Unknown Speaker  00:01
different ages, different walks of life. From 170 to one we can start by quickly going around just introducing ourselves

Unknown Speaker  00:18
and I work for the Allen bookmarkers

Unknown Speaker  00:24
Monica Myers, I'm a pediatrician with adolescent medicine so I take care of I'm Sarah Johnson. I go to school here

Unknown Speaker  00:48
Janet I work with the national church organizations that have agencies. I'm Lexie, I'm a student here and my name is Joanne mousy and I worked for two choice is what you have to

Unknown Speaker  01:31
do are destined psychoanalytic teenage High School.

Unknown Speaker  01:50
My name is Lisa. Jenny's American public

Unknown Speaker  01:59
school principal and I also work with flavors in Philadelphia anniversary.

Unknown Speaker  02:07
Shall we told the New York State Assembly task force. So just begin by raising two questions. The first thing is transplant what we'll call this time we call this workshop. And I guess I put low American baby carriage together with the question well, since it used to represent a slogan about what we wanted, and what made

Unknown Speaker  02:47
us and given all the changes that have gone on the past 15 years, that's no longer the case. It's not really representative. changes like legalization in Washington, or central London revolution, women's movement changed.

Unknown Speaker  03:07
And I think what that

Unknown Speaker  03:09
seems to mean is

Unknown Speaker  03:13
that an element to have often mentioned is the timeline. Most amazing statistics, which said the 1950s and teenage birth rates were higher. There were fewer babies born out of wedlock. 57%. And the 1975 years, and also will change clarify teenage pregnancies getting more and more associated with poverty is culture that add twice as many black girls. The whole issue is associated with the legitimacy, feminization of poverty varies on social ills. And I think we have to think about the extent that when we think about an issue, when you think about adolescent sexuality, those things are all in the background. And your column just the way we think about sexual sexuality in general. And how do we make sensible that moves between all those things? The other thing that I've kind of wondered about most of doing some research, comparing the way teenagers is looking for as little as possible populations can be that sense as well. And I've tried to move away from just a decision that besides just looking at the issue of the decision to use contraception and not using the questions that you have to ask yourself to make sense of that decision. But what does it mean to be female in society, where it's meant to be a white female? What does it mean to be black female What does it mean, to be making decisions about contraception at the same time that you separated at the same time, that just see whether relationships with peers with boyfriends, doesn't matter what your household structures are, doesn't matter with a lot of marriage or divorce or, or separation. People make sense of all these things that are going on simultaneously. What about one solutions in the future, all consoles and adolescents with a kind of normal outside doesn't matter for the opportunity to assign has to offer us. And I guess it sounds like a lot to look at once. But it's an effort to see whether or not

Unknown Speaker  05:53
maybe you can start making some of these connections. Somehow we need to make sense so we have a different view. So I see it as well as parts of the hall and I like to see so many different people since

Unknown Speaker  06:07
I think we all have something

Unknown Speaker  06:08
to say that might be useful

Unknown Speaker  06:12
and put them out.

Unknown Speaker  06:15
Deidre is going to talk a bit about the work that she's out and about mockers.

Unknown Speaker  06:18
Some of you may know that that was a comparative

Unknown Speaker  06:22
cross cultural research project, intimate issues of sexual activity, pregnancy, sex education, both in the United States in Canada, and in fact about a year ago, according to study two times and participating in this research. Mark has worked works in the GYN clinic in St. Louis. She also been part of what I hope the growing trend, which is the development of comprehensive health education programs and public schools in his analysis at Brandeis High School in Martin Luther King. And we also have a tape about both common sense monocle time or bad, and, and a movie as well, depending upon how things go. So I'm going to turn the program over to Deidre and we want to hear from you a lot.

Unknown Speaker  07:16
Talking to I'm going to be very brief, especially after Janie talked about all those interesting topics. And what I'm going to talk about is, I'm afraid less interesting. So I will try and keep it short. But it's not as well. It's not as exciting as it is immediately fascinating. It's all the things that thing throughout this and I'd like to talk about, but the Alan Guttmacher Institute used to be affiliated to Planned Parenthood Federation of America in the early 60s, but became an independent research organization in the 1970s. And we see our purpose as one on behalf of American women to keep contraceptive services available to all women, especially poor women, and ever since the legalization of abortion, to make the provision of abortion services equitable, not just dependent on where you live, or how much money you have. We're also very interested in prenatal care, because we don't just want to help women stop having babies. But if they want to have babies, we know that they want to be able to have healthy babies and get prenatal care. So it's a it's a big reproductive package. We got very interested in teenage pregnancy quite early on. And some people accused us of having created the fear of teenage pregnancy epidemic. We may be guilty, I don't know. But we certainly I think brought it to the attention of the American people publishing a lot of statistics about it. In a magazine that I work for, we published a lot of articles, we've always been aware that the pregnancy rates in this country are higher than they are in most other developed countries of the world. That is most countries where people live in an industrial society where it's not from mostly rural or agrarian, there's not a peasant system, where there are good means of communication and most people are educated with a start from high school. So I think we're broadly talking about Canada, Australia, New Zealand, countries like Japan and most of Europe. So we, we were very we were very intrigued a couple of years ago, when some demographers at Princeton published some material in our magazine, which showed exactly how much higher the birth rates were in the United States than they were in any other developed country except a few in Eastern Europe and among the Arab population of Israel. So we thought, well, we've got to do something about this. Why is this so is it Is it simply a problem of race in this country? Is it a problem? As many people have always said, kids just get pregnant here so they can go on welfare? Is it true that, for example, in other countries, teenagers don't have sex so they don't get pregnant? I mean, as the sexual revolution happened here, and not in the rest of the world, but American parents too permissive, there were a whole lot of questions we wanted to look at. So we, we did first a very complicated, called a macro analysis looking at 37 countries. And we looked at those looking at hundreds and hundreds of variables, literally to see if we could find statistical associations between the pregnancy rates in each country and things such as sex education, the provision of health services, levels of education, levels of unemployment, it was a very broad study.

