The Role of Family and Community Organizations in the Prevention of Adolescent Pregnancy

Last Editorial Review: 3/24/2004

WebMD Live Events Transcript

Sexual education expert Barbara Huberman gives her opinion on factors that can potentially help prevent youth from becoming pregnant before they're ready.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Welcome to WebMD Live's Sexual Health Auditorium. Today we are discussing The Role of Family and Community in the Prevention of Adolescent Pregnancy, with Barbara Huberman.

  Barbara Kemp Huberman was the founder and president of the nationally recognized Adolescent Pregnancy Prevention Coalition of North Carolina from 1985 to 1995, and has been actively involved in human sexuality education and adolescent sexuality issues for over 30 years. Huberman is an expert consultant on adolescent pregnancy prevention and sexuality education, and is currently the national director of Training and Sexuality Education for Advocates for Youth, formerly the Center for Population Options, based in Washington, D.C. She is a certified sex educator and counselor, and holds a bachelor's degree in nursing from the University of Florida and a master's in education from the University of North Carolina. She has also served as the president of the National Organization on Adolescent Pregnancy and Parenting.

The advice provided by Barbara Huberman is hers and hers alone and does not necessarily reflect that of WebMD. If you have any medical questions about your health you should consult with your personal physician. This event is meant for informational purposes only.

Barbara, welcome back to WebMD.

Huberman: Thank you. It's my pleasure. It's especially good to be back on WebMD because the month of May is National Teen Pregnancy Prevention Month. It's now spread to be a nationwide campaign. We know that in the U.S., still over a million young women become pregnant each year, ages 10 to 19. We know that in most cases the young man involved is not involved in child rearing when a young teen decides to parent her child. There are many strategies and roles that the parent, the communities can play in helping the young people to delay pregnancy, and to use contraception effectively and to avoid becoming pregnant.

Moderator: What are the important concepts parents need to talk about with adolescents between ages 11 to19?

Huberman: With older children, hopefully the foundation has been laid from the beginning of the start of the family that makes parents comfortable talking about sexuality in a healthy way, that makes parents feel comfortable talking with their child about the family values and what they hope their children do in terms of sexual behavior. We also hope that parents become positive role models for their children. We know that children learn more by watching. Children are very sensitive to sense hypocrisy. If a parent is behaving in one way and tells the child, "You can't do that," or "Yeah, I did it, but it's not okay for you," a young person has a difficult time understanding why they can't do it. It's important for parents to model the behavior they expect from their children, or to clarify that they're doing this because they are adults. There are some things that you need to wait for until you are an adult. For instance, a child may want to drive at 14, but that's an adult behavior that they don't have the privilege of engaging in until they are 16 or 18. I also encourage parents if they want to have a home where risky behaviors will be kept at a minimum during the teen years, to understand the role of peers and the role of media, because teens today are getting conflicting messages from what they might hear at home, and what they see and hear in both of those places.

Moderator: What are some of the ways that parents learned their sexuality, and how does that affect how they teach their children?

Huberman: When I work with parents around this issue, most of them tell me their parents didn't talk to them, so they find it difficult to talk to their own children. Many parents express the fear that, "If I talk to my child, they'll go out and do IT," and IT means become involved in a sexual relationship. The research tells us the opposite. In the home where young people feel free to talk about sexuality with their parents, to ask questions, to be listened to without judgment, in a home where a parents says, "I don't know, but let's find out together," in a home where children are given accurate, balanced reading material, not Playboy, not porno movies, but where there are materials from the time they're small until the time they leave the home that help a young person answer questions and concerns they have about their sexuality --  For instance, one of the common concerns of 11 to 14 year olds who are entering puberty are the body changes that occur. One of the concerns is, AM I NORMAL? It's important for parents to reassure a late developer that their body will change, too, and it's okay. Maybe they'll be 14 when they get breasts, or when they get tall, or when they start their period. It's also important to help a young person to understand what relationships are about, so that if there have been conversations in the family and young people feel trusted in terms of their emotional needs being met, they're less likely to go out and try to get those needs met by engaging in an intimate relationship with someone in their age group. As teens get older, they have less interest in talking with their parents, in talking about these issues. What's very normal is to seek independence from the family and parents, and so, as a result, the peer group and media become much more influential in offering them opportunities and choices around their sexual behavior.

Moderator: What role do you feel that the community as a whole plays in the development of adolescent sexual identity?

Huberman: We see a lot. When we define the community, that means the schools, health and social service organizations, government, school board or county commission, other adults who live and work in the community and might be close to the teen, and it also means the corporate or business world as well. Some examples of how businesses have been involved in helping young people learn about themselves -- in one community, the local McDonald's franchises printed small cards that were distributed in the schools that gave young people what we call "door opener questions" that they could ask their parents. In another community, a large grocery chain printed on their grocery bags "how to talk to your kids about sex" message and so over seven million bags were distributed to encourage the community at large to talk with and be a resource to young people.

Our sexual identity, how we relate to people in any relationship, begins from the moment of birth and is influenced by many factors. Young people who have a strong sense of self, who believe in themselves, who see themselves as worthy, valuable, responsible, productive individuals generally engage in risky behaviors, whether it's sex, drugs, and alcohol, far less than other young people who perhaps don't feel that way about themselves. We also know from the research that young people who feel connected to their school, meaning they see a reason and a desire to be at school to get education, where they feel connected to other adults in their world, are far less likely to engage in early sexual behavior or unprotected sexual behavior.

Huberman: In the community, our churches and synagogues can play an important role in helping young people to establish who they are. Not only are churches a place where young people learn about values, but churches also can be a place for young people to go to talk to someone. 15 to 19 is a time of moving away from home and mom and dad, and becoming an independent person. As a part of establishing their own identity during teen years, most teens seek out other adults in their life to talk to, to just bounce things off of, and a lot of times, because they love their parents so much and they don't want to disappoint them, they can't tell them certain things. As a result, sometimes they get into problems that are difficult for them to handle all alone. An example would be the young couple in Delaware who couldn't tell anyone she was pregnant, went to college, when delivery time came, went to a motel, had the baby and put it in a dumpster. We know we'd like our kids to come to us, but I think also important is that we give our kids permission to go to other trusted adults when they can't come to us. No young person should face difficult decisions all alone. It's important to say if you can't come to me with anything, then I want you to know that you can go to Aunt Mary, or to Rabbi Cohen, or you can go to coach Smith, and they'll help you.

Moderator: What are some of the clues that parents need to be aware of when their children need to have a discussion about sexuality?

Huberman: Some of the clues revolve around body changes. As children mature and grow older, and as their bodies begin to change, that's a time when parents need to sit down and have conversations to prepare their child, so that it's not a total shock to them, so that they have good, accurate information, so they don't feel afraid when something does happen. I remember when I started my period I was 11 years old, and my mother never told me anything about periods, and I thought something was wrong with me. I thought I was bleeding to death. Another opportunity for parents comes as children get older and they learn to hide their own questions behind, "Mom, my friend Susie would like to know..." It's important for parents to answer the question as best they can before they ask, "Why do you ask me that?" What's also important when your children ask you questions or come to you for information is that you appreciate them for doing that. Say, "I'm so glad you came to me, and my door is always open for you to do that." I tell parents that throughout the lifetime of raising a child there are hundreds of teachable moments. Helping your child grow up to be a responsible, healthy, positive person who feels good about themselves as a sexual person is a lifelong process. It's not an event. You don't sit down and have the birds and the bees talk. Take advantage of the teachable moments that happen every day in a family. Perhaps a relative is having a baby. Perhaps someone is getting married, a perfect opportunity to talk about relationships. A neighborhood child says, "Girls can't do that." That's a perfect moment to say, "We believe in our family that girls can do anything they want to do." Things they see on TV -- our office was flooded with calls during presidential problems with the intern with parents who were saying, "How do I explain to my six year old what oral sex is? How do I explain to my 12 or 13 year old that what the president does is not what we might do in our own home? What do I say about sexual relationships outside of marriage," and many parents wanting to know, "How do you talk about what a sexual relationship is? Does oral sex count?"

One of the trends we are seeing, especially the preteens who are engaging in oral sex to protect what we tell them they must protect, virginity on the part of the girl, this is not the case in other developed countries. Young women who heard this "abstinence only" message, in order to get a boyfriend, keep a boyfriend, be a part of the group, are engaging in oral sex, and don't realize that while it protects them or they're not going to get pregnant, they are putting themselves at risk for STD's and HIV.

Moderator: How is sex education from parents and schools changing?

Huberman: There's very little sexuality education for adult parents. There is even less for the children in our school systems. When we look at the research, only about 10 percent of schools in our country offer a comprehensive, medically accurate curriculum that's K-12 for our young people, taught by trained sexuality educators. Most parents think their kids are getting this information in school, and they don't understand that they're not getting it. When we look at research, we also see that most parents want their young person to have this comprehensive sexuality education and not only an "abstinence until marriage approach." In the national poll, over 70 percent of the adults said they do not approve and do not want to support what's called "abstinence-only until marriage" education. Yet our federal government has recently decided that that's what they will fund and support. 

