According to an NHS report girls as young as 13 should be given the contraceptive pill without having to see a doctor. Normally girls and women can only go on the Pill once they have undergone a thorough consultation with a GP or nurse as it can cause side effects including blood clots.
Now the report recommends that pharmacists across Britain routinely hand it out to teenagers under the legal age of consent in the hope of reducing unwanted pregnancies. In a pilot project, five high street pharmacies in the London districts of Southwark and Lambeth have been handing the Pill to over 16s without a doctor’s prescription. The review, carried out by NHS South East London, adds, “Consider providing the service to women under 16 years where appropriate. This may help contribute to a reduction in teenage pregnancies.”
Recently Britain’s teenage pregnancy rate has begun to fall although it is still one of the highest in Europe. The most recent ONS figures show that births to girls under 18 dropped by 10 per cent last year and are now at the lowest level since 1969. Campaigners say this is due to increased availability of contraception and improved sex education in schools.
Officials at the Department of Health say it is up to individual NHS trusts to decide if they want to adopt similar schemes. They will not be issuing national guidelines. But a number of chemists in two primary care trust areas have already begun providing the Pill to girls as young as 13 in an attempt to tackle teenage pregnancy rates.
Since November 2010, the Isle of Wight PCT has been carrying out a trial across ten pharmacies to offer it to girls and women aged 13 to 25. Girls who go into the chemist wanting the morning-after pill are also offered a month’s supply of the Pill following a consultation with the pharmacist.
But Professor David Paton, of the University of Nottingham, who specialises in contraceptive policies, said that if young girls knew they could get the Pill without their parents finding out they might be more inclined to have sex. “There is clear evidence that it is unlikely to reduce teenage pregnancies,” he said. “All the evidence is that greater provision has no impact on teenage pregnancies.”
Dr Fiona Cornish, a GP in Cambridge and president-elect of the Medical Women’s Federation, said she was ‘uneasy’ about whether pharmacists would be able to carry out a proper consultation with girls. But she added, “I’m convinced there is a good case for the over 16s as they are already offered emergency contraception – the morning after pill – at pharmacists.”
Those under 16 must have an appointment with a specially trained nurse, who will ask if the girl has discussed the matter with her parents. Kevin Noble, community pharmacy lead for the health authority, told Pulse magazine, “It’s a shame other schemes have shied away from providing the Pill to under 16s.” He emphasised those accessing the service had already sought the morning after pill.
But Dr Trevor Stammers, chair of the Christian Medical Fellowship and a member of the Family Education Trust, described pharmacy provision to under 16s as “deeply troubling”. He said, “It flies in the face of any concerns about child protection. It totally undermines the law with regards to underage sex. To public health professionals and politicians believe that underage sex should by illegal? Because if they do, this kind of policy is utterly counterproductive.” “It's also quite negligent to give out the Pill without a full patient examination,” he said, saying it increased the risk of blood clots. “These schemes are going to be dangerous.”
However, it was welcomed by the British Pregnancy Advice Service. A spokesman said, “Most under 16s are not sexually active - those who are should not be excluded from more accessible contraception services and put at greater risk of unwanted pregnancy because of their age.”
Doctors, nurses and pharmacists are legally allowed to give the Pill to a girl under the legal age of consent as long as they ensure she is aware of the risks of having sex and of taking the medication. Due to patient confidentiality laws they cannot tell the girl’s parents. The guidelines require the pharmacist to ensure the girl is mature enough to understand advice and attempt to persuade her to tell her parents. The pharmacist must be sure she will continue to have sexual intercourse with or without contraception, and that without contraception, her health will suffer.
Earlier this year it emerged that schools were providing girls as young as 13 with contraceptive implants without their parents’ knowledge.
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