Birth Control for Pre-Teens?

by Shirley Velasquez

Jaws dropped all around the country in December when Jamie Lynn Spears, the 16-year-old sister of pop train wreck Britney, announced she was pregnant. Just like that, the supposed “good Spears girl,” star of Nickelodeon’s Zoey 101 and role model to countless tweens, fell from grace. Meanwhile, parents everywhere found themselves facing a particularly contemporary and uncomfortable conundrum: How do I talk to my 11-year-old about sex?

Jessica * of New York City could have used that talk. Though a model student, she got pregnant at 15 after having unprotected sex with her boyfriend in 2005. “Telling my mom was really scary,” she says. “She cried for four days. I cried a lot too.”

She’s not alone. From young Hollywood to the girl next door, teen sex is a pervasive dilemma. Nationwide, 43 percent of kids younger than 16 years old are sexually active, according to the Centers for Disease Control and Prevention, and 7 percent of the 13-and-under set are no longer virgins. The consequences are dire: Thirty-one percent of all U.S. girls get pregnant before age 20, a number that leaps to 51 percent for Latinas. Since chastity belts are obviously out, what’s to be done?

Drastic Measures

A school board in Portland, Maine, took a major step last October. When nurses at King Middle School noticed a spike in the number of kids visiting the clinic to talk about their sexual experiences, they brought it to the administration’s attention. Meanwhile, city health officials had been tracking the increasing number of girls walking the halls with swollen bellies. “It was significant enough to be considered a public health concern,” says Lisa Belanger, an administrator for Portland's student health
centers, whose agency recorded 17 pregnancies over a four year period in the city’s three public middle schools.

After hearing extensive testimony, the school board voted to allow the school’s health center to dispense hormonal contraception. This meant that girls as young as 11 years old could now have access to the Pill—even if they’d never heard of it.

A Million Preguntitas

When 12-year-old Nurys*, a student at King Middle School, heard the rumor that anyone who wanted the Pill just had to line up outside the nurse’s office, she ran to talk to her mother. “¿Qué es the Pill, Mami?” she asked.

“I was very upset when I heard the school was practically putting the Pill in girls’ hands,” says Nurys’s mother, Angela Mateo, who didn’t realize at first that only a physician or nurse at the clinic could dispense hormonal contraception and that parental consent is required for any visit, even for something as minor as a nosebleed.

“When my daughter asked about the Pill, I explained that it would harm her and she wasn’t allowed to take it,” Mateo says, echoing a common belief among parents that the Pill might damage their daughters’ developing bodies. A 2006 study by the National Council of La Raza found that most Latinas surveyed were mistrustful of hormonal contraception—worried that birth control pills would cause cancer and sterility after prolonged use.

And the younger generation is not immune to these misconceptions. “No one ever taught me how to prevent a pregnancy,” says Andrea*, 17, of Queens, New York, who is now a high school senior and mother of a 1-year-old son. “I thought, ‘Condoms are free, so why should I pay for pills? Why take it every day at a certain time?’ I’m still not even sure how it works.”

However, Rosalinda Carrizales, M.D., an obstetric gynecologist in San Angelo, Texas, asserts that the Pill is a safe option for most women and girls. When taken correctly, it’s 99 percent effective. While every medicine has potential risks, Dr. Carrizales points out that the Pill has a long safety track record. And compared to the risks associated with giving birth at an early age, the Pill is far safer for adolescents than pregnancy, she says.

Culture Clash
Now, experts are debating the long-term impact that early access to birth control could have on adolescents. According to the National Center for Health Statistics, 2006 marked the first increase in the teen birth rate since 1991. While the bump was small (just 3 percent), Latinas are still twice as likely as their white counterparts to give birth before the age of 20.

Some point to our surroundings: The United States is both a sex-saturated and a sex-repressed society. “American culture sends very mixed messages,” says Susan Wooley, Ph.D., executive director of the American School Health Association. “It says youth can’t be sexual until they’re married, but
uses sex to sell everything.” Studies have shown that dolls, clothes and even underwear marketed to grade-schoolers are overtly sexual.

That double standard can seem more exaggerated among Latinas, who are expected to be puras como La Virgen but shake their hips like Shakira. “Most Latina girls are conflicted. They hear that it’s important to attract boys and look sexy, but then wait to have sex,” says Ruthie Flores, senior manager of the National Campaign to Prevent Teen and Unplanned Pregnancy’s Latino Initiative (NCPTUP). And when it comes to actually discussing sexuality, 76 percent of Latin parents don’t know what to say, how to say it or when to say it. “There are a lot of concerns that parents can’t talk to their kids about sexuality and contraception because they might give kids ideas,” Wooley explains.

