New guidelines on contraceptive services for young people issued by the National Institute for Health and Care Excellence (NICE) have prompted widespread coverage.
The headlines have focused on a number of elements, with The Daily Telegraph reporting that, "Schools are told to give free morning-after pills and condoms to teenage girls to cut unwanted pregnancies", while The Daily Express claims that there is "Outrage as NHS says 'give pupils the morning-after pill'."
The media coverage largely focuses on recommendations to:
NICE is the body that advises on best practice for healthcare in England. These new guidelines aim to improve access to high-quality contraceptive services for young people.
The guidance is targeted at professionals who may have a role in contraceptive services. The wide-ranging recommendations advise on how to assess local need for contraceptive services, and offer culturally appropriate and non-judgemental services to young people.
The publication of the new NICE guidelines was covered very reasonably by the Mail Online website.
The Daily Telegraph also took an initially balanced view. However, it chose to cite only two independent comments, both in opposition to the advice.
Patient Concern described the guidance as "like a way of promoting promiscuity", while a spokesperson for Comment on Reproductive Ethics, known for its links to religious groups, said: "Having a stockpile of the morning-after pill on hand is a licence for unprotected sex". Neither of these statements is backed by the evidence.
The new young people's contraceptive guidance advises those in charge of health-related services in England to give all young people access to contraception. Advice should also be provided at convenient locations so that everyone can get contraceptive services, regardless of where they live.
The recommendations emphasise the need to offer additional tailored support to meet the particular needs and choices of those who are socially disadvantaged or who may find it difficult to use contraceptive services.
There are 12 recommendations set out in the guidelines. The recommendations that have been the main focus of the media attention include:
PDGs are a legal framework established in 2000 that allows some registered health professionals to provide a specified treatment to a predefined group of people without them having to see a doctor.
Treatment provided under PDGs should be reserved for situations in which this offers an advantage for patient care without compromising patient safety.
There are quite a lot of contraceptive methods to choose from. One of the most popular forms of contraception is the combined oral contraceptive pill – usually just called "the Pill" – which contains synthetic versions of the hormones oestrogen and progesterone. When taken correctly, it is more than 99% effective at preventing pregnancy.
Women need to follow the guidance of healthcare professionals on how to use the Pill prescribed for them, including advice on what to do if a combined pill is missed.
The combined pill is not suitable for everyone – there are various groups of women who cannot take it or should take it with caution. Other kinds of contraceptive pill or devices are available.
Read more about the 15 methods of contraception.
A woman can use emergency contraception to prevent pregnancy after having unprotected sex or if a method of contraception has failed. There are two methods of emergency contraception:
Both of these methods are effective at preventing pregnancy if they are used soon after unprotected sex. However, the IUD is always 99.9% effective, whereas Levonelle is very slightly less effective.
The emergency contraceptive pill should not be used as a regular method of contraception. However, if the copper IUD is fitted, this can be used as an ongoing form of contraception.
There are some risks associated with using the combined contraceptive pill. However, these risks are small, and the benefits outweigh the risks for most women.
Oestrogen in the pill may cause your blood to clot more readily. If a blood clot develops, it could cause a deep vein thrombosis (clot in your leg), pulmonary embolus (clot in your lung), stroke or heart attack.
The risk of getting a blood clot is very small, but your doctor will check if you have certain risk factors that make you more vulnerable before they will prescribe the Pill. These risk factors include being a smoker, being overweight, having high blood pressure, or having a personal or close family history of blood clots.
Research is ongoing into the link between breast cancer and the Pill. Research suggests that users of all types of hormonal contraception have a slightly higher chance of being diagnosed with breast cancer compared with women who do not use them. However, your risk of breast cancer returns to normal 10 years after you stop taking the Pill.
Research has also suggested a link between the Pill and the risk of developing cervical cancer and a rare form of liver cancer. However, the Pill does offer some protection against developing endometrium (lining of the womb) cancer, ovarian cancer and colon cancer.
Taking the emergency contraceptive pill has not been shown to cause any serious or long-term health problems. However, it can sometimes have side effects. Common side effects include:
Less common side effects include:
When the copper IUD is inserted, it needs to be ensured that there is no current sexually transmitted infection, as an existing infection can be worsened by inserting the IUD.
Pain or discomfort is the most common side effect immediately after inserting the copper IUD. In the longer term, side effects include the possibility of heavier or more painful periods.
Everyone makes mistakes, but if you find yourself relying on the morning-after pill as a regular method of contraception, you may want to speak to a healthcare professional about what would be the most suitable form of ongoing contraception for you to use. This could include methods that do not involve needing to take a daily pill, such as contraceptive patches, injections or an implant.
However, none of these methods will protect you against sexually transmitted infections (STIs). Condoms are cheap, free of side effects and they will protect you against STIs such as chlamydia.
For more information about your contraception options, visit the Contraception guide. If you have any health questions and want to speak to someone in confidence, call: