Preventing unplanned teen pregnancies
By the time teens realize they have no special "immunity" to an accidental pregnancy, it is often too late.
Preventing unplanned teen pregnancies
Rima Himelstein, M.D., Crozer-Keystone Health System
It is normal for teenagers to believe in “the personal fable”: they think they are special and unique (no argument there!) and invulnerable to harm. So naturally they believe that unprotected sex will not result in pregnancy. Couple this belief with the normal pubertal rise in hormones, sexual feelings and curiosity, and we have a problem! About half of all teens have sex before they graduate high school. By the time they realize that they have no special “immunity” to an accidental pregnancy, it is often too late.
One 14-year-old girl was brought to me by her mother, who was concerned because she had not menstruated for the previous four months. In fact, my patient was pregnant—and was stunned when I told her. Another teenage girl had taken birth control pills for many months, never skipping a dose. Then her prescription ran out; after missing several pills, she got pregnant.
The personal fable becomes more powerful when mixed with drugs and alcohol. Some boys have told me that the only time they didn’t use a condom was when they were under the influence, and now they are teenage fathers.
How big is the problem of teen pregnancy? According to a recent report, about 750,000 teen pregnancies (equivalent to half the population of Philadelphia) occur each year in the United States—and 82 percent are unintended.
Failing grades. People have tried many courses of action to prevent teenage pregnancy. Here’s the report card for some of them and they get failing grades:
- Abstinence-only education – “F”. Abstinence-only education has not been shown to be effective.
- Condoms – “F”. Almost all sexually active teens have used condoms, but only half used them the last time they had sex. Seem like a harsh grade? Think about it: sex just once without a condom is enough to get pregnant.
- Birth control pills – “F”. On average, teenagers start using birth control one year after their first sexual experience, but most teen pregnancies happen within that first year. Ideally, if a young woman thinks she may have sex, she should start on birth control pills if she has no major health-risk factors such as migraines with aura.
Making the honor roll. There is one course that has the potential to make the grade:
- Teens being honest – “A”. Teenagers will likely talk to their parents and doctors if we give them the opportunity, time and support. But instead of giving them a pop quiz about sex, here’s my advice: Start a dialogue.
Talk with teens about ...
... the correct use of condoms. When teenagers use them every time, pregnancy and many sexually transmitted infections (STI’s) can usually be prevented.
... the correct use of birth control pills (always with condoms to prevent STI’s!). Birth-control pills are highly effective if taken at the same time every day. I suggest girls set the alarm on their cell phones. How crazy is this? A doctor prescribing cell phone use for a teenager!
... hormone injections (always with condoms to prevent STI’s!). These are very convenient – one injection every 12 weeks - and helpful for teens who don't remember to take a daily pill.
... Plan B, a.k.a. the “morning after” pill or emergency contraception. Accidents happen. So girls and boys who decide to have sex need to know how and where to get emergency contraception.
The lesson: There are effective ways to prevent teen pregnancy, but they only work if teens learn about them and use them correctly.
Parents are powerful teachers. Peer pressure is very powerful, but teens say that parents have even more influence on their decisions about sex, love and relationships than peers. For more information on avoiding unplanned pregnancy, visit StayTeen.org with your child for terrific teen-oriented media. Going on the computer with your teen - now that’s social networking!
Tell us: Do your teens believe in the personal fable? Can you help them to “make the grade” in preventing accidental pregnancies?
Rima Himelstein, M.D., is a Crozer-Keystone Health System pediatrician and adolescent medicine specialist.