But two decades of research proves that ongoing parent-child conversations about sex actually have the opposite effect: Teens who feel connected to their parents are more likely to abstain from sex, delay intercourse until they’re older, have fewer sexual partners and use contraception more consistently. Remarkably, 94 percent of Latino teens actually want the adults in their lives to tell them not to have sex until they’re at least out of high school, according to a 2007 NCPTUP study. And 51 percent of them consider their parents a far bigger influence than their friends, suggesting that a healthy parental dialogue may even be enough to crowd out peer pressure and misinformation.

Jessica, who never spoke to her mother about sex, actually started out using condoms with her boyfriend, but eventually ignorant curiosity got the best of them. “People kept telling us it felt better without a condom. We wanted to find out. I knew in my head that I could get pregnant.” Sure enough, two weeks later, she was.

Andrea also wishes that her mother had been more open with her: “When I bought the pregnancy test, my mom told me, ‘What’s done is done, and you can’t change what you did,’” she says. “But I wish my mom had said to me early on, ‘Look, I don’t want you to get pregnant. Let’s find out how to keep you safe.’ ”

But how did these two New York teens—and millions of girls before them—come to this crossroad? Bill Albert, deputy director at NCPTUP, thinks it’s because we’re not sending the right message. “Everyone agrees 13-year-olds should not be having sex,” says Albert. “But people take contraception and abstinence as contradictory messages when in fact they’re complementary.” He advocates a two-pronged approach that tells kids: Don’t have sex, because it’s an adult activity, but if you decide to do it anyway, then use hormonal contraception and condoms so that you don’t end up pregnant or catch a sexually transmitted infection (STI). Among sexually active teens, only 63 percent of Latinas used contraception the last time they had sex, compared to 74 percent of non-Hispanic blacks and 89 percent of white girls. And according to NCPTUP, teens who begin having sex at an earlier age are less likely to use contraception and more likely to get STIs.

Even the government isn’t exempt from sending unclear missives. When President Bush took office in 2001, he increased funding for abstinence-only programs, which primarily teach youth to prevent pregnancy and disease by waiting until marriage to have sex. But in April 2007, an independent and government-funded study found that abstinence-only education failed to give kids information about sex that could protect their health. Recently, New Mexico joined 14 other states in rejecting federal money for abstinence-only education in favor of comprehensive sex ed that includes lessons on birth control. Congress also recently denied the president’s request to increase funding for the Community
Based Abstinence Education program.

The move toward more inclusive sex ed programs underlines the fact that popping the Pill alone isn’t enough to protect our girls. “The Pill is only one element in the fight to end teen pregnancy; it’s not the panacea,” says Michael Carrera, M.D., who founded the Adolescent Pregnancy Prevention Program at the Children’s Aid Society in NYC. “The only way we can fight the STIs, poverty and racism that haunt the Latino community is by making sure these kids have access to confidential health care and graduate from college.”

Danger Zone
What’s alarming about Andrea’s story was her ambivalence about safer sex. “I didn’t take the initiative toward my sex education because I trusted my boyfriend to tell me stuff,” she says. “I didn’t really care. I knew the Ring, the Pill, the Shot existed, but I was scared and embarrassed to do anything about it.”

A 2006 Latinasurvey shows she is not alone in making counterproductive decisions. Nine out of 10 teens thought it wasn’t okay to get pregnant or get someone pregnant—and yet half of the sexually experienced kids surveyed said they’d had sex without contraception. Jessica’s reasons for not using the Pill are also common: She’d heard rumors that women died from taking it, and—an even bigger adolescent anguish—that it would make her fat. But research shows that most Pill-related weight gain is due to fluid retention, which is usually temporary and cyclical. (See for more

Another frequent reason for skipping birth control is that, according to the CDC, Latina teens are more likely to have older partners. In fact, NCPTUP found 46 percent of Latina teens think it’s okay to date someone three or more years older; 33 percent of Latino adults agree. But that age difference often signifies an unspoken power struggle. “When you’re talking about a 15- and an 18-year-old, they’re two completely different people,” Albert says. “He might have a job, a little cash in his pocket and a car. That represents more independence and a big difference in power.” In other words, a younger Latina may not feel comfortable insisting on contraception—or refusing sex altogether.

Greater Expectations

Last September, Jessica enrolled as a full-time nursing student at Long Island University. Now 18, she
realizes that even though she’s a mother, she’s still a teenager. A month after her daughter, Aliyah, was born, she finally spoke openly with her mom about contraception. And the two of them together decided she should have an IUD inserted. “I need to protect myself from getting an STI or getting pregnant again,” she says. “I have to consider my daughter’s future and fight hard to make something great of my life.”