Teens, Pregnancy- Never Mix The Two!

The 15 year-old had what she thought were gas pains for the past several months.  Then one day the pains became terrible, she came to the Emergency Department, and delivered a baby.  Then the doctors and nurses had their usual debate- did she really not know she was pregnant?  The missed periods?  The growing mass in her abdomen, that moved?

Yes, sometimes teenagers can be pregnant and not know it.  Some have periods so irregular they skip them.  Some are overweight enough to hide pregnancy.  Baby movements are interpreted as gas cramps. Then there’s that all powerful denial: Pregnant?  Nah, not me!  I remember going into a room to tell a teenager that her pregnancy test was positive.  She was so insistent, even pleading, that she didn’t have sex, that it was impossible for her to be pregnant, that I began to doubt it myself.  But she was pregnant in the face of the obvious- her missed periods, her morning sickness, and that positive test.

These teens evoke lots of other emotions in the adults around them, besides  bewilderment that they didn’t know they were pregnant, all the way until delivery.  Parents can be angry and frustrated.  We warned her about using birth control!  How could she make such a terrible mistake!  The doctors and nurses often just sigh about it- another teenage mishap, they’ve seen it before.  

Unfortunately, many teens are hard-wired to make such mistakes.  Teens are like toddlers, in that they like to explore.  But instead of toddling around the house looking for trouble in a 2 1/2 foot-tall frame, they are adult-sized, with raging hormones.  They want to try all the risky behaviors- drinking, driving, sex- with no thought to consequences.  It’s just the way they are.

Here is a short list of those consequences of teen pregnancy.  They visit the ER often, for the abdominal pains that accompany pregnancy, for morning sickness, for fatigue.  Their infants are born prematurely more often than for adult moms, giving the newborn a whole host of it’s own medical complications.  And pregnant teenagers may be at higher risk of death during childbirth than adult women.

Here’s a common conversation I have with teenage girls in the Emergency Department:  “Do you want to get pregnant?” I ask.  “No!” she replies.  “Are you using birth control?”  “No,” she answers.

As we discussed above, teenagers are bad at prevention.  They don’t consider the consequences of actions like unprotected sex.  They just do stuff, like drinking or driving too fast, and worry about the fall-out later.  After the crash.  Or the positive test.

Also, teens are under-prepared for pregnancy prevention.  Besides not getting enough sex-education, the education often doesn’t dispel common myths about how to avoid pregnancy.  Many teens think that if they have sex in certain times of their menstrual cycle, they’re safe.  Some have even more magical-thinking: that drinking Mountain Dew or doing jumping jacks afterward works. Many parents are uncomfortable discussing sex and birth control with their teens, for religious reasons, or denial that their “little girl” would ever do that, or just plain embarrassment.

However, discussing birth control with your daughter is way easier than if she actually got pregnant. Besides risking those medical complications we discussed above, teen pregnancy often comes with depression.  Then there’s that baby to raise.  Babies cost a lot; babies equal poverty.  Read the years of columns I’ve written on child care, remember all the foibles you experienced raising your own kids; then imagine your teen in that position.

Step one in preventing pregnancy is to teach kids BEFORE they’re teens.  Effective sex education begins in the pre-teen years, while kids are still good listeners, before the eye-rolling age, while they still think about consequences.  They should learn that pregnancy can happen any time in their cycle, with any single encounter.  They should learn about birth control and Sexually Transmitted Disease prevention. HIV rates are rising- you don’t want your kid getting that life-long, life-threatening disease!

Finally, teach them about the Plan B pill.  As teens often do, they have sex and then worry about pregnancy after.  That’s the time for Plan B, as soon as possible, within 72 hours.  Plan B is available in pharmacies without prescription, without needing an adult to buy it.  It may just save her life, and the life of a future, premature baby. 

Teen Pregnancy- A Big Accident Waiting To Happen

She really was in a fix.  She spoke only spanish.  She was a teenager alone in this country with only her father, and he was pretty mad right now.  She was having belly pain and didn’t understand why- until I broke it to them that she was pregnant.  She would come to the Emergency Department two more times that month with the same complaint- pain and nausea.  After making sure the pregnancy was okay, I would again explain that this is how pregnancy is.

Sigh.  If only more teenagers would know this before they got pregnant.  Most teenagers are told at least once about the chores of pregnancy- pain, nausea, weight gain, fatigue. And about that screaming, pooping baby after.  But alas, teenagers aren’t good listeners.  Like toddlers, they are better explorers, and have to try things out for themselves.  But unlike toddlers, they get to try driving fast, drinking alcohol, staying out late, and sex.

Some parents abet their teenagers’ exploration.  These parents explain this way- better that my kid tries these things at home where I can monitor their safety.  They let their teen and friends drink at home, stay up, and even have a live-in boyfriend or girlfriend.  They believe this makes a friendly relationship with their teen, and they can be there when the teenager fails.

Unfortunately, with sex, the failing is pretty hard.  When a teen drinks too much, they usually can sleep it off and weather the hang-over.  When my daughter missed a turn and skidded off the road into a ditch, she was unhurt and it was only a bumper repair.  But when a teenager gets pregnant, the aftermath isn’t so easy.  Pregnancy is a life-changing event that can’t be shaken off like a hang-over.  What about the birth control I got my daughter, or the condoms I bought my son?  Well, just like driving a car safely takes experience, taking birth control pills daily or using barrier methods properly in the heat of the moment requires care to get right.  And if they don’t get it right…

So you ask, what can we do?  Teenagers want to try stuff- driving fast, drinking, sex.  You tell us that teens are going to try these no matter what we say- they are better explorers than listeners, right?  And like our permissive parents above, letting the teen do these things at home where we can watch is a bad idea, because we still won’t be there at the crucial moment to prevent pregnancy.  So again, what to do?

