A&E not the place for morning after pill

By Tracey Sparling

IN a moment of panic, more and more girls who suspect they might get pregnant, are turning up at Ipswich Hospital's A&E department to ask for morning after pill.

But A&E is not the right place to get contraception, and Health and Social Services Editor Tracey Sparling finds out where people should go.

The worry comes in the week that MPS are told making the morning after pill available in schools has not led to any drop in teenage pregnancies.

SHE needs help - and fast, but where is there to turn?

Increasing numbers of young girls are turning up at Ipswich Hospital's A&E department, asking for the morning after pill.

Fearful of finding themselves a teen-mum like Coronation Street's Sarah-Louise, they head to the town's emergency department anxious to save themselves from the potential trauma of premature motherhood.

But this is not the right place to go, say concerned staff who are today urging people to learn the facts - and make a more informed choice about how to have safe, protected sex.

With anti-abortion campaigners having rowed extensively over the last few months about the morning after pill being made available at the forthcoming V2002, Ipswich Hospital's A&E staff have urged girls to get the contraception from the right source.

Judith Williamson, sister in Accident and Emergency said: "Lots of young girls are presenting at A&E for the morning after pill. A total of 121 people attended during past year, plus average of 100 attended the sexual health clinic for emergency contraception during past year."

She specialises in family planning, and added that the reasons for the rising demand are varied.

She said: "They include lack of education and information, poor understanding; not knowing how to access services and the fear of parents finding out teenagers are having sex."

The news comes as the rate of teenage pregnancies in Suffolk continues to soar - between 1992 and 1997 Town ward in Ipswich had 67 under18 girls per 1,000 pregnant.

Making condoms and the morning-after pill available to schoolchildren has not led to a drop in underage pregnancies, MPs were told this week .

There is "no evidence" that a huge increase in the take-up of the morning-after pill by teenagers has led to the expected decreases in teenage pregnancies, according to Dr David Paton, from Nottingham University.

The findings follow controversial government proposals to hand out emergency contraception to teenage girls in school, following a pilot scheme.

Dr Paton said: "The he most dramatic figures are for the morning after pill, its use has really shot up for under-16s but there's no evidence that this is reducing conception rates. The Government's policy does not seem to be working."

Dr Paton added: "If youngsters have sex at the weekend because "they can get the morning after pill in school on Monday' it may increase teenage pregnancy and abortion rates."

Of course not all teenage pregnancies are unplanned, or unwanted, but such worrying statistics prompted Geri Haliwell to back www.likeitis.org.uk to make sure girls are well informed.

French authorities, in a bid to prevent unwanted pregnancies, also offer emergency contraception or 'the morning after pill' in schools without the need to see a doctor.

But in England the morning after pill remains a medical matter.

Ms Williamson said: "It prevents approximately three out of four pregnancies. It should not be used as a regular method of contraception - it is an emergency method to be used when regular methods fail."

Ms Williamson said there are many misconceptions about when you can't get pregnant, including; you can't get pregnant when you're having a period, standing up, or the first time you have sex.

She said: "All of the above are incorrect. You might get lucky but the chances are you won't.

"The aim of family planning clinics isn't to plot against parents and encourage teenagers to have sex, but to recognise that teenagers are going to have sex and advise and inform them, enabling individuals to make a choice and take some responsibility for their actions.

"Studies have shown that where teenagers are given reproductive health information and access to services to enable them to make an informed choice, pregnancy rates and incidences of sexually-transmitted infections fall, and the average age of beginning a sexual relationship increases.

"This doesn't alter the fact that it is against the law for heterosexual under 16's and homosexual men under 18 to have sexual intercourse."

Ms Williamson added: "Because hormonal contraceptives are medicinal products, they need to be prescribed. You need to attend a family planning clinic, sexual health clinic or GP surgery to see a qualified nurse or doctor who will take a detailed medical history, advise on appropriate methods of contraception and tell you how to use it correctly and effectively.

"Some methods of contraception may be potentially dangerous or ineffective for some people. "Seek advice, don't just take your friend's, mother's, sister's pill - it may not be effective for you."

Her words come after a recent report revealed a one-off lesson improves teenagers' knowledge about emergency contraception - without encouraging them to have sex.