Unknown Speaker  10:56
A piece of paper you have shows you exactly what we were looking at, we knew about the birth rates, what we didn't know about. And what we found out about was the abortion rates. And if you add births to abortions, the black is abortions and the white of births. And if you add them together, that's a rough approximation of how many teenagers get pregnant every year. That's a fab per 1000 teenagers. If you see on the left, you've got for the United States, you've got the highest one, which is 96,000, which is for all teenagers, black and white. And then because we were interested to show that it wasn't just a black problem, we looked at the figures for whites, and you can see that it's 83. For white teenagers, the rate, of course, for black teenagers is double. But because the blacks in this country only represent about 14% of the total population, they don't push the total layout very much, very much higher than it is for whites. And then of course, you can see we looked at five other countries in detail after we looked at these 37 countries. And these were the findings that we made on England, and Wales, Canada, France, Sweden, Netherlands and the Netherlands and members of our staff, our survey staff visited all these countries. I'll tell you first about the major findings, the from the from the from the larger analysis, it's very difficult to measure lots of the variables we were looking at. So many of them have to do with attitudes, and and sociological components that are just hard to get a measure to, but we did find that in countries that were less affluent, the birth rate of teenagers was higher. Except in the United States, the United States is an anomaly. It's a very, very wealthy country, but its birth rates are higher than they are practically anywhere else in the developed world. We also found out that in countries where what we call openness and openness towards sexuality is, is is good, where there is a lot of discussion in the mass media about sex where there is nude bathing where condoms are advertised. And funnily enough, even when pornographic materials or sexually suggestive materials are widely available in those countries, we found lower pregnancy rates. We also found that in countries with an equitable distribution of income that is where there's not a huge gap between the very rich and the very poor. We found that in countries where there is a large middle class and perhaps a small group in poverty, and a very small group of rich people, there are very low, very low pregnancy rates. Again, the United States, of course, doesn't fit that pattern because the distribution of income in this country is far less equitable it is than in any, any of the other countries that we looked at. Those may not seem very exciting conclusions, but I think they'll you'll understand why we were interested in them later on. When I go on to talk about what happened when we visited the countries. When we visited the countries. We talked to everybody we could who would have anything to do with providing services to teenagers, teachers, sex educators, doctors, people in government. We also did a lot of private research, we talked to people in the mass media. It wasn't a very satisfactory way of doing things, but it was the best we could. And we gained some impressions and I'll tell you some of the major conclusions that we arrived at from that part of the study. We found out above all, that the reason for the higher pregnancy rates in this country is not because American teenagers have sex at an earlier age or have more sex than they do in other countries. So in fact, of the countries we looked at, I would say that in Sweden, if anything, teenagers began to have sex at an even earlier age than they do here. In Canada, perhaps they start a little later. But then then the other three countries England and Wales and France in the Netherlands is pretty much the same pattern. Now, again, I have to tell you that it is very difficult to find out correct data on this, you have to look at large surveys to be able to really get a good estimate of when teenagers begin their first sexual activity. And I would like to say to that, I'm not very happy with the way sexual activity is measured in any country, because basically, it's asking teenagers when they first had a sexual experience. And as soon as they've answered that they've had it, then you call them what the demographers call sexually active. And I think it's a big mistake. But a

Unknown Speaker  15:55
lot, lots of people talk to us about the problems and this because they do believe that in many countries, girls have a sexual experience, it may be a very brief liaison, and then they may not have another partner for many years afterwards. But somehow, we looked at them still as being sexually active simply because they are no longer virgins technically. We also found that the pattern of contraceptive use in these countries are rather different than they are the United States is much more emphasis on pill use in all the countries we visited. And in many of them, in order to get on the pill. Doctors don't always insist that girls get a pelvic examination as they as they do here. Sometimes that may be very off putting to a young girl to think she has to have a pelvic examination before she can go on the pill. And lots of the doctors we talked to said once she is feeling more competent and has developed a relationship with a doctor, they will encourage you to have a pelvic examination but they wouldn't insist that she had one before putting on the pill. By and large services for teenagers were better simply because all the countries we visited have a national health service. Like it's a very important point that medical care for primary health services free in all of those countries and teenagers by and large is used to go in to see their family doctor as they are to go into school, it's a natural thing to do and you don't have to pay for it. Interestingly enough, abortion services are less easily available in many of the countries abortion is free and most of them but there are more there are more rigorous requirements and in some of the countries can't get an abortion without involving the parent in some you can't get an abortion after the first trimester sex education we found was uneven. Of course, everybody I suppose knows about Sweden we were absolutely bowled over by the sex education in Sweden. I don't think anybody who's gone there wouldn't be impressed by it. It's it's a very moving experience to see. Five and six year old children even though we couldn't understand the language dealing very naturally with topics of nakedness relationships among each other with their parents. They begin very slowly they talk about it isn't it isn't an a neutral. It isn't the value free sex education Swedes believe profoundly that sex is one aspect of human relationships. And so they start with very young children talking about the family and talking about their relations with each other and then it broadens quite naturally, I think into talking about sexual matters. There was other things that we noticed when we went to these countries. One is that there was less divisiveness in the society, there seemed little polarization than there is here between those who believe that teenagers are entitled to sexual become to be sexually active and those who believe that all premarital sex is not the abortion debate is not nearly as virulent in these countries as it is here. There are people who are opposed to abortion and of course the Catholic Church in these countries is but by and large, there's not nearly the amount of highly organized and very well funded opposition to abortion and to contraceptive services as there is in this country. For example, the Moral Majority. By and large, the whole issue of teenage sexuality is not seen as a problem or is seen as a problem is teenage pregnancy. We didn't talk to any government representative whoever suggested to us that that they saw that task as to encourage chastity among teenagers. They find that very strange in American society. They think that's interference, quite uncalled for the role of government, they believe is to help young people who do decide to become sexually active to prevent getting pregnant. The other findings are more general. But I think they're also interesting. I think what we didn't find we didn't find out the answer as to why European and Canadian teenagers get pregnant less than they do. Yeah, there are, there's no one answer that we found, we found that lots of the myths that Americans have about teenagers are simply not not true. One of those myths is that teenagers are simply too immature to use contraceptives. And that was certainly disproved to us by our findings of

Unknown Speaker  20:54
very effective contraceptive use by young people in countries where services are made available for them, where there is sympathetic understanding of their problems. We didn't find that in countries where sex education and contraceptive services are widely available, pregnancy rates are higher. It's incredible to me, but you hear it every day. And you read it in the press that people honestly believe in this country that if you provide sex education, and if you make contraceptives available, you're encouraging sexual promiscuity and that you're just going to end up with higher pregnancy rates. And we simply didn't find that. We also had thought a great deal about the question of poverty. And we looked, as well as we could into whether in countries where there were high unemployment rates among teenagers, pregnancy rates were higher. Well, it was interesting to find out but the most of the countries we visited, the unemployment rates were as high and in some senses higher than they are. In this country. I'm not talking about black unemployment rates, I'm talking about the overall unemployment rates. The big difference, of course, is that in most of the countries we visited, not only are there health services, but there are by and large, much broader welfare services, and there are, there is unemployment. There are unemployment benefits for teenagers in all of these countries. In fact, in Holland, for example, if a teenager leaves school at 16, which many of them do and can't find a job. They are entitled to not not a great amount of money, but a large enough amount of money weekly to survival. And they're allowed to receive it, even if they don't live in their parents home. So many teenagers, we were told 16 and 17. Even if they don't find a job move out of the parental home and begin to live together in groups of five or six share very simple accommodation, but make some kind of a life for each other. Now, in the Netherlands, that people are worried about that, because I think there's gonna be a whole generation of young people who may never work, because unemployment rates are so high, who won't know what it is like to provide for themselves. On the other hand, in this society, where people are worried about unemployment as they are, you will see on your on your chart, they have the lowest pregnancy rates, and then in the country. And the other thing is that we found that it is not true that teenagers get pregnant in societies where welfare benefits are made available to them. How many times have you heard Well, the problem here is AFDC. If the if there were no AFDC kids that wouldn't be getting pregnant, they're just doing it so that they can get a free ride? Well, in all the countries we visited, the welfare benefits of anything were much more generous than they are here. But we didn't find that it resulted in

Unknown Speaker  24:03
higher pregnancy.

Unknown Speaker  24:06
I think I'll stop there. Because I don't want to sound I don't want to sound as if we've, we've we've found the answer. There are lots of things in the societies we looked at, which aren't going to happen here. That simply because the countries we looked at are smaller. They are more homogeneous, I think I don't think they have the problems in the United States. But I think it is useful to know that it is possible to find societies where teenagers began to have sex and around 16. That was the median age in most of the countries. And where, as you can see, pregnancy rates are very high and each country had a different way of approaching the problem, but all of them succeeded and are succeeding better than we are doing here. So you should gain some kind of encouragement For me, it was not an insoluble problem,

Unknown Speaker  25:03
because I couldn't stop them.

