It’s not about why.
It’s about accepting that your daughter is beyond your command.
May be sexually active, may already be on the pill, may have sought an abortion.
These are adult choices that 14yr olds make everyday:
will I smoke
will I be sexually active
will I use protection
will I do drugs
will I get in this persons car
Admit it, this ‘child’ is already moving in an adult world in more ways than you can accept.
If you want a real exchange with your daughter you need to accept what is plain to see for anyone with eyes.
Wisdom is the boobie prize,they give you when you’ve been --unwise!
I trust her to tell me if she needs birth control. KNOWING her as I do, and judging by the many, many conversations we have had, I believe she will tell me. Also KNOWING her as I do, I respect her enough to think that she is more in control of herself than a kittycat or puppydog in heat, which is more than you seem to think of her or any other teenager.
And once again, if she suffers from side-effects of being on the pill, it is me having to take care of her, NOT you or Dr. J. However, if she is on the pill, I am confident that I will know about it, that we will have weighed the benefits and risks, and that we’ll be on the lookout for problems.
I will add that if I found out that a doctor had offered to put my minor child on prescription anything, I don’t care if it’s Tylenol with Codeine, and he told her that she didn’t have to tell me and her dad about it, I would raise hell.
Dr.J, not to generalize or anything, but if you are going to be practicing in a conservative rural area anywhere in the U.S., whether it’s Kentucky or elsewhere, I can practically guarantee you that the parents you encounter, when you raise the subject of telling their daughters about birth control, are going to tell you, “Mind your own business.” Those are the polite ones–the rude ones will tell you, “Mind your own fucking business.”
I’m glad you raised the distinction between girls and boys. So far I think this whole discussion has been about GIRLS because girls are the ones who get literally get stuck holding the baby. I wish there had been more discussion of the boy’s responsibility.
I wouldn’t have any problem with you handing my teenage son a big ol’ box of rubbers. Double standard, huh? :rolleyes: I would bet that the good folks in rural Kentucky wouldn’t have any problem with it, either, (“hey, rubbers cost money, and if Doc wants to hand them out free, that’s great!”) but you start discussing GIRLS being sexually active, and suddenly you’ve opened the can of worms called “sin”. “(huffy voice) Our girls would never do anything like that!” You don’t need me to tell you to be extremely cautious, do you?
Also, people having the dirty minds that they do, when the new, presumably young, and presumably attractive doctor starts wanting to talk about their daughters’ being sexually active, their imaginations go into hyperdrive and the next thing you know, you’re looking for a practice someplace safe, like the South Bronx, where people aren’t so paranoid.
And good luck with your “routine psychosocial histories”! I’m not saying that everybody who lives in rural eastern Kentucky is Ma and Pa Kettle, but I would be very interested to talk to you in about 10 years, and see how it went.
A word to the wise…
“Why, sometimes I’ve believed as many as six impossible things before breakfast!” - the White Queen
Right, I know that. But I’m not talking about just financial support–I’m talking about emotional support, about just physically BEING THERE in the child’s life, 24/7. Being there when he wakes up in the morning, picking him up at school if he gets sick at school and the school nurse calls, being there at bedtime and in the middle of the night when the tornado sirens go off and everybody has to go down into the basement.
I’m not just talking about being there on Saturdays for the big soccer game, or showing up for the big spring concert. I’m talking about the little piddly day-to-day stuff that adds up to a real “relationship”, the kind of relationship that will carry you through really bad stuff like leukemia, or a car wreck, or a tornado, or even a divorce. I’m talking about Daddy being a member of the family unit, somebody who’s always there, always available, and can be counted on in a crisis, not somebody who has to check his appointment calendar before he can “be there for you.”
A written acknowledgement of paternity can’t force your child’s daddy to show up for the big spring concert or soccer game. It won’t keep him from leaving you and him and marrying someone else and having more kids with her, thus increasing the competition for his attention as “Daddy”, giving you and your child a world of pain.
I’m sorry, Juliettesmommy, but YOUR piece of paper DOESN’T “make sure the father sticks around.”
All it does is prove that he once fathered a child. BFD, sweetie–so did Seattle Slew.
And yes, I know that there ARE loving, committed fathers out there who aren’t married to the mothers of their children, who don’t have a “piece of paper” forcing them be fathers to their children, but but my observation is that they are unfortunately few and far between.
And as for getting a court order to have a DNA blood test done, I don’t know if you realize, first, how much those cost, and second, how much of an incredible hassle they are. What if you don’t even know where he is? America is the land of the free–all he has to do is hop in a car and drive, and he can start a totally new life somewhere else, and nobody there will ever know he’s got a kid. Deadbeat dads change their names all the time; they get new driver’s licenses, everything. That’s why they’re so hard to track down. There are 250 million people in America, and it occupies an entire continent. It takes time and money to find someone, especially someone who doesn’t want to be found, and unless you’re really committed to finding him, and have deep pockets, you’re SOL. Don’t expect “the State” or Child & Family Services to do it for you, 'cause they won’t. Oh, you might go down there and fill out a bunch of forms, but when push comes to shove, YOU’RE the one that has to go home with the kid and figure out what to cook for supper.
