Scenario


Sarah, 16, and her boyfriend Mike, 17, have recently become sexually active. They have been using condoms that Mike got from her older brother. However, Sarah sometimes gets nervous that they may break.  Sarah has been thinking about it and has decided she would like to start taking some other form of birth control in order to protect herself from getting pregnant. 


Sarah’s parents don’t know she is sexually active and she wants to find out what forms of birth control she can start taking without needing her parents’ consent. She has heard about different contraceptives like the birth control pill or NuvaRing from her friends, but she has no idea whether or not she can get them if she is not 18 years old. 


Eventually she plans on talking to her parents, but she is not ready yet and for the time being she just wants to make sure she is protected.


Information


There is no specific age requirement for accessing birth control. Instead, this is governed by the Ontario Health Care Consent Act, which says that health practitioners (including doctors) can provide treatment (including medication) to patients as long as that patient is “able to understand the information that is relevant to making a decision about the treatment…as the case may be, and able to appreciate the reasonably foreseeable consequences of a decision or lack of decision.” (See s. 4 of the Act).  


If a young person is not capable of understanding info around certain health care decisions, then in most cases it is their parent or guardian who must consent to the treatment. 


In this scenario, Sarah does not need permission from her parents to obtain birth control. Most 16 year-olds, including Sarah, are able to understand the information and issues around birth control and thus they don’t need their parents’ consent before a doctor can prescribe it.  However, it is important that Sarah’s doctor give her complete information about the pros and cons of taking various forms of birth control, including the risks, benefits and potential side effects.  This will put Sarah in a position where she can give her “informed consent”, which is what is required under the law.  (See s. 11 of the Act. ) 


In circumstances where youth feel comfortable and safe talking to their parents or another trusted adult about issues around sexuality, then it may be worth considering whether to discuss contraception issues and questions with them.  


For more on your health care rights, check out this JFCY pamphlet.


Sarah can get a prescription for birth control from her health care provider, from a sexual health clinic, or (if she is in Toronto) from Planned Parenthood Toronto’s Health Services. If Sarah does not have OHIP it is still possible for her to get a prescription from Planned Parenthood Toronto’s Health Services.




Forms of Contraception


While JFCY is not an expert on medical matters or sexual health, we have compiled the following is a list of available birth control options. You will need to discuss them with your health care provider.


Birth Control pills


What is it? 
Pills that contain hormones a woman takes for either 21 or 28 days to prevent pregnancy. 

How does it work?

  • Contains hormones that stop the egg from being released every month

  • Makes cervical mucus thicker to stop sperm from getting to the uterus

Where can you get it? 
A woman gets a prescription from her doctor or a clinic 


Condom (for women)
 


What is it? 
A plastic pouch worn inside the vagina 

How does it work?

  • A woman inserts it before intercourse

  • Catches semen which contains sperm

Where can you get it? 
Drugstores and some clinics 


Spermicides (sponge, foam, gel, contraceptive film) 

What is it? 
Sperm-killing chemicals, usually nonoxynol-9 

Spermicides do not protect against Sexually Transmitted Infections 

How does it work?

  • Placed in the vagina before intercourse

  • Spermicide is released which kills sperm

Where can you get it? 
Drugstores and clinics 

Depo-Provera 


What is it? 
A hormone injection given every three months 

How does it work?

  • Hormone makes cervical mucus thicker

  • May stop eggs from leaving the ovary

Where can you get it? 
From some doctors and some clinics 

Depo-Provera does not protect against Sexually Transmitted Infections. 
Use condoms every time. 


Fertility Awareness Method 


What is it? 
A combination of natural methods of birth control 

How does it work?

  • A woman keeps a record of her menstrual cycle

  • She looks for signs that she is close to ovulation (releasing an egg)

  • She and her partner do not have sex around the time of ovulation

  • The Fertility Awareness Method can be used to make other methods more effective because a woman knows when she is fertile and can use a second method e.g. condoms

Where can you get it? 
A woman can take a course to learn how to use this method effectively 

Emergency Contraception 


What is it?

  • Methods used if a condom breaks, if there is unprotected sex, or in the case of a sexual assault

  • Two methods to choose from are the Emergency Contraceptive Pill or the Intra-Uterine Device

Emergency Contraceptive Pill 

What is it? 
Pills containing hormones 

How does it work?

  • Usually stops sperm from meeting the egg

  • Also works by stopping the embryo from attaching to the uterus

  • Should be taken as soon as possible after unprotected sex

  • Can be taken up to five days after unprotected sex

Where can you get it? 
Clinics and some doctors. It is available without a doctor’s prescription at drugstores in Ontario. 

The Patch 


What is it? 
The patch is attached to the skin and delivers hormones into the bloodstream. It is changed once a week for three weeks each month. During the fourth patch-free week, the woman gets her period. 

How does it work?

  • Contains hormones that stop the egg from being released every month

  • Makes cervical mucus thicker to stop sperm from getting to the uterus

Where can you get it? 
A woman gets a prescription from her doctor or a clinic 



Nuvaring® 

What is it? 
A soft, flexible ring inserted in the vagina. It delivers hormones into the bloodstream. It is inserted for 21 days and removed for 7 days. A new one is inserted at the end of the 7-day break. 

How does it work?

  • Contains hormones that stop the egg from being released every month

  • Makes cervical mucus thicker to stop sperm from getting to the uterus

The Nuvaring® does not protect against Sexually Transmitted Infections. 
Use condoms every time. 

Where can you get it? 
Consult your doctor



JFCY is not an expert on medical matters or sexual health.  


For more information on birth control listed above please click here



If you are under age 18 in Ontario and have legal questions about your health care rights please contact a lawyer at JFCY at 416-920-1633, or toll-free at 1-866-999-5329.  


Scenario was written by Cemone Morlese, a PLE Team Member volunteer. Information written by JFCY volunteer Sarah Mehta Alexander and a JFCY staff lawyer.