America pretends to be so Puritanical when it actually is anything but. The way my mother swung it was this-no, I'd rather you didn't fornicate to be honest, but if you want to I will take you to your doctor and let her handle it. Well, the moment anybody of the male persuasion even called for me at the house was the time to make the doctor's appointment ASAP. My doctor handled it in a nonjudgmental, realistic way and just the HIV statistics where I was living at the time (DC) were frightening to me. Now they are much worse. But honestly like most kids I wanted to fornicate-most adults fornicate even more. How can your kids not do what they see you do? One more thing-the best way to make kids angry and hateful is to lie to them about what they have seen as a fact isn't so. Kids often are a LOT more naturally honest than adults, believe it or not. We all are born Muslim after all. So, she gave me Norplant before the fact in 1991 when I was almost 14-most kids now start even younger and if they are still no-sexual by the time they are 12 experts try to talk them into being gay and lesbians who are themselves and it does work more than you'd ever want to know-sorry, let the truth be told. Experts also talk kids into believing they were raped by their father when they don't like men PERIOD-something to think about with that girl who's in trouble in NJ right now. Experts should with kids just say what happened, not say "were you raped" or "Do you want to sex your own sex. Now, I do not want my own sex, and I never at age 34 conceived kids yet nor got infected with HIV. That alone where I'm from makes me a success story-I'm from the east side of DC.— DemolitionLady- You're a whackjob, lady. That's why no one wants to have sex with you.— Jesus_the_Gardener
- The problem isn't with just the teen population. Among a certain segment of our society, it's a badge of manhood to brag how many kids you fathered with multiple women. Every wonder why so many fatherless kids run the streets of Philly?— dogman5
- To piggyback on what "dogman5" said (and he's correct!), it's also hard to combat the female mentality of that same certain segment of our society that see pregnancy as notice to the world that "I've arrived as a woman."
How do you combat that sort of skewed mentality???— Benjamin Guggenheim - I don't know what "segment" of society that you and dogface are making reference to, but I do not know of any male in my "segment" of society who would brag about fathering one illegitimate child, let alone a multiple number. I do know that the statistics do show that more caucasian females from the age of 12 and up have more children out of wedlock than any other "segment". The stats are out there to prove it, unlike the lack of truth guggenheim and dogface provide in their idiotic comments. — lalaw9833
- Maybe in total number but not by percentage. 70%+ of all "segment" children are born out of wedlock; and teen pregnancy in that "segment" is nearly 3x more likely than Caucasian. I don't know about the bragging claim though. — battman21
- A friend told me she found a condom in her daughters room. She said her daughter said it was her friends -- and she believed her.— ej610
Comment removed.- I bet you could find similar pics of teenage white kids in Kensington walking down down the street with multiple kids in tow. White trash has been at the top of the welfare game for years, long before Black people were aloowed to even apply for benefits. — lalaw9833
- Again, by total number and not by percentage (although the difference between white and black is only ~2% and both less than 40% -- which I hope that you'll agree with me is ridiculously high!). — battman21
- Comment removed.
- Sorry to tell you guy, but even the nerds are getting it in. It really does not make a difference what the race is, it's the value system you attain from your parents, and those who influence our children. I have two daughters, one working on her PhD, and the other going into her senior year at Central HS. Neither has a child, nor desires to have one. I know plenty of people who have raised their children to the best of their ability, and it still happens. America has a system of twisted values, where on one hand, if you have a ton of kids ( like the Duggar's or the octomom), you can become a celebrity. However, no one talks about how much it cost in real dollars to sustain all of those kids, and the sacrifices that have to be made on their behalf. The hippocrites who like to make it a racial issue with their coded terms (segments of society) are probably the same ones who go out late at night trolling through North Philly looking for some crackhead to ease their lonliness. If you truly believe that unwanted teen pregnancy is an epidemic in only one "segment" of society, you are a blind fool indeed. — lalaw9833
- Other good options for teens:
The patch
The ring
The IUD (Mirena or Paragard)
We should really be selling the benefits of long-acting reversible contraceptives for reducing pregnancy. Again, still need that condom to prevent STD/STIs! Also should seriously consider gardasil... for girls AND boys, we can help prevent cancer people!— k.mcg - How about one of the best preventatives...strong families and parents? Not a guarantee, but as with the issues of violence, completing education, joblessness, etc. one of the most important but seldom-addressed issues is the one about strong families and parenting. Example...why do African-Americans in Philadelphia schools have such high absenteeism, high dropout rates, and low academic achievements, while the Asian kids in the same schools do so much better? Anyone? Anyone?— bartfr
- Typical!! i knew the cowards would be on here commenting on the African American children on the picture. As usual, the media portrays our children as the bad ones and the Caucasian morons come on here with their racist nonsense. Why don't you go to the many articles about the Catholic Priest who are just as sneaky as you and comment there. Oh, none are African American so it is okay. Hippocrates!!!— jeffrn
