire and Vermont are also allowed to dispense Plan B® or Plan B One‑Step® without prescription to women of all ages, even under the age of 17. Calling your doctor as soon as possible is very important because of the time limitations (up to 72 hours for Next Choice®, Plan B® or Plan B One‑Step® and 120 hours for ella®). There is also an emergency contraception website, www.not-2-late.com, which contains up-to-date and comprehensive information, including a zip code searchable database of emergency contraception providers.
There are many websites for information on EC and how to obtain it, but one of the best is: ec.princeton.edu/. Most important is to get ECPs and start taking them within 120 hours after sex, and the sooner the better as they will be more effective.
- Present information that is relevant to concerns of students.
Youth may have many questions, misconceptions, and concerns about emergency contraception, especially ECPs. For example, they may want to know such things as:
How effective are emergency contraceptive pills?
When taken within 72 hours, use of ECP reduces the risk of pregnancy by 75% to 89%, depending on the type of EC that is used. If taken between 72 and 120 hours after sexual intercourse, the effectiveness drops to 60%-64%. The sooner they are started, the more effective ECPs are.
Are emergency contraceptive pills safe?
According to studies published in Europe, where the pills have been widely used for some time, there are no serious or long-term complications or reasons they should not be taken. EC is non-toxic, with only short-term, non-serious side effects. EC poses no risk of addiction or overdose. Even when used repeatedly, no severe health consequences result. In 1997, the FDA stated that emergency contraceptive pills are safe and effective.
If the pills fail, is there any risk to the fetus?
There is no evidence that ECP will cause any birth defects or harm to the fetus.
Is repeated use of emergency contraceptive pills harmful?
Repeated use of the ECP poses no known health risks to women. However, there may be an increased likelihood of pregnancy with repeated use. For this reason, women using emergency contraception should begin using a regular method of protection immediately after using ECP.
Why can't I use emergency contraceptive pills as my regular contraception method?
There are several good reasons why ECP should not be your regular contraception. First, they are not as effective at reducing the risk of pregnancy as other correctly and consistently used birth control methods. Also, they provide no protection against HIV or sexually transmitted diseases, some of which are epidemic among youth and can cause serious and long-lasting health problems.
- Provide opportunities to review and apply information.
People remember more when they have an opportunity to apply their knowledge. Engaging youth in an activity that encourages their application of new information is a good way to reinforce their knowledge about emergency contraception.
Some examples of activities that reinforce EC information might include:
- a competition between two teams to see who can correctly answer the most EC questions
- students writing a role play of a discussion about the need for EC
- providing a lesson requiring students to practice skills needed to access emergency contraception information, through the EC web site. (See Skills for Youth for an explanation of this activity.)
How educators can address controversy about Emergency Contraception
When you are discussing EC, it's important to know that some people consider EC controversial. This is because many people disagree about exactly when pregnancy begins. Most, if not all, pro-life groups believe that pregnancy begins at the instant of conception. These people object to any intervention that may occur after an egg has been fertilized as can be the case with ECPs and the Copper-T IUD.
Individuals and groups who consider ECPs to be abortion include the Family Research Council, the Christian Medical and Dental Society, and many conservative, religious groups including the Roman Catholic Church (which affects availability of EC through many Catholic hospitals).
However, according to most physicians and pro-choice groups, pregnancy begins when a fertilized egg has attached itself fully to the lining of the uterus, a week or so after fertilization occurs. Organizations including the U.S. Food and Drug Administration, American College of Obstetricians and Gynecologists, National Institutes of Health, World Health Organization, and Planned Parenthood Federation of America all endorse EC.
According to these groups, EC does not interrupt an established pregnancy. If taken too late, EC pills will not be effective. In other words, EC will not prevent or interrupt an established pregnancy and will not harm a developing fetus. In fact, many scientific and medical experts believe that ECPs work in much the same way that regular birth control pills do, except that they are taken after sex, within a window of opportunity (up to 120 hours) between intercourse and implantation of the fertilized egg.
Given this basic disagreement in the definition of pregnancy, educators may be wise to acknowledge both beliefs. For example, you might state: "Some people believe that emergency contraception is safe, a good 'safety net' to prevent pregnancy after unprotected sex, and can substantially reduce the need for abortion. Other people believe that EC is actually just another form of abortion. You may want to consider your own beliefs (or the beliefs of your family) before using EC."
Check out the resources listed above and other information on EC prior to teaching a lesson on EC to make sure they are appropriate for the age level and setting of the youth you are teaching.