Age restriction lifted for emergency contraception

A federal judge has ruled that emergency contraceptives (ECs) be available in pharmacies over the counter without age restriction, allowing easier access to girls aged younger than 17 years who previously required a prescription from a health care provider for the medications.

The American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG), and the Society of Adolescent Health and Medicine (SAHM) commended the order that overruled the US Department of Health and Human Services’ decision in 2011 to restrict availability of drugs that prevent pregnancy after sexual intercourse from young girls.

In his decision, Judge Edward R. Korman of the US District Court for the Eastern District of New York concluded that restricting ECs for girls aged younger than 17 years was not based on scientific evidence.

The AAP, ACOG, and SAHM have contended that pregnancy carries greater safety risks for adolescents and young teenagers than the “morning-after” pill. In a press release, they said the court’s decision “reflects the overwhelming evidence that emergency contraception is safe and effective for all women of reproductive age.” In addition, ECs taken up to 120 hours after intercourse can help to prevent unintended pregnancies after contraceptive failures, unprotected sex, or sexual assaults.

“While pediatricians recommend that teens delay sexual activity until they fully understand its consequences, we strongly encourage the use of contraception-including emergency contraception- to protect the health of our adolescent patients who are sexually active,” said AAP President Thomas K. McInerney, MD, FAAP.

The US Food and Drug Administration has 30 days to appeal the ruling.

Abuse at home a factor for repeat suicide attempts [RAMESH: You can style this new story here as it should be per template]

Children who have been so severely maltreated that they have been legally removed from their parents’ homes are twice as likely to repeat a suicide attempt as their peers in the general population, new research from Canada has found.

Researchers from the Suicide Studies Research Unit at St. Michael’s Hospital, Toronto, looked at data for 6,484 children aged 12 to 17 years who were seen in an emergency department (ED) for first incidence of suicide-related behavior (SRB) between January 2004 and December 2008 and documented repeat visits for SRB in these patients through December 2010. A total of 179 study participants had been legally removed from their parental homes because of substantiated maltreatment. These children and population-based peers were analyzed for demographic, social, and clinical factors and for repetition-free SRB probabilities over time.

Children who had been abused and removed from their homes were 2 times more likely to repeat suicide attempts than their peers after adjusting for age, sex, neighborhood size, income, presence of mental disorder, and severity of the first SRB visit to an ED. Children at risk for repetition also had a high prevalence of mental disorders. Girls aged 12 to 13 years were more likely to attempt another suicide than both boys and children aged older than 13 years.

Findings highlight the importance of assessing a child’s family situation and whether he or she has a mental disorder when evaluating for repeat SRBs. The researchers suggest that clinicians work closely with social workers, child welfare agencies, and those with expertise in child maltreatment to guide treatment plans that will be effective in preventing repeat attempts of suicide among these vulnerable pediatric patients.

Rhodes AE, Boyle MH, Bethell J, et al. Child maltreatment and repeat presentations to the emergency department for suicide-related behaviors. Child Abuse Negl. 2013;37(2-3):139-149.