MORNING-AFTER PILL Study fuels debate over contraception

It meets all the criteria for over-the-counter use but is being held up by morality.
PITTSBURGH (AP) -- Teenagers who have access to emergency contraception at home are not more likely to have unprotected sex, a study has found.
University of Pittsburgh researchers questioned teenagers who had immediate access to the so-called morning-after pills at home and those who did not.
Over six months, the teenagers who had the pills on hand reported no more instances of unprotected sex but were more likely to use the pills, and use them sooner, according to the study being published this month in the April issue of the Journal of Pediatric and Adolescent Gynecology.
"People seem to be really worried that if young women knew that they had this that they would drop their usual methods and go out and have rampant sex," said Melanie A. Gold, lead study author and associated professor of pediatrics at the University of Pittsburgh School of Medicine. The morning-after pill "meets all the criteria for over-the-counter use, but what seems to be holding it up is not science, it is people's personal morality," she said.
FDA delays decision
In February, the Food and Drug Administration delayed its decision on whether to allow the pills to be sold over the counter because it wanted more information on the use of the pills by 16- and 17-year-olds.
Opponents have argued that making the pills too accessible could lead to more unsafe sex and an increase in sexually transmitted disease. Proponents say the pills reduce the number of unwanted pregnancies.
In this latest study, researchers followed 301 women between the ages of 15 to 20 who were recruited from a clinic at Children's Hospital in Pittsburgh. The women agreed to speak with researchers once a month for six months about their sex lives and use of contraception. Some of the women received education about emergency contraceptives along with the pills; others were given the education only and told how to get the pills if needed.
Results
At the end of the six months, 26 teenagers who were given the pills reported using them 38 times. In the group that was not given the pills, 20 teenagers reported using them 24 times. Also, those who were given the pills used them much sooner than the teenagers that didn't have them, the study found.
The morning-after pills are high doses of conventional birth control pills that are thought to work by either preventing fertilization or by stopping a fertilized egg from implanting in the uterus. The drugs are not related to the controversial RU-486 pill, which induces an abortion after pregnancy. Emergency contraception is most effective when taken right after having sex, but can be effective within 120 hours after having sex. The study found that the women who had been given the pills in advance used them within the first 12 hours of unprotected sex.
Unreliable?
Dr. Mike Wasserman, a pediatrician at Ochsner Clinic Foundation in New Orleans who often sees teenagers with unplanned pregnancies, said giving young women emergency contraception makes sense. But he said the study's reliance on feedback from the teenagers may play a factor in its results.
"The big fault is you're going on what the kids tell the interviewers. Teenagers all lie -- upper-class, lower-class, black, white -- you can't believe them," Wasserman said. "If I have a teenager come in and tell me they aren't sexually active, I don't believe them."
He said there may be enough participants involved in the study to make those who may have lied statistically insignificant.
John D. Lane, president of the Catholic Medical Association, which has been a vocal opponent of making the morning-after pill more accessible, said he believes long term studies are needed on the subject. Also, he said preventing teens from having sex is the more important issue.
"I think people misunderstand the true meaning of human sexuality. Sex should be limited to the married state," Lane, a family physician, said. "Our problem is we look at sex as something recreational instead of a commitment."