Why is it so important to continue working to reduce the teen pregnancy rate? How and when should parents discuss this with their children?
Learn more from Dr. Nancy McLaren, a UVA pediatrician who specializes in caring for teens.
Preventing Teen Pregnancies
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Learn more about Dr. McLaren
Learn more about UVA Teen and Young Adult Health Center
Nancy M. McLaren, MD
Dr. McLaren trained in general pediatrics at Emory University in Atlanta. She has been in Charlottesville for over 12 years and has worked at the Teen Health Center at UVA during that time. She has been fortunate to focus her time and energy on the care of the adolescent patients whom she loves. She's a clinical assistant professor of pediatrics in the UVA Children's Hospital. She also serves on the community-based obesity task force and has been active in pioneering programs that reduce obesity in childhood and adolescence. She also has a special interest in sports medicine that probably developed from the injuries her own children received during their years in competitive athletics. In her spare time she enjoys skiing in Colorado and spending time with her husband and three children (who have taught her so much about adolescents).Learn more about Dr. McLaren
Learn more about UVA Teen and Young Adult Health Center
Transcription:
Melanie Cole (Host): It's so important to continue working to reduce the teen pregnancy rate. How and when should parents discuss this with their children? My guest today is Dr. Nancy McLaren. She's board certified in pediatric medicine and specializes in caring for adolescent and teen patients at UVA Health Systems. Welcome to the show, Dr. McLaren. Why is it so important to work with teens to reduce this pregnancy rate?
Dr. Nancy McLaren (Guest): Well, we want to give them a chance at having a better life and the cycles certainly have shown as with teen pregnancy, if someone gets pregnant as a teen, then the possibility is that their child will also have children in their teenage years. It's important really, to give them a better chance at succeeding at other goals that they may have in education and really advancement and really sort of break the cycle of poverty that teen pregnancy can put someone in.
Melanie: So, what are some of the best ways to reduce? Are we looking at media outlets or are we looking directly to the parents and the loved ones of these teens to be the ones involved reducing this rate?
Dr. McLaren: Well, the most important person in the teenager's life, or persons in their lives are their parents or their guardians that they're close to. The importance of parents starting to talk to teenagers starts when they're really quite young--when they're 9, or 10, or 11. Really encouraging them to be active in other things in their lives, in school, in sports, in music, and other things that make them feel positive and strong about their lives and really getting them involved. Being involved in the community and their schools and family is a very large protector against teen pregnancy. The other thing is to talk to them also about sexuality and what they feel about their bodies and what's involved with sex, basically—to have the sex talk but start it when they're quite young so that it's not an uncomfortable thing at all when you have to sit down at age 11 or 12 and have this puberty talk. Really start with them when they're quite young, learning about their bodies, and what their bodies do, and feeling good about their bodies and wanting to take care of their bodies. And, again, I say that conversation can happen in the pediatrician's or the adolescent physician's office but it's really important that it happens at home with the parents and having them involved so that the teens get comfortable, the young people get comfortable feeling that they can go to their parents and ask questions.
Melanie: If the parents don't discuss it, the children are going to learn about these kinds of things from other sources, which may not be reliable. So, how do you tell uncomfortable parents, Dr. McLaren, how to start this conversation? What do you tell them about the fact that some of them believe that if they start this conversation, they're opening the door to permissive sex for their children?
Dr. McLaren: Well, first of all, what we try and do when parents are coming in with their young ones, even at 8, 9, and 10, is to give them some tools to have. That can be books, reading with their children. There are some great books out there to talk about how your body is changing and what's going to happen and having the conversation even earlier on before the young people get where they're sort of more reserved and withdrawn and more quiet about things. Then to continue that conversation going through the teen years and telling parents, "It may be an uncomfortable conversation, but it's really an important one to have." Otherwise, they are going to get information from their peers and from the media, from the internet, and the information they get from there may not be as reliable or as factual as what they could get from their parents and from their doctors. I think they can—and if the parents are uncomfortable, we'll say, "Why don't we have the conversation together in our office?" and that can be another way of helping with it. And starting it, again, when they're younger, and not waiting until they're 12 or 13 and no one's ever had the conversation.