Unknown Speaker  25:07
They just spoke about was this sort of idea of Americans being ignorant such as saying, like contraceptives, that there's no going around sexuality, sort of pointing into that sort of dualism. I was wondering if if you researched among European countries, etc. Their advertising because only the timeline for the summertime. There's there's such a huge amount of advertising America, geared towards teenager, teenagers and the media like that TV, magazines, etc. That sort of clown is sort of supposed to be innocent, but then again, you're supposed to be sexualized age was advertising.

Unknown Speaker  25:52
It's it's very, it is very widespread. Yes, exactly the same kind of huge billboards, young people in you know, provocative postures with blue jeans or smoking and looking very sophisticated. There is no MTV, but I would, I think that the advertising is almost it's very similar in all the countries the big difference is that the mass media, the television, and the radio, particularly most of these countries, is controlled by the state. So that there's a much broader range of programs on much more discussion on television and on radio of sexual issues, much more freedom to discuss provocative issues. And in the Netherlands, particularly where there isn't a very good sex education program. There is an incredible amount of open discussion in newspapers, magazines, television, radio about human affairs, whether it's homosexuality, lesbianism health problems, contraception, not in all the countries now. No, condoms are very widely advertised in. In England, for example, but not at all in France, there's no, there's no advertising of contraception. However, there was a huge campaign introduced in the in 1980. By the letter the head of the department of women's affairs event booty, which was a national campaign on primetime television in France, to inform women of their right to contraception, regardless of their age, their marital status. It was an enormous campaign, it was just it just there wasn't a French person who wasn't made aware of it. And I got some examples of the kind of materials that you quite openly see in some of these kinds of and I'll show some of them to you afterwards. They are amazing. When I talk about sexual openness, government, a government leaflet, simply a leaflet, printed for women to pick up in a clinic or at the doctor's waiting them explaining the use of the contraceptives, which the photographs are more frank than anything I have ever seen. In this country, there is a quite without any explanation of a photograph of a woman putting a condom on her partner's erect penis, there's a photograph of a woman inserting a diaphragm and she's simply squatting down on the floor and inserting it. And you can see that it's all done very, very matter of factly. And I think that's the other side of the coin of there being a great deal of sexually provocative advertising, but also to counterbalance it was a great deal of very, very matter of fact, in provision of information about

Unknown Speaker  29:00
contraception, and

Unknown Speaker  29:02
so I won't hand them around now. But if anybody wants to look at those after the session, we have sorry, it was a rather long and involved of good questions.

Unknown Speaker  29:19
And I'm excited to be here today, because I think we're a very special group of people to be here in the same room. Some of us are parents and foster parents of teenagers. Some of us have just been teenagers. Some of us are teenagers, and some of us are going to be teenagers. pretty unusual to have a group of people like that together in the same room to discuss what we have on the agenda for today. I think perhaps all of us getting a chance to share some of our ideas together may help us deal with this very difficult issue in America. I must say I haven't gotten over my adolescent fear of talking in front of groups, I still have to use notes excuse myself, I have a favorite cartoon that I'd like to tell you about. It's a cartoon of two young people walking down the street together, and they're talking very seriously. And one of them says to the other, you know, I think puberty is when your body catches up with your mind. Like in most corny humor, I think there's a real important kernel of truth, we all need to think about that is that by the time most young people are physically ready, and able, have the equipment they need, are easily able to have a penis that gets wrecked when it wants to have a vagina that's ready to have sex. By that time, most young people have done a great deal of thinking about having sex and what that means. It's not the thinking follows. Having sex instead, having sex really comes after doing a great deal of thinking about it. And I think part of our task for today is to discuss how we can make best use of our minds and our bodies when we decide to have intercourse. Another way to say it is that, that what we need to think about is what's best for our whole persons for our whole selves, when our penises and vaginas come together to make love. As Jamie mentioned, I run the adolescent medicine program over at St. Luke's Roosevelt Hospital Center. And so I get to spend most of my day taking care of people who are between the ages of about 12, and 21. And I also now do have the opportunity to be running a comprehensive health care program at Brandeis High School and Martin Luther King High School. We'll talk a little bit more about that afterwards. As I explained to my patients, I think people who are adolescents have a very different set of health needs than people who are this high. And then people who are parents. I think our health needs are different because of all the dramatic changes that are going on in our bodies and minds. As teenagers. Within a very short space of time, our bodies get much taller, change shape tremendously. Girls develop a figure which means get breasts and get hips. boys get much taller and stronger and a lot more coordinated. Penis grows and takes on a life of its own. Menstruation occurs, wet dreams occur. sexual fantasies occur thoughts and dreams about having sex, and often intercourse occurs. And sometimes pregnancy. It's very different for a teenager, when they go to a doctor or a health provider of any kind than when they went to the doctor, as a child, you go to a doctor as a child usually come in holding your mother's hand and sit on your parents lap. When you go in as a teenager, you want to be able to talk for yourself, you want to be able to have a confidential source of health care. And that's one of the things that we provide for teenagers at both at St. Luke's Roosevelt and at Brandeis and Martin Luther King. What I'd like to do today is I'd like to tell you about some of the whys of adolescent pregnancy, from my own perspective. And we'd like to show you a couple of films that are examples of sex education in America today. And very much like to hear your opinions of those. And, of course, it's easy for all of us to think theoretically, about sexuality of adolescent pregnancy, I think, towards the end, what I'd like us to do, maybe the hardest thing, but most important thing for all of us, and that is to try to share some of our own personal experiences, our sexuality or our thoughts or experiences with pregnancy, and perhaps come up with some suggestions for how we can make it better. Why is that? Listen, pregnancy a concern, especially in America. First, there are societies in which it isn't a problem at all, because there are societies that don't have adolescence. If any of you spent any time studying the societies that societies that Margaret Mead study, the phenomenon of adolescence really doesn't occur. What happens is children maybe go through a very elaborate ceremony that might last a day or a week. But then they take on the role of adults within a society there isn't the same in limbo period that exists in our own society, where we spend a great deal of time being somewhere between children and parents.