And yet the federal government has decided to support only programs through a $250 million appropriation that will tell teens that they must wait for marriage to have sex. Not only is this unrealistic, given that over 90 percent of couples in this country do not wait for marriage, it's an unhealthy marriage. What's happening is that many young people who feel guilty or ashamed that they are not acting upon that belief, place themselves at risk by not using protection. In this federal appropriation, young people are not allowed to learn about the positive benefits of contraception against STD and HIV. They are only allowed to talk about the failures. In this appropriation, young people must be told that if they engage in sexual behavior before marriage, they will suffer psychological and physical damage. Our national poll last summer clearly demonstrates that the American public wants their young person to be protected against an unwanted pregnancy, HIV and STD's. Overwhelmingly they said, "Teach our children a continuum: never engage in an intimate relationship that includes sexual intercourse in which you are not protected yourself or that you are not wanting to be involved in that relationship." 

I've been studying the European countries for past five years and have learned a lot in terms of how they have reduced their teen pregnancy rate, incredibly lower than ours. In the Netherlands, it's 13 times lower than the U.S., and they've done that by being honest about sex, by offering all women and men access and education about contraception, and they've done it by being positive about sexuality. These countries have achieved what we could achieve in our country, as well, but our policy makers in this country don't want to hear those messages, don't want to consider that perhaps what they're funding is not realistic or relevant when the average age of marriage is now 27. You're asking young people to delay the initiation of a beautiful, fulfilling relationship. Do I think 12 and 13 year olds should be having sex? Absolutely not. They ought to have knowledge and information and the skills to resist media pressure, peer pressure, their own sexual urges until they are much older. The European message is not one of abstinence but one of choice and power. In interviews of young people in the three countries, we heard over and over, "No, we don't talk about abstinence. We talk about responsibility. We're not preached at. We're taught that we will someday make that choice and when we do, it must be within the bounds of a loving, committed relationship." 

If we truly in this country want to reduce teen pregnancies -- and even in adult women, 50 percent of pregnancies to all women are unplanned -- if we want to contain the spread of HIV and other STD's which have serious health consequences, emotional consequences, then there are things that family, community, church, physicians, have to do. They cannot censor information. Ignorance does not produce responsible behavior. Young people deserve the correct knowledge. The second thing is that those teenagers who decide to become active, like it or not, they didn't ask our permission, we have to give them access to the health services in a confidential way that gives them whatever methods, whatever services they need to protect themselves against STD's and pregnancy. The third thing we have to do is probably the hardest. We have to somehow instill in young people the motivation to protect themselves, to not get pregnant. What this means is that young people with goals are less likely to engage in risky behaviors. Young people who feel loved and appreciated, they have the motivation it takes, maybe not to not have sex, but the motivation to say, "If I make this decision, then the next decision I must make is to protect myself." Frequently young people ask, "How do I know when it's right for me?" They don't have the ability to really understand a lot of non-cognitive reasoning. They're very concrete. I tell them, "If you haven't had a thorough discussion with your partner, you're not ready. If you are not protecting yourself against disease and pregnancy, you are not ready. If you don't think after you do it that you can tell someone important in your life about what a wonderful experience this was, then you are not ready. You might be in love, you might be lustful, but if you are not going to do those three things, you are not ready and you don't have any business engaging in intimate sexual behavior." I think young people hear that message because it doesn't preach to them. It places the choices in their hand and it also gives them some parameters around making that decision. It gives them the power to say to a partner, "If we can't do these three things, then it's not right for us."

Teen Pregnancy Prevention Month is an opportunity for community to come together and to offer programs throughout the community where parents and people involved can come together and talk about this issue. It's the month of May, because we know it's a time of proms and special events, and we know this is a time when many young people feel pressure to engage in sexual relationships. We know also that the month of May, being end of school year, is a time when a lot of relationships that may have grown over school year begin to get serious and it's no wonder that this is one of the highest months, May and December, when young people become pregnant. It's a time when all of us can talk about this issue, can explore with young people, "How do you feel about this? What would you do if you found yourself pregnant? If you were that close to someone, where would you go for family planning services? Who would have to know? Would I have the money? Would I feel comfortable going so that I'm protecting myself and my partner?" It's a time when churches can say, "Let's talk about values, not just on a superficial level, but a real opportunity." I worked with group of churches in NC that came together and offered a weekend seminar for teens and parents to explore sexuality. These families had the opportunity because it was collaboration between three denominations to learn about how other religions felt about sexuality. 

