teen pregnancy – Dr. Sari Locker: Sex Educator and TV Personality

Today is the National Day to Prevent Teen Pregnancy, which is a day to raise awareness about this problem and what we can do to try to prevent it. Unfortunately, Bristol Palin, 18, has been appearing as a “teen ambassador” on TV and for events on this day. While in an interview on the Fox News Channel several months ago, Bristol said very clearly that teen abstinence is “not realistic at all,” now she has recanted that statement. This morning she said on Good Morning America that abstinence is the only effective way to prevent pregnancy, and that she is “promoting abstinence.” She refuses to say publicly that she and other teens must use birth control to prevent pregnancy! In a post I wrote here in February, I said that I certainly hope that Bristol does not try to speak to teens about pregnancy prevention until she learns how to discuss the use of birth control and condoms. It has been clear for months that she refuses to educate teens in a constructive way, so why was she invited by pregnancy prevention groups to be a spokesperson for this day?! On this National Day to Prevent Teen Pregnancy, my message is to Bristol: Please use birth control effectively, and teach others about it, too. And please stop telling teens that abstinence is the only way, because that is exactly what led to your unplanned pregnancy.

Plan B for Teens on CNN Headline News

Dr. Sari Locker — Fri, 27 Mar 2009 16:23:59 +0000

There are too many misconceptions about Plan B, and I’d like to correct some of them.

Yesterday when I appeared on CNN Headline News, I heard many misconceptions about Plan B — also called EC, Emergency Contraception, and The Morning After Pill — and about what it means for our government to allow 17 year olds to buy it without a prescription. Here are the top misconceptions, and then the realities.

Misconception #1: It causes an abortion.

Reality Check: Plan B does not cause an abortion. Plan B is not “the abortion pill.” The “abortion pill,” called RU486, causes an abortion in pregnant women when they take it within 60 days from the first day of their last period. RU486 contains medications that will end a pregnancy: Mifepristone (steroid) and Misoprostol (prostaglandin). Those medications block progesterone, a hormone needed to continue a pregnancy. RU486 is only administered by a doctor, and costs about $500. RU486 is not Plan B, and Plan B does not cause an abortion.

Plan B is taken by women who are not pregnant. Plan B is progesterone.Plan B consists of two pills taken 12 hours apart (within the first 3 days after unprotected intercourse, preferably within the first 24 hours, possibly within the first 5 days). Plan B’s 2 pills are made of progesterone only (a total of 1.5 mg of Levonorgestrel), which prevents ovulation – it does not end a pregnancy. If you don’t know what that means, then here’s the brief explanation. Sperm and egg need to both be present in a woman’s reproductive system in order for her to get pregnant (for the sperm to fertilize the egg). Once sperm is ejaculated into a woman’s reproductive system, sperm lives for a few days and can fertilize an egg if it arrives during that time. When sperm is present, the woman’s egg may not be there yet, because she may not have ovulated yet. So if hormones prevent her ovulation for just a couple of days, then that will prevent the egg from being there to be fertilized by the sperm, and therefore, prevent pregnancy. That is how Plan B works. Sperm never meets egg. No conception occurs. Sometimes Plan B can make it so that if the egg has already been released then the egg and sperm will not have an environment in which they would unite. But that still is preventing pregnancy before sperm meets egg, not ending a pregnancy. Some researchers think that if fertilization had just occurred then there is a possibility that Plan B could end the potential pregnancy by making it so that the fertilized egg does not implant in the wall of the uterus; however, others say that there is no definitive medical evidence that Plan B prevents implantation. Most importantly, Plan B will not work once implantation has begun, which is about 5 days after fertilization. If a woman has a positive pregnancy test, then Plan B will NOT end her pregnancy. Plan B will not affect an existing pregnancy, will not cause a miscarriage or abortion, and will not harm a developing fetus at all, according to the FDA.

Misconception #2: It causes major side effects and creates lasting problems.