Unknown Speaker  34:20
Is adolescent pregnancy, and sexuality and abnormality in a barren sea, something we ought to try to change. Perhaps it's something we ought to try to change, at least to the extent that it exists, but it certainly isn't an abnormality. It's part of the normal processes. One of the side effects of growing up being a teenager in America today. And I think that I listened pregnancy results from four different areas that overlap a lot. The first is the normal process of adolescent development that we'll talk about in a moment. The second is adolescent sex education, what it is and what it isn't in America today. As Detroit was telling us And the third is Deidre also mentioned is that the availability and the accessibility of health care for the sexually active adolescent today. And by availability and accessibility, I mean cost and accessibility of confidential care for adolescents. And the fourth reason has to do with the role of mythology in our society today. First, let's look at adolescent development, we like to think about adolescents having four main tasks that they need to accomplish to grow from being children to being adults. The first is a physical task, that is the change in bodies that occurs. And main change, as you all know, from experiencing it right now, or from having experienced it some time ago, is the development of the genital parts of our body. So that means primarily breast and penis, and testicles and the whole pubic area of our bodies. The physical task is growing into people capable of having sexual activity. The second task is achieving one's own sense of identity, becoming one's own person, no longer being a child within a family, but instead taking on one's own set of values and beliefs. And for most of us, this includes a great deal of time in which we identify a whole lot with our peers, people our own age and want to do things that our peers are doing. So for many young people growing up today, having sex means doing the same thing that one's friends are doing, being able to talk about it with one's friends being able to score. It's also a very important time in which we form serious relationships with members of the same sex are members of the opposite sex. And much of that intimacy, much of experiencing a close relationship with another person is having a sexual relationship with that personal part of achieving one's own identity is naturally rebelling from the values that we were taught about. So most of us when we were teenagers go through a period of time where we feel very differently than our parents feel. And if our parents have a hard time talking with us about sex have a hard time recognizing sex as part of normal growing up, then it's an obvious way for us to rebuild from them. So we have called kind of sexual acting out, we act out by having sex, just to get back at our parents for not being able to talk about it as an act about it as a normal part of growing up. A third area of adolescent development is the cognitive one, we have a new way of thinking about the world. And this new way of thinking causes us to do a whole lot of exploring and experimenting. And certainly one of the ways that we explore an experiment is sexual. Sometimes teenagers do a lot of Magical Thinking, can't tell you how many times people come into the office and say, I just knew I couldn't get pregnant last night. And I really believe it. It's a real magical thinking that's associated with being a teenager. It's different than the magical thinking of believing in Santa Claus. But it's, it's just as important.

Unknown Speaker  38:04
The fourth task of normal adolescent development is finding a meaningful place in society. And, again, some of the issues that both Deidre and Jamie were addressing the issue of finding a meaningful place may mean establishing a family of one zone, or not establishing a family of oneself may mean getting a job or not being able to get a job and certainly for many teenagers growing up today, having a baby, it's a way of being real, a way of having a real place in the world. And the story that's most poignant for me is a story of a 12 year old young woman who was incarcerated at Spofford reps. Most of you are from New York City know about Spofford. Spofford is the juvenile detention facility in the city of New York. And it's where kids go, they've gotten into trouble with the law. And in there was ice running the MediCal program there. And we routinely did pregnancy tests, and all the young women came into school. And a 12 year old young lady had a positive pregnancy test. And I was talking with her about the results of the test. And I asked her what her plans were actually she was sitting in my office kind of sucking her thumb and sort of curled up, almost fetal position. And I asked her what her plans were. And she said, without hesitating moment that she was going to be keeping her baby. And this was a young lady who had no idea where she was going to be in the next nine months, because she didn't know if she was going to be sent home or she was gonna be sent upstate or what was going to happen. And I asked her how she made her decision. And she answered again, just as quickly that she wanted to have a baby because because she wanted to have someone to love her. So her view of having a child was that she was going to have a permanent being there to provide her with love. And she really couldn't see that we're having a baby really means is spending a whole lot of yourself giving love to this person who can return very little for many years. Yes, I'm going to leave there the issue of adolescent development and how that affects adolescent sexuality and pregnant See, and let's look out for while the issue of sex education. The truth is that in this country more and more sex education really is occurring, more and more adults are saying that sex education is important. And I think that maybe within 10 or 20 years, we may catch up to Sweden. And we may really see that we're a much open our society not only by word, but actually an action about the issue of giving sex education. I want you to know what the difference is right now between our country in a place like Sweden, where sex education is much a winner. Between 1974 when Sweden instituted a new sex education program in 1980, the rate of pregnancy went from about 70 young people who are teenagers per 1000, being pregnant, went down to 43 per 1000, almost cut in half in those six years in Sweden. Within our own country, the rate went from 100 per 1000. So 100 young people between the ages of 12 and 19, giving birth, I'm sorry, becoming pregnant to about 115 per 1000. So actually went up in our own country, despite the fact that we say we have more sex education, and more availability of birth control. We have more than a million pregnancies occur and adolescents in our country. One of the amazing facts for me as a provider of health care is that about half of these pregnancies occur within the first six months of having sexual intercourse. So of those million adolescents who get pregnant, more than half of them get pregnant within the first six months, having intercourse for the first time in more than 20% of them get pregnant within the first month of having sex for the first time. That despite the fact that when some statistics show that about 16% of young women think they couldn't possibly get pregnant the first time they have sex. A study that was done in Baltimore showed that about four out of 10 Adolescents thought they needed their parents permission to go to a birth control clinic, thought of 10 thought they needed permission. And more than 50% thought they needed permission to go to a drugstore and buy birth control of any kind, whether it's condoms, or phone, gel, or birth control pills.

Unknown Speaker  42:15
What do we mean by sex education, certainly not just the physiology of what has to go where the egg and sperm meet, but we need to talk freely about sexual expression and making sexual choices. We need to address our teenagers respectfully and talk about the validity of sexual feelings and choice making. More than 75% of major American cities today have some sort of program and sex education, including New York City, but less than 10%. Talk about contraceptives and where to get them by ninth grades with less than 10% of all those programs say anything about contraception and where to get it. Yet we know that 84% of males 50% of females have had sex by the end of junior high. They haven't heard anything in school about where to get contraceptives out most. Okay, those statistics are based again, not on national studies. They're based on urban and urban study done in the Baltimore area. But also the study about sex ed was based on a similar population. So number that I said was about 84% of males. And 50% of females had had at least one episode of sexual activity by the end of June. And again, as Deidre has said, in as many believers feel sex education does not seem to increase the likelihood of having sexual activity studies have shown that where you have sex ed, kids aren't any more likely to have sex than in places where you're not having sexual education. So we said before puberty is when the body catches up with the mind. The third area I said think makes a difference. adolescents have the ability to use birth control and decision to do so has to do with the availability and accessibility of birth control, and birth control clinics. When adolescents were asked to select how they choose a place where they would go for birth control, they said the first thing that was important to them was a place where they could get confidential care. The next thing was a place that cared about taking teenager cared about taking care of teenagers. And the third place was that they would go to a place where their friends went. The cost of birth control is a major issue we need to be aware of in Sweden all birth control is free. Here we don't even have vending machines for kids to get condoms at for example usually have to go into a drugstore. Many drugstores condoms are behind the counter. So for either a girl to get condoms for a boyfriend or for boy to get them for himself. You have to go up to someone and ask for him. A lot of times when you're first having sex, that's not a real comfortable thing to do. So here even non prescription brisket control can be difficult to get. Now, all kinds of birth control are available on Medicaid. And that's very important. So those of you who are able to get Medicaid know, you ought to be able to ask your health provider to give you a prescription for condoms or give you a prescription for the diaphragm, or the birth control pill. If you don't have the fortune of being on Medicaid, the costs are incredible birth control pills cost $13 For a month's supply, the diaphragm costs about $12. In order for the diaphragm to be effective, you have to have some spermicidal jelly, and that costs $8 per two. And condoms range from about 250 to $16. For 12 of

Unknown Speaker  45:39
us to go get food for definitely you if you go to Planned Parenthood, it's like $50

