NICE guidance on young people and access to contraceptive services

Today, NICE released evidence-based guidance entitled ‘Contraceptive services with a focus on young people up to the age of 25’, which calls for improved access to contraception for young people. 

The guidance sets out various actions which it suggests will improve young people’s access to contraception, and thus decrease unplanned pregnancies amongst under 25s. As you may know, the teenage pregnancy rate in England and Wales is currently the lowest it’s been since 1969, but still remains one of the highest in Western Europe.

The guidance provides practical suggestions for improving young people’s access to sexual health services such as ensuring that services are:

• Accessible (have flexible opening hours and accessible materials for those with learning difficulties, or for whom English is a second language)

• Comprehensive (give information on the full range of contraceptive options, including the insertion of an IUD as a method of emergency contraception)

• Practical (youth-focused services based in schools and colleges, where young people can access them easily)

• Non-judgemental (staff should be trained and supported to offer impartial information)

We were glad to see that NICE specifically mentions the importance of access to contraception following pregnancy, encouraging professionals to "dispel the myth that there is no need for contraception after an abortion and explain that women are fertile immediately following an abortion." We have long been concerned that the myth that abortion causes infertility, often touted by anti-abortion groups which visit schools, may have an impact on a young woman’s access to contraception following an abortion.

The media reaction to the guidance has been interesting, with some outlets focusing on NICE’s suggestion that emergency hormonal contraception (EHC) be available in advance of sexual activity (rather than just obtained following unprotected intercourse).

The guidance states that "the evidence shows that advance provision of oral emergency contraception does not encourage risky sexual behaviour among young people. Evidence also shows that women who have emergency contraception in advance are more likely to use it, and to use it sooner after unprotected sex. Having emergency contraception on hand does not affect the use of other kinds of contraception."

Certainly, we have heard anecdotally of young women’s difficulty in obtaining the morning after pill. Some pharmacists refuse to give EHC to younger women, or attempt to charge them (at around £20 this can be too much for many teenagers). Some young people living in rural areas might struggle to get hold of EHC, especially in the first 24 hours after unprotected sex, when it is most effective. It makes sense to improve access to EHC for those who need it, to ensure it can be taken when needed, as quickly as possible.

However, some newspapers seem to think that there is a danger young women will ‘stockpile’ EHC. The Telegraph opens with:

“Teenage girls will be able to stock up on the morning-after pill under new NHS guidance which will allow young women to pre-order the drugs, despite Government fears the move will increase promiscuity.”

An interesting concept. These young women, who are seen as too feckless to access contraception before having sex, are organised enough to plan to ‘stockpile’ EHC in advance of having sex. Which is it to be, lazy and incompetent or cunning and prepared?! EHC is a form of contraception, which young people already have free access to. NICE is simply stating that it might be helpful for some young women (particularly those who live in rural areas, perhaps without their own transport) to be able to access EHC in advance, in case they ever need it.

We’re glad to see such sensible, evidence-based guidance being issued, we only wish the media could resist scare-mongering around young people and contraception, and that access to sexual and reproductive health could be rid of such stigma.

'Youth For Choice' blog launches today!

Our fabulous young volunteers have been busy working on a social media project and it’s finally here. Introducing the new ‘Youth For Choice’ Tumblr!

Our volunteers decided that it was about time for a youth-led blog in the UK which focuses on sexual health and reproductive rights. Young people giving other young people FACTUAL information about sex, pregnancy, abortion and related topics. All our bloggers are 16-25, and are contributing written blogs, photos and film clips from all over the country.

Here’s Kathryn, 19, on why she got involved with the project:

“I’m a firm believer in women having control over their own bodies and their reproductive rights – through contraception, abortion and other ways. I feel that people need to have choice over what they do with their body, and not be coerced or pressured into doing something because they feel it’s the right thing to do, or that they have no other option. And that’s why I’m excited to be involved in this Tumblr. Because one of the ways you help to give people choice is through sharing information with them, and I think this is especially important for young people, who might have a harder time getting access to quality information about sexual health and all the other stuff that goes with it. We might not be taken seriously, or be told both sides of the story when it comes to reproductive rights and sexual health. And when this happens, how are you supposed to make an informed choice about what’s going on with your own body? This is why I think this blog is going to be so good – it’ll give young people a good source of news and information about stuff that’s really important to us.”

 So please follow the Tumblr and share the link with your friends and colleagues!

Life-saving vaccine denied to girls

When the UK Government first decided to provide the human papillomavirus (HPV) vaccine to all girls it was met with opposition from those who claimed that it would 'fuel promiscuity'. Of course this is nonsense and everyone who works in sexual health with young people said so at the time. 


Either the vaccinations would be given with no explanation to the girls of the fact that HPV is a sexually transmitted infection in which case most girls would make no connection – either positive or negative – between the vaccine and sexual activity OR – obviously the option we favoured – the vaccination programme would be used as an opportunity to do some sexual health promotion. This work would:

• celebrate the fact that this vaccine could prevent the majority of deaths from cervical cancer 
• encourage girls to have regular pap or 'smear' tests once they are old enough 
• talk about minimising risk factors for other cancers and the importance of regular breast checks for adult women and testicular checks for men
• outline the risks for men of contracting HPV 
• emphasise that the vaccination does not give them protection against any of the other panoply of STIs or, of course, against pregnancy. 

I haven’t found much information about what education or information is being provided alongside the vaccination, but this study suggests that offering and giving the vaccine has NOT changed young women’s sexual behaviour, turned them into wild nymphomaniacs; or caused them to throw their condoms on the bonfire and caution to the wind.


Today this article reports on schools that are not providing the vaccination because ‘their pupils follow strict Christian principles and do not have sex outside marriage’. So, first the vaccination was rejected because it would promote unsafe sexual behaviour and now it is rejected because pupils in some schools don’t need it as they will definitely not have sex outside of marriage.


Even if it was true that girls who commit to chastity in their early teens don’t ever end up having pre-marital or extra-marital sex (clue: it isn’t), it doesn’t take account of the fact that an abstinent girl can be raped, can be coerced into sex, or can marry a man who has previously had sex and is infected with HPV. 

Approximately 1,000 women in the UK die each year from cervical cancer. Clearly the schools that are rejecting the vaccination think that this is a risk worth taking....

More on risk perception following vaccination

Mothers and adolescents' beliefs about risk compensation following HPV vaccination