Teen pregnancy: the why is never simple

2014-09-15 08:49

I've had this conversation more times than I care to count, at this point.  Person asks, with serious face: "So, Teen Pregnancy Expert Tracy - why do girls get pregnant?" Clearly hoping for some snappy soundbite that will fit on a t-shirt or billboard in nice readable font. They're after one reason, one thing we need to change to fix this scourge.

Newsflash – there ISN’T ONE.

They believe everybody is the same and it’s all down to not enough discipline, not enough education, not enough green vegetables. Or something. It’s a combination of all those things and 100 more, and everybody has their own story.

Parents, teachers, healthcare providers, society (that’s you and me, buddy) – all have a part to play.

First I’ll tackle the “accidental” reasons for teen pregnancy. Will leave the “on purpose” post for another day. That one is bound to bring on some apoplexies so I'll save it for when we're all feeling stronger.

Clearly,  teens fall pregnant because they’re having sex. Captain Obvious has landed, ladies and gents.

Parents are terrified of admitting that teens are sexual beings. That sexual expression and wanting to have sex is normal, natural and part of growing up. The context in which it happens is the issue, not the fact that they're tempted to have it at all. Those who choose not to have sex are safe for now - but not forever. So even if abstinence is their choice, we all still need to be having these conversations because sooner or later, they will need to know.

 You can’t get anywhere NEAR preventing unintended pregnancy, sexually-transmitted disease or HIV infection until you admit that sex happens, even to the nicest of people.

If you’re stuck thinking that sex is wrong, evil, unnatural or is only had by problem children – do not pass go. Do not collect $200.  Watch those teen pregnancy stats rise while you clutch your pearls. Go on, we’ll wait, over here in the real world.

In some cases, it's clearly about education and access to contraception. In others, it's less about the unprotected sex that's being had, than the context of the relationship in which it occurs. When we focus completely on abstinence or contraception, we miss out thousands of young people who need advice about what healthy relationships look like from the inside, whether they're sexual in nature or not. Birds and bees don't cut it. It's people we need to be discussing.

Back to the easy reasons. Some of the reasons seem simple: everybody knows that contraception is free. Surely that means everybody can use birth control? In practice, no. (Have you been a 16 year old girl in need of birth control lately? Obstacles everywhere.)

Clinics can be difficult to access: logistically (how will I get there without anybody knowing), financially (I need taxi money to get there), emotionally (I know I’ll be treated badly when I get there, or I won’t be treated confidentially).

Then there is the issue of partners not being willing to use condoms (don’t you trust me? I can’t get you pregnant / don’t have HIV, if you loved me you wouldn’t ask me to use a condom). The ugly truth of the state of women’s rights (in practice) – even today. Too many girls (and women) feel they have not autonomy over their own lives, bodies, choices. It’s easy to scoff at that – it’s 2014 after all. Why don’t they just say NO?

But they’re too often right. Sometimes they DON’T have the ability to stand up to the men in their lives. All the self-esteem and empowerment lectures in the world will do nothing, if she still has to go back home to the same guy, the same family, the same community – where nobody has been lecturing the men.  Sometimes this means that she can’t say no, realistically, to sex.  Sometimes it means she cannot demand condom use. This is not something a 16 year old girl can change by herself. We all have a part to play in this.

She has the right to want a romantic relationship – it’s no good telling her she should concentrate on her schoolbooks and ignore the boys. Everybody wants to be loved. There is nothing wrong with wanting this. It’s how that love is expressed within that relationship which is the issue.

Some simply don’t know anything about sex or contraception – the people who should have explained (parents, teachers) – HAVE NOT DONE SO. Let that sink in for a second. A basic conversation which should have started 10 years ago is just not happening, in too many homes.

A once-off conversation is not enough. Explicit details are needed. Over and over again. Questions need to be anticipated and answered truthfully, without judgment. Information needs to offered continually, even without being asked. ESPECIALLY when she hasn’t asked.

Other reasons:

Not using contraception properly: again, parents, teachers, health care providers: are you being explicit about how it works? Are you ALL being realistic about what she will be able to make work successfully, in practice?

Contraception fails sometimes. It happens. Has anyone told her what causes failures?

Temporary lapses in judgment also happen. People make mistakes sometimes, which could have lasting consequences. Cover all the bases above and those lapses will be less likely to happen, but you can never eradicate them completely. Because humans are human.

“It won’t happen to me”  – I’m invincible. A momentary lapse is one thing. An ongoing attitude of not caring about consequences is another issue altogether and is a sign of some serious problems in thinking. Parents, teachers – anyone with access to teenagers who think this way need to be talking constantly about how nobody is bulletproof. Unplanned pregnancy is most assuredly not the worst outcome of unprotected sex.

These are just some of the reasons. For every teen pregnancy statistic, there’s a human being with one or more of these reasons all tangled up in a messy web of what’s called LIFE. Nothing is simple, nothing is black or white.

So, by all means – talk education.  Talk self-esteem. But never forget who you’re talking TO.

Human beings with their own circumstances, personalities, brains, lives and feelings.

None of this will fit on a t-shirt. Or even a billboard. Sorry.

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