Unknown Speaker  45:45
Great that to my next. Medical care is tremendously costly. I don't know any place other than a few free clinics were clinic visit now costs less than $75. And an abortion and abortion in this country costs between 250 and $350. The fourth area that I mentioned, affects sexuality today in America has to do with the mythologies that we have in our society, I think there are a whole lot of ways that we're kind of a lip service society, we pretend to be open minded about sexual activity, appropriateness of it, and yet, there are a lot of messages to teenagers about what's not right, what's not good about it. This we've already spoken about the importance of advertisement, teenagers get a real double message all the most popular movies have a lot about sexual activity. And the idea you get as it's this great, glorious thing from the first moment on magic happens. Yet when I asked my teenage female patients how they experience intercourse, usually what I say is when you have sex, is it fun to block? Or is it painful? What do you think I get? More than 50%, more than half of teenagers say that it's but since I've been taking care of teenagers is trying to find ways to make it easier. And one of the things that sometimes works is that for most teenagers a big question in their minds is am I normal? Are the feelings that I have normal feelings? Or are they just feelings that I have? And so sometimes I'll try to help teenagers talk about things by sort of introducing a topic and saying something like, you know, one of the things that is on almost every teenager's mind when they come into the office has to do with some questions about having sex. And then I might kind of bring up the issue in that way. Sometimes when we tell people that everybody has that question, thought undermine, it makes it easier to talk about. But sex is hard for adults to talk about. Most of us don't ever really do as good a job as we do talking about the weather, or what we had for breakfast. So as you just really brought up, I think the idea of how important it is to talk about and yet being able to do it are two different things. It's very hard to acknowledge our sexuality, I can't tell you how many kids, young people who really have a very good relationship with their parents, and try to talk about everything they can, their parents won't go on birth control, because going on birth control means they're admitting to themselves that they're sexually active. So if you go so far as to go get condoms, or go get birth control pills, or go get a diaphragm, you're saying to yourself, Hey, me, I'm having sex. And that means meeting to kind of tell your parents that that's what you're doing. And for a lot of people, it's easier to kind of pretend it's not at all happening, except for those few moments when you're having intercourse. Yes.

Unknown Speaker  48:49
My friends told me that everybody knows us actually.

Unknown Speaker  49:04
Know I think you know, that's, that's somewhere part of what we mean by the myths that go on, people have all these beliefs that have nothing to do with the truth. And I think one of the hardest things for teenagers is that the people they talk to the most are the people they believe the most, you talk to the most of your friends, even though your friends may notice some of the same myths that you do. So it's, and I'm sorry, I don't remember. Your name is Everett was saying when people come into the office to talk to a doctor who might have some more information, it's often very hard to ask the right questions to get the information you want. So was very courageous, you'd ask that

Unknown Speaker  49:50
think one of the statistics that really amaze me is that teenagers in America today watch more than six hours of television a day. A lot of those six hours are spent in watching selves, a lot of us are much more concerned about what goes on in the lives of somebody else. And what goes on in our very own know, we're much more student taking responsibility almost for those people than being able to take responsibility for ourselves. The issue of confidentiality, I think that's another myth that we have in America today. A lot of health providers don't even know that teenagers are allowed under law, to have birth control information, without discussing with their parents. That's something they're adult enough to have sexually active bodies until they're allowed to have that care. So some of you may need to let your health providers know that you're allowed to have that kind of health care without parents knowing. Does that mean it's, it's right? Should it all be done without parents knowing there are real complications, sometimes, for example, last year, it's a very sad story. There's actually a young lady who died at our hospital after having an abortion is the only time I've ever known about a patient dying portion, she had a very rare rare complication during surgery. And part of the reason for the problem was that she was 20 weeks pregnant, she was about five months pregnant, and she'd been terrified to tell her parents about it. And so she'd gone and borrow someone else's Medicaid card. And she had an abortion procedure much later than most people do. And the very safest time to have an abortion is for 12 weeks, and she was more than 20. And what happened to her was that she, she hurt, her heart stopped beating sometime while she was under anesthesia, which she said is very, very, very, very rare. But when her parents came to the hospital afterwards, they said, What was most upsetting to them was that there were health providers who encouraged their daughter to get an abortion without even talking to them. And while while I very firmly believe that teenagers should be entitled to confidentiality, I believe that because I think we're not a sexually free society. And at the same time, I want us all to recognize what some of the horrible problems can be, of not being able to talk with. gotten away from that issue, just again, to thinking some more about about how much we think about our sexual activity. One of the problems in our society today is that having sex is often unplanned. Again, when a study was done in this Baltimore community, which very similar to New York, only 17% of females, less than one in five, said they plan to have sex the first time they did. Four out of five, more than four out of five didn't plan to have sex the first time they do. And similarly for males, only 25% planned to have sex the first time they did three quarters of them didn't plan. How can you be ready? How can you use birth control? It's not something you've planned ahead of time. Can I mentioned the importance of confidentiality, people under Medicaid can get birth control can have an abortion confidentially, but they don't have their own Medicaid cards. So it means you have to steal your parents Medicaid card to go and get your own birth control. Medicaid is still far ahead of insurance programs a lot of times get certainly even if their parents have medical insurance, how can they go to the doctor on their own, since the insurance form is going to say the reason they came to the doctor. So it's a very difficult issue really to get confidential care here. And I'll end up with just two points. One, I mentioned before that I'm involved in giving comprehensive health care at Brandeis and Martin Luther King High Schools and yet, the Board of Education is not this far allowed us to give out contraceptive medication, contraceptives in school, so we can give out tetracycline for acne and Sudafed for nasal congestion, but we can't give out condoms. And one of education still refers to the penis and the vagina as privates? No, those are the parts of the body you don't talk about. And certainly they are more private in a way than our hands and our mouths, which everybody sees at all times. But we're not expected to talk about them freely. It's hard to get care for women. And I'll, I'll end up on that note. Are there any questions? Now before we take a look at a couple of examples of sex education today? Yes,

Unknown Speaker  54:24
I know, it's, I don't mean to put you on the spot. But I did hear about this particular childhood who was given 20 months to use another person's Medicaid but what do what do health providers tell parents about the legitimacy? Question? What would be the wording of the statement that you would make to a parent that legitimacy of advocating on your child's behalf? Without therapy? How would I advocate for the cat? How would you explain to a parent that there is legitimacy? If you are confronted by that? Well,

Unknown Speaker  55:16
it's actually the law that says that and not be.

Unknown Speaker  55:21
But in the case where the parent really did want an accounting from a doctor or a nurse, what kind of a statement would you make? To that they're not I think,

Unknown Speaker  55:35
depending upon what the situation was over, kind of take them back several steps to the unfortunate Enos, in our society of the tremendous secrecy between most parents and children about this issue, and then it's nobody's fault that that exists, but it does exist. And it's because of that need for privacy. The fact that being able to have free sexual expression is really not something that our society allows. It's for that reason that a law like this came into being. And that's the way I would try to explain it my answer your question, more or less.

Unknown Speaker  56:10
There's an interesting case in England at the moment, a Catholic mother of six daughters who sued the government, the government had established privacy that teenagers under the age of 16, could get contraceptive care without the doctor telling their parents. And she sued the government and said that she wanted the government to say that they would never give her daughter's contraceptive care without telling her went all the way up to the highest score, which is the more Lords and the rooms that were written about it in the press, and the decisions is really fascinating. And I think the thing that you have to ask yourself is, in the case of that young girl, and this is the problem that faces a doctor, if the doctor says Well, I'm sorry, I'm not going to give you the pill or give you an abortion unless you tell your parents and if she is so terrified of telling her parents that rather than then tell them she will go on and have a an unwanted birth. I mean, that is the kind of dilemma that

Unknown Speaker  57:19
dilemma, but you do ultimately, can marry well, not many instances, but in some instances have to deal with those parents. And I'm wondering, since we all are bound by the same situation, how do we have to we rationalize it to parents when we're confronted by them? Because we're in the United States right now we have to take a very circuitous path is to come up with well, I make abortion referrals, I would hate to have to face a parent.

