A mother called me yesterday wanting to schedule a pelvic exam for her 15-year-old daughter. The girl had confided to her that she was having sex with her boyfriend. The mom wanted her daughter to have birth control. The mom’s voice was low and hesitant. She seemed sorry that the time had come. She was also conflicted about whether she was doing the right thing. She feared she might be encouraging her daughter to have sex.
When it comes to their sexually active teen, many parents do not want to stick their heads in the sand. They want to be sure that when their children begin having sex, it is safe. Many want their children to avoid their own adolescent experience of anxious days visiting free clinics, hiding birth control pills or living with the fear of pregnancy. However, the opposite approach can seem risky. Willingness to provide birth control may seem to make light of sexual activity or even encourage it.
Sensing the mother’s concerns, I reassured her that studies demonstrate that offering birth control does not increase the likelihood of sex. Her daughter’s willingness to reveal her sexual activity was a manifestation of the strength of their relationship. The door was now open for the mother to discuss her feelings about sex, the role of sex in a meaningful relationship, the risks of sexually transmitted disease. Adolescents, who feel ready for sex but don’t have this kind of relationship with their parents, are potentially in a more risky situation.
Unfortunately this mother’s relationship with her daughter remains uncommon in my practice. Regarding matters of sexual reproduction teens are emancipated minors and can get birth control and treatment for sexual transmitted diseases without parental consent. They are most often choosing birth control methods based on what their friends are choosing. There are many good methods including safer pills with less estrogen and lipid friendly progesterone, the Nuvareen ring and of course the condom for both pregnancy and infection protection. And as a last resort there is the “ morning after pill” ,or Plan B. This is simply a pill containing adequate progesterone to induce shedding of the uterine lining before a potentially fertilized egg can become implanted and start to develop.
Perhaps this teen will use her mom’s support in making her decision. In any case the head in the sand approach is not very effective in protecting children from adverse outcomes related to sexual activity.
OTBKB is thrilled to feature The Doctor is In, a regular weekly column by Amy Glaser. Born in Brooklyn, Dr. Amy Glaser of Slope Pediatrics received her undergraduate degree from Smith College, her medical degree from Mount Sinai School of Medicine and completed her pediatric residency at Montefiore Hospital. She started in Park Slope 25 years ago with a special interest in teens, after completing a fellowship program in Adolescent Medicine at Mount Sinai. She has brought her expertise in that area into the community during her career at the Door, El Puente, Elmhurst Adolescent Center and Barnard. Dr. Glaser has been named by NY Magazine as a “top pediatrician” and as one of the “Best Doctors in America”. She recently started a part-time practice for ages 13-22 called “Adolescents Only.”