Researchers at the University of Bristol found that a single lesson with a trained teacher was enough to significantly improve teenagers' knowledge of the correct time limits for using emergency contraception after sex.

In the study, around 1,850 pupils aged between 14 and 15 at 12 mixed state secondary schools in the South West were given a lesson on the use of emergency contraception.

Another similar sized group from 12 other schools were specifically not given the lesson until after the study had been completed.

The researchers found that after six months, the proportion of pupils knowing the correct time limits for using emergency contraception was significantly higher among those teenagers who had received the lesson.

The lesson did not increase the pupils' level of sexual activity or their use of emergency contraception, such as the morning-after pill, the researchers said.

"The change in the pupils' knowledge may not translate to a change in behaviour as so many other factor undoubtedly play a role,'" said the report, published today in the British Medical Journal.

"However, educating teenagers on the time limits for the use of emergency contraception after unprotected sex is more likely to have an impact on behaviour than say, encouragement to use a condom.'"

The study was carried out by Dr Anna Graham, from the University of Bristol's division of primary health care.

She said teenagers were not taught enough about emergency contraception in schools and that as a result, many teenagers had no idea how long after sex things like the morning-after pill were effective for.

"The idea was to demystify this method of contraception, which is a good method of contraception if you need a back-up - if you forget to wear a condom, if you forget to take the pill, or if the condom breaks,' she said.

"We have to be realistic, these kind of things do happen. It is better to stop a pregnancy at that point, rather than by an abortion, when someone is not planning to have a baby."

Weblinks:

www.likeitis.org.uk

www.netdoctor.co.uk/sex_relationships/facts/morningafterpill

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Panel:

Free emergency contraceptive pills can be taken up to 72 hours after sex - the sooner the better.

Where to go?

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In addition to GP surgeries, sexual health clinics, some chemists for £20, and some A&E departments (not Ipswich), you can access family planning clinics every working day, at:

Trottman Court in Lower Brook St Ipswich, Allington Clinic in Woodbridge Rd Ipswich, Gainsborough Clinic in Clapgate Lane Ipswich, Stowmarket Clinic in Chilton Way, and Felixstowe Clinic in Constable Rd Felixstowe.

The senior midwife in the maternity department of Ipswich Hospital can also dispense it.

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Sessions led by a trained nurse advisor, who can give contraception and sexual health advice and information, give out condoms and emergency contraception, and do pregnancy tests, are held in:

Leiston Community Education Centre, Stowmarket Leisure Centre, Whitton Health Centre and Rochford House Woodbridge.

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Bodywise is a drop-in sexual health service for staff and students at Suffolk College, or the dedicated Sexual Health clinic at Ipswich Hospital.

Any information given to staff at clinics or surgeries is confidential between yourself and the nurse/doctor/health advisor/receptionist and legally cannot be discussed with anyone else.

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For advice out of office hours, contact NHS direct on 0845 4647 and for out of hours emergency contraception contact the senior midwife at Ipswich Hospital.

Weblink: www.ypsh.net

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Types of contraception:

The Pill

The risk of pregnancy with the Combined Pill is virtually nil, but its effectiveness depends upon correct usage and it offers no protection against sexually transmitted infections.

The pill can also increase the risk of developing certain medical conditions.

Injectable Contraceptives

An injection and then you don't need to worry about contraception until the next injection is due.

There can be a delay in the return of normal fertility of up to one year.

Condoms

The only method of contraception currently available to be used by men and are stated as being 98pc effective from preventing pregnancy if used correctly.

They also protect from sexually transmitted infections.

Implant

A small flexible rod which can stay in place, under the skin of the upper arm, for three years. It releases the hormone progestogen into the body.

Intrauterine Device (IUD/Coil)

A device that sits in the womb, to stop the sperm meeting the egg or stop an egg settling.

The coil needs to be fitted by a doctor and can stay in place for three to 10 years.

Diaphragm/Cap

Prevents sperm travelling through the cervix and meeting the egg.

They are stated to be 92-96 per cent effective and need to be fitted by a trained nurse or doctor every 12 months.

Natural family planning

This uses several fertility indicators to identify fertile and infertile times of your menstrual cycle, showing when you can have sex without risking pregnancy.