Reality Check: Plan B may have short term side effect, but it is usually well tolerated, and has no lasting side effects. When taking Plan B, some women may experience nausea, fatigue, headache, dizziness, breast tenderness, vomiting, and abdominal cramps. However, not all women would feel these, and they may feel them only slightly. Research found that 23% of women taking Plan B experienced nausea and 5.6% vomiting. Also, the side effects would go away in a couple of days. Most women (87%) have their period on time after taking Plan B, but some may be late or early. By the next cycle their ovulation and period should be normal. There are no lasting effects on fertility from taking Plan B, according to the FDA.

Misconception #3: It is new and may be dangerous.

Reality Check: Plan B is not really new. Post-sex birth control was researched in the 1960s and began to be used in the 1970s in Europe. Other brands with other combinations of hormones have been used all these years. The progesterone pills in Plan B have been used as a component of regular birth control pills for 35 years. Plan B is just a newer way of administering the pills. Plan B, with its use of progesterone-only, was first approved by the United States FDA in July 1999, and became available with a prescription. In 2006, Plan B was approved to be use without a prescription by people 18 years and older. Plan B is FDA approved, and also by many other medical sources, including the American Medical Association and the World Health Organization. It is currently used in at least 50 countries.

Misconception #4:Allowing 17 year olds to purchase it without a prescription changes the need for parental consent that had previously been in place.

Reality Check: There has never been the need for parental consent to get Plan B. Since approved by the FDA in 1999, Plan B has always been available in the US without parental consent for people of any age. Even people under age 18 who would need a prescription for it, can still get a prescription without parental consent. Any person of any age, including a teen, can get a prescription from a doctor or health clinic with no consent. Parental consent was never needed for Plan B. Why? Because it prevents conception, similar to birth control pills, and no parental consent is ever needed for teens to buy any type of contraception.

Misconception #5: It is easy for teens to get it over the counter.

Reality Check: Plan B is a “behind the counter” medication. In order to buy it, someone has to go to a pharmacy and show a government issued ID for proof of age 18 (which will soon change to proof of 17). School ID is not a government ID. At most pharmacies, it costs about $50. So, while parental consent is not — and never has been – needed for Plan B, there are challenges for teens to buying it. If parents are concerned about their teens being able to purchase Plan B, then why are they not concerned about their teens buying true “over the counter” medications without parental consent? Over the counter diet pills, cough medicines, pain pills, are extremely widely available, easy to buy, under $5 in many cases, require no ID, have a high risk of abuse or misuse, and greater side effects.

Teen Birth Rate Up 1% in 2007

Dr. Sari Locker — Thu, 19 Mar 2009 19:17:13 +0000

Last year, when research from the National Center for Health Statistics (NCHS) found that there was an increase in the teen birth rate for the first time since 1991, we were not sure if that was simply a blip in the research. Also, despite that 3% increase, it still marked a lower rate for the US when compared with fifteen or twenty years ago. The teen birth rate had declined 34% between 1991 and 2005. Now we find that in addition to the 2005-2006 increase, it has also increased 1% between between 2006 and 2007. An increase two years in a row is cause for concern. Is the problem lack of comprehensive sexuality education? In part. Is the oversexualized media to blame? Could be. (But according to research, probably not.) Most of all, when teens get pregnant their parents had some role in the matter. Parents are the primary sex educators of their children. Through conversations and examples, they learn values and behaviors. I’ll be talking more about this on TV over the next couple of days. So stay tuned. Meanwhile, here’s a link to the NYTimes article about the new NCHS findings, including that the overall birth rate for all ages was the highest in ever 2007 — a true baby boom.

Bristol Palin Speaks, But Won’t Say “Birth Control”

Dr. Sari Locker — Thu, 19 Feb 2009 14:16:05 +0000

Bristol Palin, 18, decided to step into the spotlight this week with an interview by Greta Van Susteren on the Fox News Channel. Bristol claims that she wants to be an advocate for teen pregnancy prevention, saying, “I hope that people learn from my story and just, like, I don’t know, prevent teen pregnancy, I guess.” She says that she thinks teens should wait ten years to get pregnant, because, “it’s so much easier if you’re married and if you have a house and a career and — it’s just so much easier.” She adds that teen pregnancy is not, “a situation that you want to strive for.”