But I do agree with you on one point–people shouldn’t get married just to make sure the child has somebody to support him. This used to be called a “shotgun marriage”, but we don’t do this anymore. For one thing, we have a massive welfare system, so there no longer is the actual physical danger of you and your baby starving or freezing to death. In the old days, of course, there WAS this danger, if the pregnant teen had no family to take her in, (or if her family disowned her), and no husband to provide food and shelter, she usually ended up on the street as a prostitute.
Well, this is getting cheerful. :rolleyes:
“Why, sometimes I’ve believed as many as six impossible things before breakfast!” - the White Queen
Gee, Notthemama, thank you for my daily dose of cynisism :). I do what I do in my marriage because I love my wife and am committed to building a life with her. The “PIECE OF PAPER” meands nothing to me. When we have kids, my responsibility to them is greater than anything the state could do to me if I left. You have a point, but it is a very dark one. ( this is the third or fourth post here where I have mentioned responsibility. I am gonna have to call my dad and tell him that it actually sunk in! He’ll probobly have a heart attack! :))
DoctorJ:
As Notthemama mentioned, a major factor would be your relationship with the girl. Girls shouldn’t have to discuss their sex lives with every doctor they come in contact with. If I went up to a teller at a bank to deposit a check, and the teller started asking me what my annual income is, what sort of investment portfolio I have, etc., I’d think about finding another bank with tellers that aren’t quite as nosy. But if I had a personal investment consultant, I would expect to be asked those sort of questions. Similarly, if you are someone’s personal doctor, questions about a patient’s sex life might be appropriate, but if you’re seeing a patient on a casual basis they wouldn’t.
Something else that I’m not clear on is whether this girl would have a separate gynecologist, or whether that is usually handled by a general practitioner. If she does have a gynecologist, then it seems like birth control should be handled by that doctor.
As for how far you should push it (assuming you have a valid reason to ask in the first case), you should make it clear that anything she says is confidential, and tell her how she can get birth control. If she says that she’s not having sex, then just tell her that you want her to have the information in case she starts later on. And you should definitely make it clear that it’s not 100% effective and it does nothing about STDs.
You should encourage openness, but you should make it clear that it’s her decision.
As soon as a girl is menstruating, she’s old enough to learn about birth control. In fact, it may be better to discuss it earlier so that it’s easier to keep a hypothetical tone.
SouthernXYL:
The fact that parents are responsible for their children’s health does not mean that they are solely responsible, nor does it mean that their children don’t have a right to privacy.
Certainly, the child’s primary care doctor should be the one to prescribe the pill for her, or any other non-temporary medication; this doctor being the one who is familiar enough with her medical history to know whether it’s appropriate or not. Definitely the gynecologist, if she has one, or whoever does her pap smear if she’s doing that yet, and if she’s sexually active, she should. Once again, the pill is not OTC, and there’s a reason for that. It’s not like popping an aspirin when you have a headache.
As to whether parents are solely responsible for their minor children’s health - I’ll have to disagree with you there, and say that they are. If I neglect my child’s health, I could have criminal liability, right? As a rule, I really don’t think children should have secrets from their parents, and I certainly don’t think health care professionals should encourage them to keep secrets from their parents.
Dr. J, if my daughter came to you for a sprained ankle, and left with a fistful of condoms, I’d think that a bit odd, but it really wouldn’t bother me.
I think you’ve missing the “solely” part. If you neglect your child’s health, you may be held liable. So may your spouse, so may your child’s doctor, so may your child’s teacher, etc. Do really think that if one his patients gets pregnant because her parent wouldn’t let her take birth control, DoctorJ is going to feel no responsibility for not trying harder?
The Ryan, if the doctor felt responsible for that, I would think he’s taking a lot on himself, that nobody’s asked him to.
I guess I just don’t subscribe to the “it takes a village” view of child-raising.
What might Dr.J have responsibility for?
If he’s taping her ankle, and he looks up and sees something that appears to him to be a melanoma on her leg, I think he has to tell her AND her parents.
If she’s in for a physical, he probably ought to discuss birth control with her, in the same way that he discussed cabinet locks with her mother when she was a toddler. I don’t see any reason why this needs to be some big secret, though, and I think he would do very well to take this opportunity to encourage openness between her and her parents.
If she comes in to get her ankle taped and SHE asks HIM about birth control (which I don’t think likely) he should give her some info, and I actually think he’s obligated to encourage her to talk to her parents. If he absolutely feels he MUST give her something, condoms yes - pill no, for reasons I have mentioned repeatedly.