The first thing is to explain the facts of life before your kids are teens, when they are still good listeners, before they become eye-rollers.  Elementary school age is best to discuss safe driving, drinking, and sex.  This is when you teach about the miseries of pregnancy, and how the fun-loving teen years are over when baby comes.  How tiring it is to feed baby and listen to all that crying .  Dirty, stinky diapers.  Spitting up.  And how if you have a baby with someone, that binds you as parents for the rest of your lives.  That guy may be cute now, but do you want to be raising a child with him, stuck together forever in a loveless pseudo-marriage of co-parenting?

Second, for those parents who are permissive so they can monitor their teens drinking and partying, stop!  Teens don’t need their parents to be friends; they have friends.  Teens actually want a parent who is an authority figure.  Teens know they may act out-of-control, and a parent who sets guidelines is a comfort.  My wife and I are pretty careful about where we let our youngest daughter go, and once when we okayed her to go to a party, she did a double-take: “Wait, you’re actually letting me go?  What if there’s drinking?”  She seemed a little disappointed that we didn’t say no.

Teen pregnancy and parenting is a chore, thousands of times worse than having to do the dishes or make the bed.  Warn your kids when they are young and instill those guidelines, so that they are well aware of the Big Accident waiting to happen, before it does.

No, Drinking Mt. Dew Will NOT Prevent Pregnancy!

This happens at least once per month, the last time just three weeks ago.  A teenager comes into the Emergency Department complaining of abdominal pain, vomiting in the morning for a week or two; and by the way, has not had a period for three months.  When her pregnancy test comes back positive, her denial is profound.  “No way, its impossible that I’m pregnant!” she cries.  In fact, sometimes the teenager seems so convinced that she can’t be pregnant that I begin to wonder if the test was wrong.

Then after further questioning, her denial begins to fall apart.  “I didn’t have sex” becomes “I didn’t have sex in the past four months.”  That is followed by “I didn’t have sex in the bad part of my cycle.”  Did you use birth control?  “Yes!”  How many times?  “Once.”  Aha.

Teenagers who get pregnant sometimes mean to get pregnant.  Many times though, they get pregnant because they had wrong ideas about pregnancy prevention.  Not only do teens have wrong beliefs about how pregnancy happens, they often have almost magical thinking about how they cannot get pregnant. 

Here are some of the wrong beliefs teens have about getting pregnant (remember, the following are ALL WRONG!): You can only get pregnant at certain times of the month.  You can’t get pregnant the first time you have sex.  Drinking Mt Dew, sipping a little clorox, or doing jumping jacks after sex can prevent pregnancy.

Furthermore, some teens get even more odd, almost magical, beliefs about their invulnerability to pregnancy.  For example, they come to believe that they or their partner are sterile.  How they get to this idea is strange, since sterility is a diagnosis that is pretty much made after seeing a fertility specialist and a battery of tests.  What teenage male of female has undergone that?  Or sometimes, a teenager just plain denies that she can get pregnant.  Oh no, not me.

However, the truth is this: if you have sex once, at any time, you can get pregnant.  Period.  End of Sentence.  No Buts.  Birth control or not.

If you don’t want your teen to get pregnant, and you want to get around the odd beliefs, start talking to her (and him!) before they are teens and are prone to magical thinking.  Talk to them when they are in elementary school and junior high.  Make sure they know that sex = risk of pregnancy, and only abstinence or birth control can prevent it.  And birth control is not perfect.  After all, birth control requires forethought and can be a little tricky to get right, like driving a car.  How good is your teen at driving a car?

Finally, I have one more thing to say.  Any time you have sex, you can get pregnant.  Got it?

Babies Having Babies

Take it from me, the father of three teenagers: teenagers are trouble.  They whine and grump when asked to do the dishes, fold clothes, or clean up.  They beg for fast food day and night.  The good manners they practiced just a few years ago are forgotten.  Now, I say all this in fun, because my teens are essentially good kids, as are most teens.  But if you want a truly difficult and unhappy teen, with a truly miserable life, have a pregnant one.

First, there are the usual problems with pregnancy.  There is often pain, as baby grows inside, and the pain of delivery.  There is morning sickness and abnormal bleeding.  There are worries about infections and miscarriages.  Now, give all these problems to a teenager- guess how well they will handle them?  Added to that, teen pregnancies tend to be more complicated, with things like  high blood pressure and premature birth. 

Secondly, there are the emotional problems of teen pregnancy.  How will I raise baby- change diapers, feed baby, get baby to sleep (you think chores are hard now!)?  Will the father be involved?  If so, can I stand to be associated with him for the rest of my child’s life?  What will my parents think, and do?  Teens, not surprisingly, have much worse problems with depression after delivery than adult moms.

Finally, after baby is born, the life of a teen mother with baby is very hard.  Being a teen mom is a sure way to poverty- raising babies is hard enough without having to finish school or hold down a job, and babies are very expensive to clothe, feed, and entertain.   Babies of teens are more often premature, and thus sicker, and need to be brought to the doctor or the Emergency Department much more.  A depressed teen mom makes for a depressed and fussy baby.  Many teens have babies so that they will have a baby to love them, and are often disappointed that babies at first give so little love for all the hardship. 

So what is the best way to avoid the living hell of teen pregnancy?  For parents, showing your teen this blog will probably not work.  Scare tactics seldom have an effect on teens.  They are not rational decision makers, much like toddlers.  You need to talk to your child before they are in high school, or even junior high.  The age you can teach your kid about not getting pregnant is when they are in grade school.

Parents, get to work!  Have that uncomfortable conversation (it actually is pretty easy with grade-schoolers) now, so your babies don’t have babies before their time is right.