Bristol says that teen abstinence is “not realistic at all,” which shows progress in the political media discussions that began when her pro-abstinence mother, Gov. Sarah Palin, confirmed then-17 year old Bristol’s pregnancy last year. However, in the Fox News interview, when asked about her views about birth control Bristol declined to comment. She seems to want to be an advocate for teens avoiding pregnancy without explaining how they can do this. She also perpetuated the myth that teens today are more interested in having pre-marital sex than teens in previous generations. In fact, according to sex research for at least four decades about 95% of Americans have been having premarital sex.

Perhaps Van Susteren made Bristol defensive by asking her a personal question about why or if she did not use contraception (which she declined to answer). But, despite that, when asked how she could change the fact that teens have sex and may get pregnant, all Bristol could muster was a statement that she as a teen mom can scare teens into not having sex. No mention of the need for teens to use birth control or more effective sexual decision making methods, or for them to have comprehensive sex ed or better communication with their parents, or any other factors that truly could help teens avoid pregnancy.

I certainly hope that Bristol does not try to speak to teens about pregnancy prevention until she learns how to discuss the use of birth control and condoms. Teens may be positively influenced by hearing about the profound challenges of teen parenthood from a teen mother. However, only telling teens how tough it is to be a teen mom won’t keep teen sperm from uniting with teen eggs.

Sarah Palin’s Teen Daughter Is Pregnant

Dr. Sari Locker — Mon, 01 Sep 2008 21:11:12 +0000

Teen pregnancy is not more accepted today than ever before, but it certainly seems to be sanctioned by our political candidates.

It was announced today that Vice Presidential candidate Gov. Sarah Palin’s 17-year-old daughter, Bristol, is five months pregnant. According to The New York Times, Sarah Palin said, “Bristol and the young man she will marry are going to realize very quickly the difficulties of raising a child, which is why they will have the love and support of our entire family.”

Presidential Candidate Senator Barack Obama seemingly condoned this teen pregnancy, saying: “My mother had me when she was 18.”

Obama also said, “How family deals with issues and teenage children – that shouldn’t be the topic of our politics.” His remark does not alter the reality that teen pregnancy is now most certainly a topic of our politics. When a hurricane occurs along side a political campaign, it becomes a topic of our politics. Similarly, when the “abstinence-only” VP candidate’s teenage daughter’s unwed pregnancy is announced during a political campaign… this is a political issue. I hope it opens up the conversation about the causes, consequences, and possible methods of preventing teen pregnancy, as well as the issue of sex education.

Comprehensive sexuality education should be funded and/or mandated, and the government must stop funding abstinence only sex education. Also, political parents should be able to say that Americans should talk to their teens about how to prevent pregnancy. Research has found that when parents talk to their teens about sexual choices, values, and birth control, then teens are more likely to delay sex and less likely to have an unintended pregnancy. Either Bristol Palin didn’t know how to use birth control, or she didn’t care to use it. This is related to how she was parented, and what she may or may not have been taught by her mother about sex, love, and life. I find it disturbing that thus far there have been no statements from the political campaigns about sex education, parenting, or about the fact that teen pregnancy is preventable.

Jamie Lynn Spears, the Gloucester Girls, fictional Juno, and now Bristol Palin. Will spotlighting another high profile (“celebrity”) teen pregnancy, help or hinder the conversation about teen pregnancy, sex education and parental education? More of my thoughts on this are here and here. Teen pregnancy has been a very public issue in 2008. It’s sad that another teen in the public eye had to become pregnant in order for this to become a political issue. It’s worse that politicians are still silent about the most important issues of teen pregnancy.

Bristol Palin and Trig Palin: Photo from The New York Times

Posted by Dr. Sari Locker

Exclusive: My Talk With The Gloucester Girls

Dr. Sari Locker — Fri, 08 Aug 2008 12:27:03 +0000

In addition to telling me that there was no “pregnancy pact,” they also told me that there was no “homeless guy” impregnating the girls of Gloucester.