I say to our businesses throughout the country, you have a role in prevention of teen pregnancy. You can sponsor community activities during this month. You could make sure that your insurance company covers contraception as well as Viagra. You can provide internships for young people. That's part of that motivation factor I talked about. You can offer release time to your employees and staff to do volunteer work on boards, to do mentoring with young people who perhaps may not live in an environment that produces a lot of assets in their life.

Moderator: Do you feel that talk shows, like "Love Line" hosted by Dr. Drew, give good advice and are healthy for adolescents?

Huberman: Absolutely. I think what's important is with programs like Dr. Drew's where there is humor and offbeat questions that are presented and you've got celebrity guests, what's important is that parents and family have time to talk about things they're learning on shows like that. It's a teachable moment, and that parents not be afraid for their children to get information. Ignorance does not promote responsible behavior. I think I would applaud the Dr. Drew for bringing accurate information and knowledge to young people, because so often what they hear are myths and a lack of good information.

Moderator: Do you feel that parents close their eyes to what their children are doing sexually?

Huberman: Yes. Very definitely. Many parents that I talk with, many workshops that I do around sexuality, say I don't want to know. I hope my child is getting information they need at school. I think many of the adult population, Congress especially, are burying their heads in the sand when it comes to the world in which many young people live. Most young people in this country do not grow up and live in a two parent middle class, Ozzie and Harriet or Cleaver family anymore, and there is not a societal change that's going to take us back to that place. We have the Internet today, we have pornography access on the Internet, we have TV. At the turn of the century, teenagers did not drive. In 1940, only 1 out of 500 teenagers had a car before they graduated from high school. The world has kept moving, and parents have to acknowledge that and help their children. Parents don't want to accept that it's really a Beavis and Butthead world. They can't do what their parents did for them. They've got to help their young people get information and the motivation to avoid risky behaviors.

Moderator: To what extent can we re-educate adolescents who have already formed erroneous or harmful conclusions about sexuality in their childhood?

Huberman: One way we could do that is by schools offering comprehensive, balanced, accurate sexuality education courses where young people would have opportunity to discuss things they've learned in the past and be able to understand that maybe what they learned wasn't true. Maybe what they learned was fine when they were six and seven, but they're now 15 and the world is very different. I've been working on a workplace program for parents on how to talk to their kids about sex. This would be offered at workplace settings during lunch hour, etc. By educating parents, we can hopefully help them to work with their children to help them feel positive about themselves as sexual beings.

Moderator: What do I do when my kids ask me questions about what I did (sexual behavior)?

Huberman: That's also a very prominent concern of parents. There's a couple of things. Number one, you have a right to some privacy in your life and if you want that right for yourself, you have to respect your young person's need for privacy too. One response for a parent might be, "I don't want to share that right now. I'd much rather you figure that out without knowing what I did." Other parents might feel comfortable in saying, "I had my first relationship when I was 17 or 18, and it was wonderful" or "it was yucky and I hope that doesn't' happen to you." The parent who is able to say honestly what their expectations are, they're going to produce children who will think carefully about their behaviors. I had a young person tell me their mother had said, "'I had sex before marriage. It was a rushed, uncomfortable experience for me and in my religion, I felt guilty because it's not permitted in my religion.' My mom said to me, 'You're going to make the same choice, and I don't want you to feel shameful, or to risk getting pregnant or an STD. In our religion, we believe you should wait for marriage but I know you're going to have to make that decision yourself. It's something you have to decide to do.'"

Moderator: As we near the end of our session, do you have a closing message for our viewers?

Huberman: Take this opportunity during the month of May to think about your own life, the life of your children and family, and what you can do to make it a world where no young person would have to face pregnancy or a STD. In my experience of working with teens, many had these things happen to them, there were no good solutions. I also worked with teens who felt very good about their relationship and their decision. I want to applaud those children and their families.

Moderator: Thank you for joining us, Barbara. WebMD members, please join us every Friday at 9 pm EDT here in the Sexual Health Auditorium for our live weekly event. 

Huberman: You're welcome. I love doing it.

Moderator: The advice provided by Barbara Huberman is hers and hers alone and does not necessarily reflect that of WebMD. If you have any medical questions about your health you should consult with your personal physician. This event is meant for informational purposes only.

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