Now I have a question for you. If she comes in to see him for any reason at all, and he reaches the conclusion that she probably has gonorhhea (which, untreated, can cause severe physical damage if not death) but is too embarrassed to tell her parents, and he’s strongly encouraging her to go to a clinic but it’s his gut feeling that she won’t - now what?
Sorry I haven’t been around to reply–I’ve put a lockout timer on my internet connection so that I can actually get some studying accomplished.
First of all, I heard back from the pediatrics attending (and Dean of something-or-other) that I asked about the legality and ethics of prescribing the pill without parental consent:
This is what I thought.
I should also point out that talking to said teen about birth control wouldn’t come out of the blue. If the girl has a regular physical, that would be the time to do it. However, if someone comes in for an acute illness or injury, and I’m their regular doctor and I know they don’t come in for regular physicals (as most teenagers don’t), it’s good to get in as much preventative care as possible–certainly not the full 355-point workup, but the 5-minute quickie history and physical and a urine dip probably wouldn’t be out of the question. Thus would the topic come up more naturally.
Would I feel some responsibility for not trying harder if one of my patients got pregnant? Yes, I would, if I didn’t feel like I gave her the information and the opportunity to get what she needed.
As for the gonorrhea–if the girl is too embarrassed to tell her parents, I can treat her without telling them. However, I don’t think I can let her leave untreated without telling her parents. So I would just explain to her that it’s one way or the other.
Dr. J
“Seriously, baby, I can prescribe anything I want!” -Dr. Nick Riviera
“genital warts (with their risk of cervical cancer late on)”
Ummm no relation betwixt the cervix & warts, you are thinking of HPV 16 & 18, which don’t cause genital warts but do the cervix thing.
It would not surprise me if most people have #16 or 18 already. That’s why women having sex early in their teens, are at great risk later in life for having that LEEP cervix operating thingy or a hysterectomy? Never did find the answer to why early sex causes cervical dysplasia but that might be because there was no test for 16 & 18 until recently??
So as long as no one explicitly asks him to do something, he doesn’t have to do it?
“Hey doc, why didn’t you mention this malignant tumor six months ago when you first noticed it?”
“Hey, you never asked me to tell you about any malignent tumors you may have.”
What exactly do you mean by that? Do you mean that you have the responsibility, the trust, and the expertise needed to personally take care of any problem your child has? Do you mean that every parent has the responsibility, trust, and expertise?
Seeing as he’s a doctor (or a med student, or whatever his current status is) I’ds say he’s responsible for his patients’ health.
What he sees that she has a scraped knee, and she says that she fot it sneaking out of her room? Should the doctor tell her parents?
Really? You don’t see any reason why the girl would need privacy in order to feel comfortable discussing sexual issues? Just how much time have you spent in American society anyway? Maybe you have managed to bring your children up without any embarrassment about their sexuality, but if you have you are very rare indeed.
Encouraging openness is one thing. Requiring it is quite another.
He should mention this gut feeling to the girl, do everything he can to convince her to go, and that’s it. I don’t think that the end of curing gonorhhea justifies the means of betraying her trust.
Even being raised in an extremely open and understanding home by a mother that I love and have a close relationship still didn’t give me the level of comfort I needed to talk about sex. If mother hadn’t have brought it up first and insisted that I get on the pill I probably wouldn’t have. It’s easy enough to “sin” when there is no evidence, but calling up a doctor making an appointment to get a perscription is a full scale admission to yourself and the world about what you are doing.
Even if you are as close to your child as you can be, the societal programming to deny sex is far to strong. Plus, there are multitudes of parents out there whos answer to undesireable activity is denial of privlages, physical violence or even disownment. There is a lot of motivation for teens to keep sexual activity secret.
So yes, if girl has the guts to ask for the pill she should get it. When a girls is old enough to make adult decisions about her body (like having sex) she is old enough to make decisions about what she puts into her body (like perscriptions). Physicians are very good at explaining side effects and offering support. It may not be as good as a parent, but it is better than an abortion. I also belive that teens should regularly be asked by physicians if they are sexually active and givin proper advice if they are. Even then it takes guts to say “yes”, but most teens wouldn’t volunteer the information.
In the end, making birth control as accessable as possible is the only way to effectively prevent unwed teen pregnancy. It’s better than the alternative used in some other countries…marrring them off at fourteen.
The Ryan, I stand by every word I’ve said. I guess we disagree. I notice that Dr. J’s response about the gonorrhea does take into account the possibility that her parents might have to be informed and I can certainly live with what he says he would do in that case.
For the record - I think that sex is for adults. A minor child is not an adult. As always, you are free to disagree.