I recently talked to two pregnant teenagers from Gloucester, MA and the mother of one of the girls (who had also been a teen mother). We discussed their sex ed, sexual choices, and their feelings about being pregnant (and in the public eye). I also asked about the babies’ fathers… and THE question that many had wanted answered, but no one seemed to have asked. Yes, I asked about the “24-year-old homeless guy.”

You surely remember the Time magazine article that claimed that teens were trying to get pregnant as part of a “pregnancy pact” at Gloucester High School (GHS). In it, the principal was quoted as saying that they, “found out one of the fathers is a 24-year-old homeless guy.” Well, the pregnant girls from Gloucester who I met told me that they were not trying to have babies, and they were not seeking out random men to impregnate them. They had boyfriends their age, and their pregnancies occurred because they didn’t use birth control — not because they wanted babies. They did not understand how the “homeless guy” rumor got started, or why the principal would have stated it to a reporter. They said very definitively that the other girls in their school also got pregnant “by mistake” from boys their age – boyfriends, not homeless men. Also noteworthy, they confirmed that some of the 18 pregnant girls have gotten abortions.

Of course, I must emphasize that I am reporting what two pregnant Gloucester teens told me. I did not talk to all 18 girls, and no one will truly know who got pregnant from whom and why, except each of girls who got pregnant and the guys who got them pregnant.

The press latched on to the “pregnancy pact” story because America loves a “shocking teen sex story.” The reality of the Gloucester pregnancies may be far more mundane, but no less troubling. One of the Gloucester girls told me that she, “didn’t think that pregnancy would happen,” to her. She said that she knew about birth control, but she and her boyfriend didn’t think they needed to “bother with it” — even though they did not want a baby. It’s that type of denial that is often at the root of teen pregnancy. Other reasons commonly cited for why teens get pregnant include: perpetuating a cycle of teen motherhood when their parents had them as a teen; when parents do not encourage them to wait or don’t teach them any values about sex; and when the teen does not have future goals, dreams or aspirations to provide an incentive for why they would want to delay pregnancy until much later in their lives. The girls from Gloucester who I spoke with fit these models.

Will there be a chance to focus the media’s attention on the realities at Gloucester High School? Is there hope that Gloucester can teach teens to wait to have sex and to use birth control when they have sex? Gloucester is a small, predominately Catholic, blue-collar community that seems reluctant to help teens get birth control and learn how and why to use it. The town is organizing “listening posts” to get the community talking about teen pregnancy, but they are not planning to get teens and their parents together to talk about values about sex. It is imperative that parents and teens discuss these issues. If GHS would let me facilitate these conversations, you know I would. Though now the school is not open to having a sex educator visit (especially one who works on television). In fact, there have been many health educators who have recently advised GHS about how to provide access for their students to contraception and how to implement comprehensive sex education, but they have yet to begin these programs. (GHS curently offers sex ed to freshman, but it is not a comprehensive course, and is not offered after freshman year.) To understand some of the reaction to these issues in Gloucester, check out their local paper, including the recent editorial written by the school track coach, in which he equates condom distribution to giving drugs or “alcoholic beverages to the students, and… a “safe” place to booze it up, such as in the high school field house.”

The Gloucester Fisherman, and effective birth control.

Posted by Dr. Sari Locker

Media’s Influence on Teens’ Sex Decisions

Dr. Sari Locker — Wed, 06 Aug 2008 08:06:10 +0000

This graph is from a survey of 12-19 year olds, conducted by the National Campaign to Prevent Teen and Unplanned Pregnancy (2003) in “Science Says: The Case for the Cautious Generation.” Only 2% of teens say their sex decisions are affected by the media, and 53% say that they are influenced by their parents or morals, values or religious beliefs. This is teens’ self-evaluation of what they think affects them. From my work with teens and parents, I believe this chart accurately reflects their greatest influences. Also the National Campaign to Prevent Teen and Unplanned Pregnancy has a great fact sheet about this to help parents.