Unknown Speaker  57:53
Do you often encourage you know I as a parent, on the upbeat I'm

Unknown Speaker  58:00
feeling that doesn't really make me any more capable of bridging that gap?

Unknown Speaker  58:07
Do you often have the resume to encourage your teenagers to confer with their parents to talk about their being pregnant? Do you have that opportunity to encourage them to talk with their parents? Beforehand,

Unknown Speaker  58:19
I wish that the average President himself is coming because she can.

Unknown Speaker  58:24
But but sometimes people feel they can't. And yet, with some encouragement really can't. haven't been able to do. Because I would say at least half the time, that's been possible. And what really happens is teenagers are so terrified about what their parents would feel. But if you sit and sort of analyze the situation, a lot of times, teenagers know that their parents might have gotten pregnant, and they were very young. And so they know that their parents could identify with that if they stop and think. And that abortions might not have been possible. Parents are very young. A lot of times teenagers are terrified that their parents are going to be furious with them, but really know that their parents won't stop loving, if they find out. So if you if you kind of introduce ideas like that, and sometimes services third person, like it can be very hard to go home and tell your mother about it. If you have to bring your mother into the doctor and talk the three of you together that might make it easier. So although I mean, I think that I'll never forget that example that I mentioned. And and certainly we all know that situations in which it is very difficult to talk about. But I'd say at least half the time, it's very possible to get teenagers to talk with their parents. And then the parent becomes a great source of support and it may for the future, open up to being able to talk about sexuality.

Unknown Speaker  59:44
I'm curious what what you do when you have the woman come in or get a specifically if she's pregnant, and she's pregnant? What being employed by the city, what your rights that you're buying, what your limits are and talking to her urging young men and women to use birth control or to make a decision to men pregnancies where you can?

Unknown Speaker  1:00:09
Well, I actually worked for the city, I work for St. Luke's Roosevelt. So I work in the high school, right and in the high school is what we've chosen thus far is to respect the board of EDs policy, in the hope that they'll see the light. And I think they will, I think in a very short time, there's a real good chance we'll be able to give out contraception as part of our comprehensive health care. And I think if we had tried to flaunt our right to do that, despite the board of EDs, not wanting us to in the beginning, the program might have fallen. So we've been in existence for a year now. And I would say that probably before the end of another year, I think we'll have that permission.

Unknown Speaker  1:00:47
I mean, I thought at one point that it was against the law to give out birth control to people on the 16th without their parents knowing, like every parent parenthood now I'm gonna do remember being in a Planned Parenthood at one point, years ago, and there being a sign saying, we charge because that we were in maybe it's getting three, even like with Medicaid, you can do get it without your parents knowing. Yes.

Unknown Speaker  1:01:12
In fact, it's actually Medicaid that brought it about its Medicaid first said that people are entitled to get birth control at any age. And it's because of equal protection under the 14th amendment that people argued if people on Medicaid are entitled to it, then certainly everyone under equal protection is entitled,

Unknown Speaker  1:01:30
I think what you're talking about is a couple of years ago, the government did try and introduce into planning clinics that were funded by title 10 money that they were requiring those clinics to tell the parents of teenagers that look, teenagers have come for birth control. And it was called the squeal rule. But actually, it was reversed in the courts, and it was found unconstitutional, and they couldn't do it. The trouble is that everybody had heard about the squeal rule than some. I should think that lots and lots of people like us still think that it's an effect. It was never an effect, but there was always the threat that it was gonna be an effect. It isn't. So that's another sad thing. Well, posters That's right.

Unknown Speaker  1:02:18
Did not weigh this because now I mean, I didn't.

Unknown Speaker  1:02:25
Like if I don't say to senior good as pregnant, her mother puts on a home can they take the child with the rules about

Unknown Speaker  1:02:41
matters somewhat complicated use your choice to decide whether you saying you say it is a young person's choice to decide whether to keep a pregnancy or whether it has an abortion, and then her choice to decide whether she goes through the pregnancy, whether she's going to keep the baby, or give the baby up for adoption. There can be most homes when that occurs, we'll make provisions for being able to take care of for the young person being able to take care of her baby. The only exceptions to that are if a young person in gives evidence that she's really not able to do that, for example, she neglects her baby. And just the same way that a parent of any age of a parent of any age neglects their child and the child is taken away. That's the only time the child doesn't want me to

Unknown Speaker  1:03:41
that's what you mean, if it seems like there's neglect going on, but the child wants to stay? I think that's the best terrific question. Because that's, that's another tremendous dilemma in our society that so often, even if the opinion of the court parent isn't taking the kind of care that a child needs to have child still loves their parent very, very, very much. And I don't think we've learned how to resolve that there are still children taken away at some level really want to stay with their parents. And his parents want them to stay but where, where there still has been evidence that their ways the child isn't taking care of her child doesn't get enough food or clothes or gets beaten. But even if those things happen sometimes children still love their parents a lot. So it's it's a real problem. Teenage teenagers in the home and does the kid got fooled. Apparently it does get cool in the home. Yes, they did some editing. But when is the close or close? If a teenager is living away from her family in general, when that is happening, that the teenager and her baby are on assistance of some kind so they're getting money from the government that would help them To be able to get food and clothing and medical care and all those things. Yes, you're talking

Unknown Speaker  1:05:07
about your program and what is it like outside of PRC, especially in the rural areas? Are there programs in existence where presenters have been given too many

Unknown Speaker  1:05:20
fewer and rural areas. I mean, most of these clinics that exist are in urban areas, and most other programs that currently exist that have some funding in terms of being able to provide health care or contraception at a reduced rate or in urban areas. Certainly, some physicians more and more, recognize that adolescents are allowed under the law to get this care. And so we'll find some other way. If a child comes in to do it. And so they will write up a visit if a parent has insurance and a child comes in, they would write up a visit being something other than contraceptive care. It

Unknown Speaker  1:05:55
was a while until being refused to make this arrived, or is that possible?

Unknown Speaker  1:06:02
Me to have it be a free, right.

Unknown Speaker  1:06:07
If there's a health bar set up in the school is, is it not possible to do some bills with that the kind of center to be a part of that?

Unknown Speaker  1:06:18
Again, I think there's so much attention being focused on this area. Now, I think that really will happen within the next five to 10 years. But as you know, is there's so much controversy about it at the federal level. That was gonna have to be I think it will still be a matter of time before that would pass legislation. There certainly are a lot of proponents of it, though.

Unknown Speaker  1:06:43
There's been a lot of attention in the last several years around teen pregnancy. virgins, are there any programs that have been identified, effective in preventing that are moving in that direction?

Unknown Speaker  1:07:00
It's very hard to measure. There's a program in St. Paul, Minnesota that has had contraceptive care in the schools for the past 10 years, and they have shown a reduction in pregnancy rates among kids attending that school. It's the only one I know, it wasn't a very good evaluation. However,

Unknown Speaker  1:07:22
there's an ongoing study now a program in Baltimore that I gave my statistics from that had an evaluation component built in to its setting up to recognize the problems with the St. Paul study, and the critics of the program say those aren't accurate statistics. This program is trying to build in evaluation, but they've really only been existence for a couple of years. So they're early, but do the first one that can be trying to look at it carefully.