Melanie: Well, one thing I appreciate that you pediatricians do is when the teens come in for their well visit, now they get to fill out a form that discusses with them about drug use and that the parents don't get to look at it unless the teen says it's okay so that they feel like they can trust their pediatrician, which is a great resource for them to get some of this information. Now, when the parents are beginning this discussion, do they come at it as "I don't want this to happen"? How do they discuss protection and “if you are going to have sex, you must protect yourself from pregnancy and sexually-transmitted infections”?
Dr. McLaren: Well, I think you can almost say it in just the way you said it. In the sense that we do know that teenagers are having sex as they go through middle school and high school and the goal would be first to talk to them about the risks of having sex at an earlier age, so if that is going to happen, talking about protection and what ways can they find out and learn about protection, whether it's condom use or whether any of lots of different birth control methods that are out there. Even to say, if you're not comfortable talking with me, let's go to the doctor's office and talk to the doctor. We do give, once they're 11 or 12 years old, we do always want to have a time of privacy with the adolescent to give them freedom to talk about some things. Maybe to help them figure out how to talk to their parents about some of these issues, too, and letting them know that the parents really want to protect them and take care of them and help them through this time and have them see their parents as resources, also.
Melanie: Is there a role for those after-school specials and scare tactics showing 14-year-old girls with babies and kids that have had to drop out of high school? Do you agree with that kind of way of going about it?
Dr. McLaren: I think it's--I mean, we certainly in our clinic use humor and information in that way, not as scare tactics, but just to have them think about things. I think that it's better to talk about "if this does happen," and certainly after-school, having young people in activities after school. The time for highest risk for pregnancy with an adolescent is between the 3: 00 - 6: 00 time because people are not around and they have more time alone, so getting them involved in other things. But it's really talking more about what their hopes and dreams are and what they want to be doing. I think it puts it in a different way of having them look that way rather than what's going to happen if you get pregnant. Really trying to get them to think beyond just the moment and what they want to accomplish and how to go about doing that and that preventing pregnancy--teen pregnancy--can make a big difference in helping them accomplish that.
Melanie: So, in just the last few minutes, give us your best advice for parents about discussing this with their children, when the appropriate time is, and how to begin. Parents don't even know, Dr. McLaren, how to start that conversation.
Dr. McLaren: Well, it's not an easy conversation to have. I've had to do it with my three kids, and it's just a matter of sitting down and saying, "You know, I have something we need to talk about, I'm concerned about this or that. We want to make sure that you have all the opportunities that you can. We would encourage you not to have early sex but we also understand this may happen. We want you to get the right information from us or from your doctor. So, let's talk about it." And they can even say, "I'm uncomfortable talking about this, too. Let's talk about it now and then we can certainly go to the doctor's office and get more information." And also, I think they do need to bring up contraception and say, "There are really effective methods of contraception and if this is something that is a possibility that is going to happen, let's go and talk to the doctor or the clinician about contraception and what's going to be the most effective method for you to use."
Melanie: It's so important--that open line of communication—and to know if your child has a boyfriend or girlfriend and then you can discuss those things. And so, now, tell us about your team at the UVA Teen and Young Adult Health Center.
Dr. McLaren: Well, the Teen and Young Adult Health Center actually was started 21 years ago to prevent teen pregnancy in Charleston and the surrounding area. We have evolved into a full adolescent and young adult health center so that we do total adolescent and young adult care, which can be sports physicals, it can be care for asthma, it can be care for sexually transmitted infections. We do a lot of contraception. In fact, we're probably one of the leaders in this part of the country in providing long-acting contraceptives for adolescents. We also do mental health care. We are developing an eating disorder program. Then, we also have a program for transgender youth and young adults. So, it's really trying to meet a lot of the different needs and issues that come up for adolescents. It's a place that they can come and feel safe and feel welcome. We have a small staff and we get to know them very well. We try and have them see the same provider when they come back. And so, it really is a great, great location. We also do community outreach. We have a person--a health educator who works with peers in the schools and actually gives the peers the right information. So, if a young person goes to a peer, they are getting the right information. We work with Boys and Girls Clubs in the community and with different youth groups. So, it's really a full, comprehensive health center for teens and young adults.
