May-02-2012

Preventing Teenage Pregnancy in Rural America

{I don't wanna be a statistic; PAA}

(Guest post by Diana Prescott, PhD, psychologist, and chair of the American Psychological Association Committee on Rural Health)

May 2 has been designated the National Day to Prevent Teen Pregnancy,  a day that carries significant meaning to me, as a woman, a parent and a psychologist. Recently released statistics reveal that while teen pregnancy rates have declined throughout the country, states with large rural populations have the highest rates in the country.

These numbers—and the stories of the families behind them–mean something to me, because I grew up in rural Indiana and now live in rural Maine. So here I am, 50 years old, a clinical psychologist with 20 years of experience reflecting on what it was like to grow up in rural Indiana.

Where I Grew Up

My family lived seven miles out of the town, where I attended school on a farm that was primarily committed to growing corn and soybeans.  There was only one other house on my gravel road, which was near a “town” that was a town by name only.

Sex wasn’t something that was talked much about in school or with my family. Like many kids my age, I learned about it from reading “Playboy” and “Playgirl” with my friends in middle school, in the bathroom during Home Economics.

In my independent Protestant church, only men were allowed to stand up front in roles of preacher, deacon and elder.  It was one of the few institutions that taught us about sex. The lesson for women: You must do it but only when you are married. When I was sick, my mother took me to another nearby small town, where we waited to see the local country doctor.  There were large bottles of medicines behind the counter for prescriptions of cough medicines and lollipops for after-shot treats.  But of course, there were no contraceptives.  This was rural Indiana in the ‘60s and ‘70s.

My College Choices

I was a good girl and vowed to abstain from sex until marriage, but life became filled with more choices and independence when I went to college. After a dance and too many drinks, I had sex for the first time with my hometown boyfriend. The day after, I didn’t feel good about what I did. I felt ashamed, dirty, terrified. The awful feelings compounded when I missed my period. After an exam at a clinic in the city, I was told I was pregnant. I broke the news to my parents while home during semester break. But my mother said I wasn’t; she said I had scared myself into being pregnant.

And just like that, I started my period within the hour, and I felt enormous relief.  (The human body is mysterious sometimes.) The clinic had either provided me a false positive,  or I miscarried.  I wasn’t having a baby, but since my family knew I had been sexually active with my boyfriend, I married him (and subsequently divorced).

I Got Lucky

Friends and relatives had similar experiences but with different endings. They had babies. I was the lucky one, in that fate had destined that it was not my time to bear a child.  This fork in the road enabled me to pursue education, become a psychologist, and be in the position now to speak on behalf of the people I care about in rural America.

I wonder for me, for my relatives, and for my friends who were in this situation what our life experiences would have been like, had we been provided access to information we needed to prevent teen pregnancy.

How Psychologists and Parents Can Help

As I consider how psychologists and other health care providers like me could make a difference for teens in rural areas, I think of how parents are encouraged to “talk to your teen” and “keep lines of communication open.”  It’s important psychological advice. But as a parent of two teens and a preteen girl, I know that is often much easier to say than to do in real life.  Parents may need to make special efforts to create occasions to have these discussions, like taking your child out for a beverage or meal.

  • Making contraceptives readily available and initiating contraceptive use with the primary care provider is important (regardless of the religious convictions of the grown-ups and their intentions for teens to be abstinent).  Contraceptives could be made available in the bathroom of psychologists’ and other health care providers’ offices, schools, homes and even churches.
  •  In rural communities where everyone knows everyone’s business, “brown bag specials” of contraceptives could be picked up discreetly by teens at local pharmacies.
  • Information on sexuality, sexual development, and contraceptive use could be present in offices and homes, offered and discussed with children and teens, emphasizing that sex is a normal part of development.

I think what I am describing really amounts to helping communities change the culture, making it acceptable for persons to understand, discuss, and embrace their sexuality and sexual development, without shame or fear.  As a rural psychologist, I am grateful to support the National Day to Prevent Teen Pregnancy in the hopes that information can be provided to children and teens in rural America to enable them to make the choices that will lead them to live the lives they dream of living.

Dr. Diana Prescott is a clinical psychologist who practices in rural Maine at Hampden Psychological Consultation, PLLC.  She treats women and children and consults in Eastern Maine Medical Center’s integrated pediatric obesity program titled Way to Optimal Weight.

 

Photo by charley121595 via Flickr

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