Unknown Speaker  1:07:47
The problem is that the pregnancy prevention programs usually happen in areas where the pregnancy levels are already very high. That's that's the problem. So that the declines that you see I'm not going to be overwhelming.

Unknown Speaker  1:08:08
I just want to say that a couple of examples of when I was in high school and the very poor out of Chicago, the cultures are stable, that cut the girls instituted run control center with the school they cut the rate

Unknown Speaker  1:08:29
of dropped out. Yeah.

Unknown Speaker  1:08:32
And also just a footnote as I work for an educational administrative unit in New York County, Canada for education. And one thing they're working on something and teenage pregnancy among middle schools, and that's where it really starts as I guess you said you were talking about how most kids assess way before they even introduced the idea of contraception. A lot of time into this program is working with life options with community centers and schools are showing that a lot of girls are pregnant as you said because then apply there's another options linked this program crucially to showing that there are future alternatives that's being done by now granted by the Academy for education. You think that was keep you there? No, they would get they would, you know, they could or is it has like the long as a very difficult question. You answer it.

Unknown Speaker  1:10:00
I think it is all of that is more motion time. I think there's a tremendous ambivalence again, those of us who are female in the room, know that for most of our lives, there's a feeling about wanting to mother and maybe an ambivalent feeling. But it's a feeling that's present for most of us. To some extent, I think that's present from very early age. I think there's always part of that desire that gives.

Unknown Speaker  1:10:27
I think, though, that if you look at the exam, 1.1 million pregnancies a year now, I think if you look at the fact that 500,000 of them ended up being aborted. I think that gives you some sense of at least half of them. They didn't want to get pregnant. I don't think more than half. Yes. That's it, it's always

Unknown Speaker  1:10:58
about, I just want to put Canada's footnote because you were talking about the inability to go to contraception, because the team's knowledge, their sexuality, their appearance, but studies that were done in assemblies with adult

Unknown Speaker  1:11:13
women coming for early abortions, we're having the same problems acknowledging to themselves, I just think we have this broader problem as women in our culture with acknowledging and accepting so that it's not only teams that have this problem, to tackle the level of how we can

Unknown Speaker  1:11:34
absolutely agree with you that you said that, because I think that the teenage part of the study we did, we're not doing for adults. And I think what we're finding is that the patterns we found, duplicated among adults, I don't think it's a teenage problem, I really do think that it's a problem of the society. And it sounds about

Unknown Speaker  1:11:55
sexual, especially for women. Yes. Have sex but women aren't supposed to have contraception because we're not supposed to be prepared. So it's still

Unknown Speaker  1:12:12
and what the good girls do, good girls say no. Because it wasn't a set of leaves that they have maybe go up, or it was

Unknown Speaker  1:12:41
an interesting question. We want to keep met, he said, in a country where there wasn't any contraception Do I think that the teenagers would wait because they know that they know where to get into something?

Unknown Speaker  1:12:55
No, no, because people seem to think that in the 1800s, that pre Victorian era that people were very chaste, and people weren't ready to study to show that a huge percentage of marriages in this country and in England soon after a child was born, I mean, people got married, there was a lot of commercial sex. Oh, 70 countries, even in an all you know, the 1800s and not just rural people, educated people, urban people. I mean, it's not it's not a new phenomenon. I really wish I read I read the study for a class quickly and discussed again, the numbers but if there wasn't, I mean, I don't know what kind of reception they had was in the early 1800s. But people didn't.

Unknown Speaker  1:13:43
I mean, I know from myself that is abortion, like my deputy motion was threatening and I will choose absence I think that the pregnant the numbers of pregnancies might be remained stable but I think that definitely the sexual revolution has come about in large part because of the right type of abortion and the right to obtain contraceptives and to have that Brandon definitely won't have

Unknown Speaker  1:14:17
sex or I'm just trying to say that when even when people that do not have that option, and even when people knew they're in the agreement there's nothing to keep them from getting pregnant but isn't it also true to really be pregnancies and abortions was thinking that I really unmarried girls, and that's the concern of the society. So you can't even talk about what happened there. Let's talk about what the matter was.

Unknown Speaker  1:14:45
Married the marriage legitimize they were already pregnant,

Unknown Speaker  1:14:49
the marriages and jayvees coming three and four months after, after the problems. What was considered yeah You have to manage as abortion and pregnancy, I have some average rates during the pregnancy.

Unknown Speaker  1:15:17
That's a worry,

Unknown Speaker  1:15:18
cuz they're more babies in the old days, they used to be just as many babies born. But the girls were married, they didn't get married. That's so really good to say, you know, the language we, you know, maybe really what we're

Unknown Speaker  1:15:38
talking about just sort of baseline economics.

Unknown Speaker  1:15:43
The old days you get married because we will take care of us. And, you know, there's economic foundation for even premarital sex. And now there's no economic foundation for or young people who start having sex, because young men can often get jobs and young women don't always get.

Unknown Speaker  1:16:07
In fact, they're behaving quite rationally, in many cases, deciding not to get married.

Unknown Speaker  1:16:15
I was told by the social worker at my site that the broad spread spectrum of free rights is beginning to be narrowed somewhat, and parents income will be evaluated and inflation date take care of the young lady, and medical expenses and grandchild that they will be expected to.

Unknown Speaker  1:16:36
They're introduced. They're trying to introduce them in Wisconsin, where they're trying to make the parents responsible for her daughter's child. I just wonder about that how successful that will be in cases where the parents themselves living at the poverty level, however, they

Unknown Speaker  1:16:57
still get sick for them, but it is in which they are found the same time, the teenager has the right to say yes. I get this

Unknown Speaker  1:17:14
problem. The parents of the daughter Yeah, definitely. The father to the music can be identified, I think,

Unknown Speaker  1:17:29
is. Teeny teenagers do not have to consult their parents

Unknown Speaker  1:17:46
on their decision to write,

Unknown Speaker  1:17:50
to write to make a decision, and then my parents, my parents have to take care of me if I do choose. You thing about consulting the man who's involved in pregnancy.

Unknown Speaker  1:18:08
It's a real conflict. It really is a real common.

Unknown Speaker  1:18:18
I thought it was interesting, though, that with regard to the problem of confidentiality, then it does seem as though what you were saying was in most of the countries that the study took place, and it does seem to be one attitude about contraception in the teenager, but abortion Yes, apparently teenager.

Unknown Speaker  1:18:41
Which is interesting.

Unknown Speaker  1:18:45
Would you say that it's better communication in those kinds of teenagers and their parents?

Unknown Speaker  1:18:52
Certainly, I would say that in a country like Sweden, where the parents themselves had sex education from from an early age, I would think that it's a very different it's a very different mothers and daughters talking to each other. In the other societies, no, we heard exactly the same kind of, we had exactly the same kind of opinions, but parents are embarrassed to talk to their children and children are embarrassed. It's a very private, it's a very private matter for teenagers. And I often wonder when, when, when you hear that a child or teenager doesn't want the parents to be involved, whether it's a fear that the parents knowing or whether in some way they're trying to protect their parents, from knowing, keeping the mother in blissful ignorance. I think there's a lot of that feeling somehow that the parents are less adequately prepared than the teenager themselves.

