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December 1999/January 2000
Welcome
to Skills for Educators!
The instructional
strategy highlighted this issue is:
Teaching
Youth about Emergency Contraception
Providing
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 emergency
contraception: what it is, how to use it, where to get it.
Description
Several
guidelines can help in providing knowledge about emergency contraception
in an effective manner:
- 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
it is.
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
it might be needed.
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 any case,
you need to act within 72 hours since emergency contraception pills
(ECP) are more effective the earlier they are taken.
How
to get it.
A health care provider must prescribe the correct dose of ECP and explain
how to use the method. Calling your doctor as soon as possible is very
important because of the time limitations (72 hours). There is also
an automated 24-hour hotline (1-888-NOT-2-LATE), which provides information
in English and Spanish about providers within a caller's area code who
will prescribe emergency contraception.
Many websites exist as well, but one of the best is: ec.princeton.edu/
for information on emergency contraception. Most important is to get
ECP and start taking them within 72 hours after sex.
- Provide information
that is relevant to concerns of students.
Youth
may have many questions, misconceptions, and concerns about emergency
contraception, especially emergency contraceptive pills (ECP). For example,
they may want to know such things as:
How
effective are emergency contraceptive pills?
Use of ECP reduces the risk of pregnancy by about 75%. However, the
sooner they are started, the more effective they 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. 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 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 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
- having
students write 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, either through the hotline
(1-888-NOT-2-LATE) or through the EC web site. (See Student Skills for
an explanation of this activity.)
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Tips
How educators
can address controversy about Emergency Contraception:
When discussing emergency contraception, it's important to know that
some people consider emergency contraception 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 emergency contraceptive
pills and the Copper-T IUD.
Individuals
and groups who see emergency contraceptive pills as abortion include
the Family Research Council, and Christian Medical and Dental Society,
and many conservative, religious groups including the Roman Catholic
Church, (which affects availability of emergency contraception 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. Organizations including the U.S. Food and Drug Administration,
the American College of Obstetricians and Gynecologists, the National
Institutes of Health, the World Health Organization, and the Planned
Parenthood Federation of America all endorse emergency contraception.
According to these people, emergency contraception does not interrupt
an established pregnancy. If taken too late, EC pills will not be effective.
In other words, emergency contraception will not prevent or interrupt
an established pregnancy and will not harm a developing fetus.
In fact, many scientific and medical experts believe that emergency
contraceptive pills work in much the same way that regular birth control
pills do, except that they are taken after sex, within a window of opportunity
(about 72 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 may 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 emergency contraception
is actually just another form of abortion. You may want to consider
your own beliefs (or the beliefs of your family) before using emergency
contraception."
Check out the resources listed above prior to teaching a lesson on emergency
contraception to make sure they are appropriate for the age level and
setting of the youth you are teaching.
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