Melanie: Thank you so much, Dr. McLaren, what great information. We applaud all the great work that you're doing on behalf of teens and young adults. You're listening to UVA Health Systems Radio. For more information, you can go to uvahealth.com. That's uvahealth.com. This is Melanie Cole. Thanks so much for listening.
Melanie Cole (Host): It's so important to continue working to reduce the teen pregnancy rate. How and when should parents discuss this with their children? My guest today is Dr. Nancy McLaren. She's board certified in pediatric medicine and specializes in caring for adolescent and teen patients at UVA Health Systems. Welcome to the show, Dr. McLaren. Why is it so important to work with teens to reduce this pregnancy rate?
Dr. Nancy McLaren (Guest): Well, we want to give them a chance at having a better life and the cycles certainly have shown as with teen pregnancy, if someone gets pregnant as a teen, then the possibility is that their child will also have children in their teenage years. It's important really, to give them a better chance at succeeding at other goals that they may have in education and really advancement and really sort of break the cycle of poverty that teen pregnancy can put someone in.
Melanie: So, what are some of the best ways to reduce? Are we looking at media outlets or are we looking directly to the parents and the loved ones of these teens to be the ones involved reducing this rate?
Dr. McLaren: Well, the most important person in the teenager's life, or persons in their lives are their parents or their guardians that they're close to. The importance of parents starting to talk to teenagers starts when they're really quite young--when they're 9, or 10, or 11. Really encouraging them to be active in other things in their lives, in school, in sports, in music, and other things that make them feel positive and strong about their lives and really getting them involved. Being involved in the community and their schools and family is a very large protector against teen pregnancy. The other thing is to talk to them also about sexuality and what they feel about their bodies and what's involved with sex, basically—to have the sex talk but start it when they're quite young so that it's not an uncomfortable thing at all when you have to sit down at age 11 or 12 and have this puberty talk. Really start with them when they're quite young, learning about their bodies, and what their bodies do, and feeling good about their bodies and wanting to take care of their bodies. And, again, I say that conversation can happen in the pediatrician's or the adolescent physician's office but it's really important that it happens at home with the parents and having them involved so that the teens get comfortable, the young people get comfortable feeling that they can go to their parents and ask questions.
Melanie: If the parents don't discuss it, the children are going to learn about these kinds of things from other sources, which may not be reliable. So, how do you tell uncomfortable parents, Dr. McLaren, how to start this conversation? What do you tell them about the fact that some of them believe that if they start this conversation, they're opening the door to permissive sex for their children?
Dr. McLaren: Well, first of all, what we try and do when parents are coming in with their young ones, even at 8, 9, and 10, is to give them some tools to have. That can be books, reading with their children. There are some great books out there to talk about how your body is changing and what's going to happen and having the conversation even earlier on before the young people get where they're sort of more reserved and withdrawn and more quiet about things. Then to continue that conversation going through the teen years and telling parents, "It may be an uncomfortable conversation, but it's really an important one to have." Otherwise, they are going to get information from their peers and from the media, from the internet, and the information they get from there may not be as reliable or as factual as what they could get from their parents and from their doctors. I think they can—and if the parents are uncomfortable, we'll say, "Why don't we have the conversation together in our office?" and that can be another way of helping with it. And starting it, again, when they're younger, and not waiting until they're 12 or 13 and no one's ever had the conversation.
Melanie: Well, one thing I appreciate that you pediatricians do is when the teens come in for their well visit, now they get to fill out a form that discusses with them about drug use and that the parents don't get to look at it unless the teen says it's okay so that they feel like they can trust their pediatrician, which is a great resource for them to get some of this information. Now, when the parents are beginning this discussion, do they come at it as "I don't want this to happen"? How do they discuss protection and “if you are going to have sex, you must protect yourself from pregnancy and sexually-transmitted infections”?
