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.