Unknown Speaker  1:20:00
Well, that's certainly the case. I mean, I did that. I mean, I had, I was pregnant when I was a teenager and had an abortion, and told my mother much later, you know,

Unknown Speaker  1:20:18
because he didn't want to hurt her.

Unknown Speaker  1:20:19
I didn't want to hurt her. And I didn't want her to have to worry about it. And her comment to me, she's really, she's a really good person. And she was like, why don't you tell me I can't believe you went through this, you know, and didn't tell me and, but I mean, it was my, what I perceived at that time was, Oh, she won't be able to deal with it. I can't deal with telling her so I went through it on my own. And I think that's, you know, pretty common. And she didn't even know what the procedure was. Didn't she's, you know, well educated and older and very ignorant about the whole thing, because that was not an option for her.

Unknown Speaker  1:21:14
apartment that has a child as pregnant

Unknown Speaker  1:21:25
and she has a miscarriage. What do they do, when they tell the parent? No,

Unknown Speaker  1:21:30
the session she did speaking

Unknown Speaker  1:21:36
is kind of one of the problems, the courts will face you trying to figure out whether in fact, you really had the need, and whether in fact immediate caused you to miscarry, it almost wouldn't be an issue because beating for any reason that were so severe, got hurt from that could be a reason for parent and child will be separated. So a lot of times that will happen. But it would be very difficult to prove that a miscarriage happened because of a beating. Because actually, babies are very well protected. Inside.

Unknown Speaker  1:22:27
Well, a lot of times girls have grandmothers or aunts that they can live with. So sometimes there's another member of the family who loves

Unknown Speaker  1:22:34
her sister for this hill to go. What if she

Unknown Speaker  1:22:38
didn't women, sometimes she would go live in a home. And depending upon your age, sometimes kids can't live on their own. So that if she were old enough adolescent, she might live on her own 60 or 70 or 80. And probably have any relatives she wanted to live with probably she was in a group home that could be significant. And then start acting doesn't want to give up too soon. She's, she has a baby. She got

Unknown Speaker  1:23:30
she has a baby. And she wanted to finally be at

Unknown Speaker  1:23:36
this point in this country, nothing if they're not married, they were married, it would be different. But if they're not married, there's many legal if you do not have rules about rape in the society, our whole area that we have to kind of do some thinking about but it still is technically in the rules for girl has sex under the age of 18. That can be called rape. And also that sometimes there have been court cases in which a family has taken a father of a child to court stating that you raped their daughter. But that's, again, that kind of thing can be very, very difficult to prove because in most cases, at least at the time sex occurred. Both partners agreed to have it. So although there's a rule on the books that says you can call it rape when it's under the age when the girl is under the age of 18. That's that's a difficult lot to prove difficult.

Unknown Speaker  1:24:39
Why do you think they're ever Why do you think there are lots of boys who don't want to be fathers? Don't want to buy Jewish girl

Unknown Speaker  1:25:14
do you think a lot of young men would be willing to use was controlling some kinds of that they can be with their girlfriends but not have happened? Because I think that's one of the big problems is how to make that work. How to have people think about it? Yes.

Unknown Speaker  1:25:36
Can impairment was the guy to get married with?

Unknown Speaker  1:25:41
No, we actually know. A lot of times pressure does get put by parents and children remarried, but they can't legally do that. If

Unknown Speaker  1:25:53
you have a stepfather was the youngest step I will pass when you can the child, the girls get married a step farther

Unknown Speaker  1:26:04
away. Sometimes that certainly does happen, sometimes. Children have sex either with their real father or with their stepfather, then it depends a lot on whether you legally have what the situation is, if a girl has sex with anyone who's married to anyone else, she can just go and get married? No, there isn't a marriage. If there isn't an already existing marriage, then at least under law, it would be possible to do that. But certainly there are a whole lot of problems for any young person who's having sex with someone who has been their father.

Unknown Speaker  1:26:45
I don't know if you have written this motivation into it. And a lot of times, that happens a forced situation. I've worked in homes with dead women. And most of them, all of them had been sexually abused by someone in that in that situation. And I think the complication if the emotional complications get very get very, very complicated, because there's so many interpersonal factors going on with the mother and the mother that is set by the nurse and then be connected. And then there's it gets really complicated. I mean, it's more than just in hacking. I don't know, I wouldn't say that blockchain can be someone that was having to, I would just have concern for that person to name for that situation. That's when she wasn't being forced at this.

Unknown Speaker  1:27:39
Point. And, again, I think if any of us know that's happening to someone, a good thing to do is to be sure that that person has some adult that they can talk to get some other advice,

Unknown Speaker  1:27:49
but what if the, okay the girl is making Stefan's best friend then they can know the father was the final

Unknown Speaker  1:28:01
kid killed finally because they had a relationship what happens if if the girl comes up friend from time to

Unknown Speaker  1:28:21
very difficult questions you're asking? It does happen sometimes. And then if a pregnancy occurs, sometimes it becomes a case in the court the court has to decide what to do depends if the people want to have a baby together and certainly when people are having sex because when it does happen, what people have to know then there's a lot of danger when people who are relatives

Unknown Speaker  1:28:47
and cousins

Unknown Speaker  1:28:48
can think they can legally but one of the problems with that is that when babies are the product of people who are very closely related, there often are a lot of talk a lot of damage to the baby because the jeans don't mix as well.

Unknown Speaker  1:29:02
On my listening I think we should maybe stop looking

Unknown Speaker  1:29:09
let's let's been looking at a short part of this film and see what you think about it as a piece of

Unknown Speaker  1:29:17
sex education. Just turned up love it Okay so thanks Can I

Unknown Speaker  1:31:21
take a shower

Unknown Speaker  1:31:22
Rachel What's this might notice that commonly referred to

Unknown Speaker  1:31:37
as a safe reliable

Unknown Speaker  1:31:38
form of birth control for men. Men are slower direct reporting of course those burden of adjustment for pregnancy

Unknown Speaker  1:31:54
not the party can go

Unknown Speaker  1:32:00
swimming under different plans. Most Jamaica latex rubber what some called skins or natural condoms are many programs intestines, how items are all the same size with rubber condoms come in different shapes, straight sided or contoured with or without receptacle tips and lubricated. In addition to birth control,

Unknown Speaker  1:32:20
humans are the only contraceptive

Unknown Speaker  1:32:22
that can prevent the transmission of sex related infections.

Unknown Speaker  1:32:26
The trouble is some men think that condoms are

Unknown Speaker  1:32:29
a barrier the pleasure of showering with their anchor on the back is American and now there's more than one way to deal with the idea of tasers.

Unknown Speaker  1:33:01
What's up an IT, Scott. All right, I guess we mean all right, I guess I don't know how long it's gonna last. Because she's pulling out the pill and she wants me to start using rubbers. So we're gonna change birth control all the time. What's the problem? The problem is I can't stand representing a Donald Fiji I used to feel the same way. You would want to use rose?

Unknown Speaker  1:33:27
I see no

Unknown Speaker  1:33:28
way. But we talked about it worked out.

Unknown Speaker  1:33:32
Now everything

Unknown Speaker  1:33:34
would have nothing really. I just want to make fun but hey, man, I'm already real good okay, let me ask you this. What do you think? Again, this is what do you use? But he's a whole lot more to it you all