Dr. McLaren: Well, I think you can almost say it in just the way you said it. In the sense that we do know that teenagers are having sex as they go through middle school and high school and the goal would be first to talk to them about the risks of having sex at an earlier age, so if that is going to happen, talking about protection and what ways can they find out and learn about protection, whether it's condom use or whether any of lots of different birth control methods that are out there. Even to say, if you're not comfortable talking with me, let's go to the doctor's office and talk to the doctor. We do give, once they're 11 or 12 years old, we do always want to have a time of privacy with the adolescent to give them freedom to talk about some things. Maybe to help them figure out how to talk to their parents about some of these issues, too, and letting them know that the parents really want to protect them and take care of them and help them through this time and have them see their parents as resources, also.
Melanie: Is there a role for those after-school specials and scare tactics showing 14-year-old girls with babies and kids that have had to drop out of high school? Do you agree with that kind of way of going about it?
Dr. McLaren: I think it's--I mean, we certainly in our clinic use humor and information in that way, not as scare tactics, but just to have them think about things. I think that it's better to talk about "if this does happen," and certainly after-school, having young people in activities after school. The time for highest risk for pregnancy with an adolescent is between the 3: 00 - 6: 00 time because people are not around and they have more time alone, so getting them involved in other things. But it's really talking more about what their hopes and dreams are and what they want to be doing. I think it puts it in a different way of having them look that way rather than what's going to happen if you get pregnant. Really trying to get them to think beyond just the moment and what they want to accomplish and how to go about doing that and that preventing pregnancy--teen pregnancy--can make a big difference in helping them accomplish that.
Melanie: So, in just the last few minutes, give us your best advice for parents about discussing this with their children, when the appropriate time is, and how to begin. Parents don't even know, Dr. McLaren, how to start that conversation.
Dr. McLaren: Well, it's not an easy conversation to have. I've had to do it with my three kids, and it's just a matter of sitting down and saying, "You know, I have something we need to talk about, I'm concerned about this or that. We want to make sure that you have all the opportunities that you can. We would encourage you not to have early sex but we also understand this may happen. We want you to get the right information from us or from your doctor. So, let's talk about it." And they can even say, "I'm uncomfortable talking about this, too. Let's talk about it now and then we can certainly go to the doctor's office and get more information." And also, I think they do need to bring up contraception and say, "There are really effective methods of contraception and if this is something that is a possibility that is going to happen, let's go and talk to the doctor or the clinician about contraception and what's going to be the most effective method for you to use."
Melanie: It's so important--that open line of communication—and to know if your child has a boyfriend or girlfriend and then you can discuss those things. And so, now, tell us about your team at the UVA Teen and Young Adult Health Center.
Dr. McLaren: Well, the Teen and Young Adult Health Center actually was started 21 years ago to prevent teen pregnancy in Charleston and the surrounding area. We have evolved into a full adolescent and young adult health center so that we do total adolescent and young adult care, which can be sports physicals, it can be care for asthma, it can be care for sexually transmitted infections. We do a lot of contraception. In fact, we're probably one of the leaders in this part of the country in providing long-acting contraceptives for adolescents. We also do mental health care. We are developing an eating disorder program. Then, we also have a program for transgender youth and young adults. So, it's really trying to meet a lot of the different needs and issues that come up for adolescents. It's a place that they can come and feel safe and feel welcome. We have a small staff and we get to know them very well. We try and have them see the same provider when they come back. And so, it really is a great, great location. We also do community outreach. We have a person--a health educator who works with peers in the schools and actually gives the peers the right information. So, if a young person goes to a peer, they are getting the right information. We work with Boys and Girls Clubs in the community and with different youth groups. So, it's really a full, comprehensive health center for teens and young adults.
Melanie: Thank you so much, Dr. McLaren, what great information. We applaud all the great work that you're doing on behalf of teens and young adults. You're listening to UVA Health Systems Radio. For more information, you can go to uvahealth.com. That's uvahealth.com. This is Melanie Cole. Thanks so much for listening.