A full 20 percent of American women give birth before the age of 20. This is more than any other developed nation. To combat this growing problem, the Food and Drug Administration approved Plan B to be legal without a prescription for females 15 and older, starting this summer. The product will be available in retail outlets with pharmacies. But the pill can be sold during non-pharmacy hours, too.
The key ingredient in Plan B - approved in 1999 - is a synthetic hormone called levonorgestrel. This drug stops an egg from being released from the ovary, or preventing fertilization of the egg by sperm. If there has been fertilization, Plan B may prevent a fertilized egg from embedding in the uterus. But if the egg has already been implanted in the uterus, the morning-after pill will not work.
Emergency contraceptives are intended for use within 72 hours after sex but are most effective if taken within 24 hours.
Along with women's health groups, much of the medical world has supported the use of emergency contraception as safe and effective.
"Research has shown that access to emergency contraceptive products has the potential to further decrease the rate of unintended pregnancies in the United States," said FDA Commissioner Dr. Margaret A. Hamburg in a statement two weeks ago. "The data reviewed by the agency demonstrated that women 15 years of age and older were able to understand how Plan B One-Step works, how to use it properly, and that it does not prevent the transmission of a sexually transmitted disease."
Even President Obama said last Thursday that he was "comfortable" with the FDA's decision.
No doubt that it's important for women to have control over their health care choices. This ruling, indeed, protects minors by ensuring no unreasonable delays are put in their way to avoid becoming pregnant.
But it is not enough to offer them contraception and to explain to how to use it.
We need to convince them that they want to use it; that they and their children will be better off if they wait to become mothers. In short, we need to present girls at risk of becoming pregnant with an attractive alternative.
Facing limited education and job prospects, as well as a slim chance of finding a suitable man to marry, ethnographic work on young, single mothers shows that many low-income women simply ask, "Why not have a baby now?"
We need to help young people navigate reproductive decision-making by giving girls AND boys a reason to believe that there are accomplishments in their future. Adolescent girls aren't ambivalent about pregnancy independent of their relationships. There is a lot of good emerging research about male ambivalence toward pregnancy being an important factor their partner's ambivalence and even in contraceptive non-use.
This all isn't to say we should abandon our traditional approaches to fighting teen pregnancy. They do deliver benefits. For instance, greater access to contraception may not prevent many teen births, but it prevents some, and it is a cost-effective strategy to pursue. It also provides teens that are seeking to prevent a pregnancy a way to achieve that goal.
But to really drive down rates of teen childbearing, we need young women becoming teen mothers to see a reason to delay motherhood. They need to believe that they have reason to invest in their futures, and they need a viable way to do so. Education on a broad spectrum is where we need to focus our efforts.
Sarah T. Schwab is a Sunday OBSERVER contributor and Fredonia State graduate. Send comments to
or view her Web site at www.SarahTSchwab.com