In the United States, many barriers limit teens' access to sexual health services. Barriers may include transportation difficulties, high cost, fear of invasive procedures, limited clinic hours, disapproving health care personnel, and fear of parental disapproval. Societal negativity about teenage sexuality combined with significant barriers to health services may encourage sexual risk behaviors by teens.

As a health care professional, you can play a key role in ensuring that young people have confidential access to emergency contraception. Studies show that, once informed about emergency contraception, approximately three-quarters of young women report that they would be likely to take the pills if they needed them. How can you educate youth about emergency contraception and ensure availability for them?

I. Commit to providing emergency contraception.

• Register to be included in the directory of providers.
• Make emergency contraception available in various settings. Sexually active teens may not visit family planning clinics if they are using condoms. Provide emergency contraception in both clinical (family planning clinics, school-based health centers, health departments and physicians' offices) and non-clinical settings (pharmacies, community-based organizations, and youth-serving organizations).

II. Improve service delivery.

• Create "teen-friendly" office policies and/or procedures that welcome ALL youth including teens whose sexual health needs are often overlooked, such as lesbian and bisexual young women.
• Ensure that clients are able to receive EC in a timely manner.
• Simplify the response for times when young women call and report having had unprotected sexual intercourse. Take a medical history over the phone, and assess if the young woman needs emergency contraception. If she is aged 17 or over, inform her that she can go to her local pharmacy and obtain EC without a prescription. If she is under the age of 17, call in a prescription to her pharmacy. If phone assessments are not possible, be sure to accommodate walk-in appointments.
• Educate ALL staff on EC. Train receptionists, volunteers, and medical assistants, as well as counselors and clinicians on the office policies and/or procedures that are related to EC.
• Use pregnancy test visits as an opportunity to discuss EC and to counsel the young woman about regular methods of birth control, as well.
• Provide telephone referral to another emergency contraception provider that may be more financially and/or logistically convenient for a teen.
• Develop formal referral networks among family planning clinics, hospitals, health maintenance organizations, school-based health centers, physicians' offices, community-based organizations, pharmacies, and local health departments.
• Provide specific instructions on EC for the office or facility, as well as provide information on the office's voice mail and a sign on the door describing how to access emergency contraception whenever the office/clinic/pharmacy is closed.

III. Educate teens about emergency contraception—before they need it!

• Provide teens with information about where to obtain and how to use emergency contraception. Posters and patient education pamphlets should be noticeable in waiting areas. Provide teens with the specific language in which they can request emergency contraception over the telephone, for example, "I need to speak to someone about emergency contraceptive pills."
• Invite a young woman's partner into counseling sessions. Educate the couple together about emergency contraception. Increase young men's comfort by providing magazines and posters that target men in the waiting room.
• If the young woman is under age 17, provide her with a prescription for emergency contraception during routine visits. If the woman is age 17 or over, explain to her that she can get EC at her pharmacy anytime without a prescription. Anticipatory provision will ensure that young women can use emergency contraception as soon as possible after unprotected sexual intercourse. Young women who have emergency contraception in advance may begin treatment sooner than those with a prescription that will have to be filled.

IV. Provide teens with emergency contraception—when they need it.

• Assure teens that all emergency contraception services are confidential, whether the services occur face-to-face or over the telephone. Inform teens that using their parents' medical insurance may result in the health plan sending parents forms for billing or services rendered.
• Use a system of sliding-scale fees to provide low-cost or free access to emergency contraception.
• Provide emergency contraception without a pelvic examination or pregnancy test, reducing financial and psychological barriers.
• Encourage teens seeking emergency contraception to adopt a regular contraceptive method in the future. Providing emergency contraception can create a bridge to regular reproductive health care for sexually active teens.
• Teens who have been forced or coerced into genital sexual activity should receive emergency contraception, HIV/STI testing and counseling, contraceptive counseling, and referral to important social services, as mandated.