Being a Teen (17 page)

It may seem as if it is the girl who bears the consequences of pregnancy and birth, and sometimes it is. She carries the
child inside her, she gives birth, and much of the time she is the one who ends up caring for the baby. The culture makes some young men believe that a sign of manhood is having fathered many children with different women. Any mature, smart man knows, however, that true manhood means being responsible for one’s actions and, for a young father, that means showing up as a co-parent.

Impact on the Child

Whatever the man’s circumstances, he should be a presence in his child’s life. It is as important for daughters to have loving, present fathers as it is for sons. Some mothers grew up without the presence of a father. Perhaps their own mothers did as well, and this can lead several generations of females to think, “Who needs fathers?” Studies have shown that a child needs a loving male presence when they are young. It doesn’t necessarily have to be the biological father but, ideally, there is a loving man who is a constant presence in the child’s life. For a girl baby, it is how she learns what safe love from a man feels like. Her daddy’s (or uncle’s or grandpa’s) lap and arms are like a rehearsal space for appropriate male warmth and caring. Girls who are deprived of this can tend to search for male love in all the wrong places. Little boys need a male presence to show them how to be in the world. A father (or father figure) provides the blueprint for how to be a man and a father. Studies show that boys with involved fathers do better in school, especially in math and science. Naturally, we are speaking here of fathers who are responsible, kind, nurturing men, not violent or sexually abusive men.

Consequences for Boys

So what’s the impact of teenage parenting on the father, you may ask. Again, studies have shown that young men who have children and then abandon them are more likely to turn to substance abuse to numb the psychic pain they experience. They may not even be aware of the source of their pain. But it is there, inside them. When such men are reunited with their child, it is possible that they will be motivated to turn their lives around, stop abusing drugs or alcohol, and try harder to find employment so as to provide child support. A wise man said to me once, “When you connect the father’s heart to his child, his mind will follow.”

Ways to Prevent Pregnancy

If you are thinking about having male-female sex, then it is time to think about what you and your partner are going to do to prevent pregnancy. Make an appointment to discuss contraception with your medical provider so you are all set before your first intercourse. This will reduce your anxiety about a possible pregnancy, and is the first step toward caring for yourself and your partner. Always use a condom in addition to whatever form of birth control you chose. You will greatly reduce your risk of contracting an STI.

Some kinds of contraception are more effective than others.

Here are some longer descriptions of the different methods of birth control available, listed in the order of their effectiveness:

The most effective forms are the ones that are long-lasting and do not require remembering every day or week. Implants such as Nexplanon are one type. Small matchstick-like rods are inserted, or implanted, under the surface of your skin, usually in the upper arm. They last for about three years. They can be removed at any time. This is a convenient type of contraception for a teenager who may not be interested in becoming pregnant for many years.

Another long-term contraceptive is the intrauterine device (IUD), such as Mirena, a small device that is introduced through the cervix and into the uterus by a doctor. IUDs can remain in place for three to ten years, depending on the type of IUD, and can also be removed anytime you would like to become pregnant. You are likely to experience a small amount of spotting while the IUD is in place, which may require wearing a panty liner.

The next most effective methods are shots, oral contraceptive pills (“the Pill”), patches, and rings. Depo-provera is an injection of contraception that is given every eleven to twelve weeks. It is very effective at preventing pregnancy if given properly every few months. Some teenagers who use Depo will have spotting (small amount of bleeding) or will stop having periods altogether during the time they are using it. You can become pregnant if you miss a shot.

Oral contraceptive pills are very popular and have been in use for many years. If you decide to use the Pill, you need to trust yourself to take it every day at about the same time. There are many different types of pills, and you and your provider or family planning counselor can decide together which one would be best for you.

A contraceptive patch is a small patch that you place on your skin. It contains the same hormones that pills contain. You put the patch on your skin once a week for three weeks, then take a week off. During the week off, you will have a menstrual period. The following week you start again.

The Nuvaring is a small ring that you insert deep into your vagina. It stays in place for three weeks. You then remove it and leave it out for one week, during which time you will get your period. The following week you put in a new one. Nuvarings also contain the same hormones that are in the pill, but you only need to use it once monthly. You must feel comfortable inserting something into your vagina in order to use the Nuvaring. Once in place, you cannot feel it, and it cannot get lost.

Every sexually active young woman should have access to Plan B. Plan B is a pill that can prevent pregnancy after unprotected sex. It comes in either one- or two-pill dosages, and it must be taken within 72 hours of having unprotected sex. If you are under the age of 17, you must have a prescription. Ask for a prescription at your next doctor appointment.

Choosing which contraceptive is right for you is a very personal decision. Think about your privacy (do you need to keep your method a secret from your parents? your partner?), the likelihood you would remember a daily pill, how comfortable you are inserting things into your vagina, how you would feel about not having a period. Knowing these things will help you decide the best method for you. Planned Parenthood has a questionnaire on their website to help you think about it before you see your provider. See in Resources at the end of this chapter.

Since the two of you are having sex, both of you should be doing something to prevent pregnancy. If you share sex, share the responsibility. That means the female chooses a method—implant, IUD, pill, patch, or injectable—and the male wears a condom. This approach can also help prevent STIs, which will be discussed in
Chapter 14
.

