NHS urged to relax rules on morning after pill for teens

Free condoms and the morning after pill should be more readily available to the under-25s through school nurses and GP surgeries.

That is the latest advice from the National Institute for Health and Care Excellence (Nice), which provides independent advice to the government.

Allowing some teenagers to take home emergency contraception as a pre-emptive measure will also help to reduce unwanted pregnancies, Nice added, repeating its 2010 call for a “small number” of pill to be prescribed before unprotected sex has taken place where appropriate.

Young people currently find contraceptive services difficult to access, Nice added.

Although under-18 conception rates have fallen, England still has one of the highest teen pregnancy rates in Europe, and carrying out abortions for under-25s in the UK costs the NHS around £53m a year.

Under the plans, Nice said that qualified school nurses and pharmacists should be able to dispense free emergency contraceptive pill without the need for a prescription. There are two types of emergency contraceptive pill: Levonelle has to be taken within 72 hours (three days) of sex, and ellaOne has to be taken within 120 hours (five days) of sex. An IUD (or coil) can be inserted up to five days after unprotected sex.

Teenage pregnancies:

• The latest Office for National Statistics (ONS) figures from February showed that the UK under-18 conception rate was 27.9 per 1,000 women aged 15 to 17 – the lowest since 1969.
• In 2012, there were 27,834 unwanted pregnancies among under-18s, compared with 31,051 in 2011 – a 10 per cent drop.
• Among under-16s, some 5,432 became pregnant in 2012, compared to 5,991 in 2011 – a fall of 9.3 per cent. Among this age group, almost 60 per cent of pregnancies resulted in abortion.
• The figures also revealed that 253 girls under 14 became pregnant in 2012, fewer than the previous year, with almost 75 per cent having an abortion.

‘Stockpiling’ morning-after pill?

Nice also said that young people should be given better advice about where they can access contraception, and which kind would be most suitable for them, so that nobody is denied services because of where they live.

The news was welcomed by Anne Weyman, chair of the independent committee that developed the guidance and former chief executive of the Family Planning Association (FPA): “Nearly half of all pregnancies among 15 to 18-year-olds end with an abortion,” she said. “The new guidance aims to reduce unwanted pregnancies by ensuring that young people have access to a full range of contraceptive methods, not just pills and condoms, but the longer-acting methods, such as contraceptive injections and implants.”

But other groups raised concerns that an increase in the use of the morning after pill would increase risks of sexually transmitted diseases. “Having a stockpile of the morning after pill on hand is a licence for unprotected sex, and that puts young women at increased risk of sexually transmitted diseases,” said Josephine Quintavalle, from Comment on Reproductive Ethics.

Professor Mike Kelly, director of the centre for public health at Nice, said: “It is really important that sexual health services offering information and advice can be found in places where young people have access to them.

“Evidence clearly shows that the availability of contraception reduces the rate of unwanted pregnancies. Local planners and providers of services must make sure that what they offer is right for their area.”

The guidance also said condoms should always be provided in addition to other forms of contraception to cut the rate of sexually transmitted infections.