Let's start with a beyond-dispute premise: We need to do everything possible to prevent unwanted
teen pregnancy.
But should pediatricians pre-prescribe “morning-after”
pills to
girls younger than 17, as the
American Academy of
Pediatrics has suggested?
Even though I'm the
mother of two
teen boys, I believe that if I were
instead
charged with the
health and well-being of two
teen girls I'd be
saying “Heck, yeah!”
But who am I to say that other
parents would feel the same?
My neighbors are a devoutly churchgoing Hispanic
couple with two
sons
and a 15-year-old
daughter. The
father of the
family, a cheery
Mexican
immigrant who holds fast to
traditional conservative religious ideas
about his
daughter's reproductive
rights — which is to say he probably
doesn't believe she has any — would surely not feel comfortable if he
thought his daughter's
physician would give her access to morning-after
pills “just in case.”
You might be saying to yourself that this child is probably an
excellent candidate for becoming one of the 55.7 per 1,000
Hispanic
girls ages 15 to 19 who give birth every year — 80 percent of these
pregnancies are unintended — and you'd be absolutely right.
With this terrible state of
affairs, it would seem obvious that
pediatricians should provide explicit, unsolicited counseling about
birth control and
emergency pregnancy prevention to
teens, and
especially
girls, independent of a
parent's wishes, right?
Maybe. Especially maybe in
communities where teen
pregnancies among
minority
girls are particularly pervasive. For instance, New
York City's
public schools face a powerful mix of high poverty, underinsured
families, and teens who frequently start
sexual activity before the age
of 13. The
schools are trying pilot
programs to provide birth control
and morning-after
pills right in
school buildings.
Health officials
there recently reported that
parents are fine with the program.
What we're really witnessing here is the
medical establishment's
acknowledgement that way too many
parents refuse to admit that in our
highly
sexualized society, they are the ones who need to provide their
children with reliable
information about
safe sex.
Because overall averages of
teen pregnancy have been going down for
the last few years, there is an opportunity here to get to the root of
the problem, which is less about what talks
doctors should be having
with their minor
patients and more about what
information should be
shared at
home.
Studies have shown that
kids of
parents who have meaningful and
informative conversations about
sex are less likely to engage in risky
behaviors leading to unintended
pregnancy and
sexually transmitted
diseases.
If the
pediatric medical establishment wants to go ahead and codify a
policy that says “talk to your
kids about
safe sex or we'll do it for
you,” it should do so hand-in-hand with
general practitioners who treat
parents.
In other
words, as the AAP tells pediatricians to initiate these talks with kids, the
American Medical Association and the Centers for
Disease Control and Prevention
should ask that physicians screen
patients who are
parents for their
ability to provide their
kids with age-appropriate
sex education, give
them a score predicting their
child's likelihood to engage in risky
sexual behaviors and provide them the resources to prevent such negative
outcomes.
Another beyond-dispute premise: Efforts to reach
kids without
involving their
parents in helping them make good choices will
ultimately falter.
A ZOO’S sex education programme for primary pupils left kids feeling sick.