I just had the following conversation with my 13-year-old: me: “Do you know what form of birth control also protects against disease?” her: “Condom.” me: “Do you know where to go to get one?” her: “Walgreens.” me: “Do you have to have a prescription to get one?” her: “No.” If she becomes pregant as a teen, I don’t think her pediatrician would bear any responsibility at all. I think she, her dad, I, her boyfriend, and his parents would share that responsibility.
Okay, I started out as a teenage parent. 2 kids in 2 years!
Should I have waited? Probably. Would I know the things I know today? Probably not.
At 18 I went to school, held a job, and had my own apartment.
My father hated me for it, and I heard worse things from him than I did from people on the street. My mother was accepting and helpfull. Then again my parents were teen parents.
My first childs father is a wonderful man. We are best friends to this day, and he and my husband get along great also. Allyssas’ dad has been there since day one. We just didn’t get along well as a couple. He was still into his toys (he was 23) and I was prepared to suck it up and deal with things.
Right before I had our daughter her grandfather had a talk with her father about just exactly what he would be missing if he didn’t start showing more interest. He should know he missed a majority of his childrens lives because of divorce.
This changed everything and everybody is happy now. My daughter has three parents who love her very much.
My sons father and I don’t get along so well, but I will say one thing for him he is always there when Josh needs him. We get along civilly enuff to make choices concerning our son.
At that point in my life I was attending a school for pregnant teens. It was founded the year my mother had me in 71’.
I had the birth control, I knew the concequences. Why then? It just happened. It was nothing my parents did or didn’t do. It didn’t have anything to do with my friends who bailed on me when they found out!
I am now happily married with five wonderfull children. Yes, times were hard but doesn’t everybody have hard times?
I swore I would never get married but then I met my husband and all that changed six months later. We were married a year before we had children of our own.
People get divorced everyday. It is a shame. My grandmother and my mother-in-law both married alcoholics who weren’t always nice, and they are still married to this day.
Now I ask you is that right? My grandfather got sober and changed his life. My father-in-law was an abusive man. He did quit drinking but he is still mean and bitter.
Now, that little piece of paper kept my mother-in-law in a terrible unhappy marrige.
Sorry, that is kinda off topic but not really with the little piece of paper conversations going on.
I would stick it through with my husband no matter what with or with out our paper work.
Next topic. How to talk to my children about sex? Openly and honestly.
Right now I have guardianship of a 17 year old who just found out that she is going to be a mother. Her mother is upset, her father is understanding. They were teenage parents! My husband and I disagree on teens and birthcontrol. I say educate and be there for them, and he says no, that is only giving them the okay to have sex.
My children will know that my life has not been easy, but we survived and well at that. With no help from the outside.
Oh, and on the who watches a teenagers kids? I lived with both of their fathers so it was like what juiliettesmom described. Funny thing is though that now at 28 my mother-in-law babysits! It cuts cost, yes I do slip her some money, it let’s her see her grandchildren everyday, plus the fact that we live in the same house means that my kids really don’t have to leave home for daycare which is scary in itself!
I am sure if I wasn’t clear on anything I will be called on it.
I don’t advocate teen pregnancy, I just wanted to tell my story a bit. I went to school for pregnant teens like I said, and I actually went to school with a 13 year old who was having her second child. That is sad. Then I think who am I to judge. Even though I was in the same boat it was still upsetting. Do you think that maybe it was because I was an older teen? That I was close to being out on my own anyway?
Once again sorry bout the long post I was just trying to cover everything.
Notthemomma, I bet if you put all my posts together you could get the whole story of my life!
My husband says that I talk to much. He doesn’t listen to half of what I say that is where you guys all come in.
I can expect to be critisized, complimented, flamed or sympithized with and I get to get it off my chest.
I haven’t been flammed yet that I know of because I mostly stay out of the pit. Yeah, I know big chicken!
Like I said though, this is a touchy subject for the fact that I was a product of and was a teenage parent.
I get upset when I see it, but then I can speak too loudly. I know what I went through, and I hate to see others go throught it.
The school I went to also had a young fathers program where the director let the fathers know what rights and responsibilities they had. I think they also taught them how to care for a child when they had them by themselves. Under the circumstances that is pretty cool. A same it has to be, but nice that someone is making an effort to educate after the fact and maybe before it happens again.
The more I read, the more sadness and misconceptions of love and marriage and parenthood.
Force, stick around… This is honestly sickening.
For young mothers, most State Welfare type agencies will do these free. Not too much of a hassle. If you know how to fill out forms, you should manage it.
Alcohol and calculus don’t mix. Never drink and derive.
doctor starts wanting to talk about their daughters’ being sexually active, their imaginations go into hyperdrive and the next thing you know, you’re looking for a practice someplace safe, like the South Bronx, where people aren’t so paranoid.