Male Condoms

Male condoms are cheap and easy to buy in drugstores, grocery stores, and convenience stores. A condom is a soft cover made of a very thin, rubbery material called latex; latex gives condoms their nickname, “rubbers.”

Here is how to use a male condom properly:

• Use a new condom with every act of sexual intercourse, from start to finish.

• Use only latex or polyurethane condoms. Animal-skin condoms do not provide any protection against sexually transmitted diseases.

• Store condoms in a cool place out of direct sunlight and not in a wallet or glove compartment. Do not use damaged, discolored, brittle, or sticky condoms.

• Check the expiration date on the package.

• Carefully open the condom package. Teeth and fingernails can tear a condom. If a condom rips or tears, take out another one. It is a good idea to have several condoms on hand.

•
Put on a condom after the penis is erect and before it touches your partner’s body. If a penis is uncircumcised, pull back the foreskin before putting on the condom.

• Unroll the condom a little bit to make sure that it is being unrolled in the right direction. The rolled ring should be on the outside. If the condom doesn’t unroll easily on the penis it is probably on upside down. Throw it away and begin again.

• If you need additional lubrication, use a condom lubricated with spermicide or a water-based lubricant like Astroglide (available at pharmacies). Other lubricants such as Vaseline, cooking oil, baby oil, or hand lotion will weaken the condom.

• Put on the condom by pinching the reservoir tip (the space at the end of the condom that will collect the semen) and unrolling it all the way down the shaft of the penis from the head to the base. If a condom does not have a reservoir tip, leave a half-inch space at the head of the penis for the semen to collect after ejaculation.

• Very soon after ejaculation and before the penis becomes soft again, withdraw the penis, holding on to the condom at the base to prevent slippage and leakage.

• Wrap the used condom in tissue and discard it in a wastebasket. Do not flush condoms in the toilet or leave them on the ground.

Some Boys Don’t Want to Use a Condom

Some males will argue against the use of a condom, saying it is less spontaneous, reduces sensation, and is costly or embarrassing to buy. None of these are legitimate reasons to go without protection. People who do not practice safe sex are denying the truth that anyone can get sick from STIs. Using a condom is not about how much you love or trust someone—it is about safety. Think of it as common sense—like wearing a seat belt in a car or a helmet when you go biking or skateboarding. Any
man who refuses to wear a condom isn’t the type of man you want to be having sex with. If you want to have sex, it has to be safe, and on your terms.

Myths About Preventing Pregnancy

A woman can still get pregnant:

• whether or not she has an orgasm.

• if the male has any semen on his finger and puts it into her vagina.

• if she has vaginal intercourse while standing, if she is bleeding from her vagina when she has sex, or if she has not even begun to menstruate.

• if it’s her first time.

• if she jumps up and down right after sex. The sperm will not come out.

• if she douches, showers, or washes right after sex.

• if she’s been having sex for a while and hasn’t gotten pregnant the other times.

• if the man pulls out before he ejaculates. This is known as the withdrawal method.

Using withdrawal as a method of contraception is not suggested. Pulling out poses a risk because during intercourse, a clear fluid (also sometimes called pre-cum) comes out the end of the penis, and this fluid may contain sperm if there is some left behind from a previous recent ejaculation. (Pre-ejaculate does not contain sperm on its own but there is a small chance leftover sperm could become mixed in.) It is safest to not take
any chances. Do not rely on the man pulling out before he ejaculates.

If You Become Pregnant

Each pregnant teen has three options with her pregnancy.

Becoming a Parent

She can choose to continue the pregnancy and become a parent. For teens who plan to continue a pregnancy and become parents, start prenatal care: take a prenatal vitamin and stop smoking, drinking, or doing any drugs. Discuss with your partner and both of your families how you are going to move forward. Discuss things like housing, work, money, education.

Adoption

She can choose to continue the pregnancy and seek adoption services. For teens who plan to continue a pregnancy and adopt, do all of the above, but also ask a doctor if he or she knows a social worker who can help you set up an adoption.

Abortion

She can end the pregnancy and seek abortion services. Remember that if you have Plan B and have had unprotected intercourse in the previous seventy-two hours (three days), take your Plan B. It works by preventing implantation of a fertilized egg into the wall of the uterus.

For teens who need to end a pregnancy, there are options
for abortion care. If the pregnancy is less than nine weeks, a medication abortion can be accomplished by using the medicine RU-486. This can come only from a doctor who is familiar with prescribing this medicine. A woman using medication abortion will experience cramping and bleeding, much like a spontaneous miscarriage at home. If she is more than nine weeks pregnant, or prefers not to take the pills, a woman can have a surgical abortion, with a D&E (dilation & evacuation) or with a D&C (dilation and curettage). These are simple procedures done most often in a clinic setting. They are virtually the same. For a D&C, the cervix (opening to the uterus) is dilated or stretched open about a centimeter. Then a curette is used to scrape the wall of the uterus to remove the pregnancy. An evacuation is when a small suction device is used to vacuum out the contents of the uterus. Often an abortion includes both curettage and evacuation. Both approaches to abortion are very safe and do not interfere with your future ability to get pregnant.