Teen Sex and Contraception on Television: Where’s the Personal Responsibility?


In the last few weeks, I learned that Bristol Palin was on the pill and all of the stars of 16 and Pregnant used condoms.  I find this slightly curious because, as we know, all of them ended up parents before they were old enough to vote. If I didn’t know any better, I would start to wonder if contraception just doesn’t work.  But since I do know better, I am instead left wondering if the media is letting our most famous teen parents get one over on us and in the process perpetuating myths and misunderstandings about birth control.

Birth Control Pills Work

In her book Bristol Plain explains how the first time she had sex took place while drunk on a camping trip and she feels that Levi “stole” her virginity, though she was not raped.  (I have already admitted that I’m obsessed with Bristol and discussed this odd explanation of hers in an earlier piece.) Despite this, she went on to have a sexual relationship with him for the next two years and became pregnant with their son, Tripp.  In her book Palin explains that at the time she got pregnant, she was on birth control pills that “had been prescribed to her for cramps.”

That reminded me of a sex ed lecture that I had during my senior year in high school (yes, senior year, because when it came to sex, East Brunswick High School didn’t like to tell us about anything until after they were sure we had already tried it). The health teacher held up a packet of pills and said “Some of your friends may be on these, but that’s just for cramp control.” We all stifled our laughter and fought the urge to say in our best sarcastic teen voice “yeah, right.” Some of our friends were on it, hell, some of us were on it, and it wasn’t just for cramp control.

Sure some women use the pill for the benefits it provides other than birth control—it regulates one’s period, can reduce cramps and other premenstrual issues, and some brands can actually help control acne. The good news is that even if the motivation to start or keep taking the pill is something other than contraception, if taken correctly, that very same pill will prevent pregnancy.  When pressed by Barbara Walters in a recent appearance on The View, Bristol said: “I was on birth control when I got pregnant yeah, but it obviously was not used effectively.” 

It’s in the passive voice but I guess it’s as close as we will get to some personal responsibility.

Birth control pills are extremely effective at preventing pregnancy.  As Planned Parenthood explains, “Less than 1 out of 100 women will get pregnant each year if they always take the pill each day as directed. About 9 out of 100 women will get pregnant each year if they don’t always take the pill each day as directed.”  Maybe Bristol was part of that unluckily less than one percent. Or maybe, because Bristol wasn’t thinking of her birth control pills as pregnancy prevention, she was more lax in taking them than she should have been.  In truth, given the other revelations in the book—that Levi was having sex with a number of other women and got another one pregnant around the same time—she probably should have been using condoms instead or in addition to the pill because condoms are the only birth control method that can protect against sexually transmitted diseases (STDs) as well as pregnancy.

Condoms Work

Unfortunately, condoms get a really, really bad rap on television. A friend of mine who teaches middle school and high school sex-ed classes says that she asks all of her classes if they’ve ever seen a TV show in which “the condom broke” and without fail every student raises his/her hand.  Maybe her students watched the recent reunion show for MTV’s 16 and Pregnant.  Called 16 & Pregnant: Life After Labor, it features couples sitting down for in-depth interviews with Dr. Drew Pinsky, MTVs go-to sex expert (despite the fact that his background is actually in addiction).  I have to admit that I did not watch the whole episode and I apologize for not knowing the names of the couples I am talking about.  In the first clip I saw, Dr. Drew asks one couple what went wrong with contraception when they got pregnant.  The young woman is tentative and starts with a long, drawn-out, and almost apologetic “well….” Her partner jumps right in with “the condom broke.”  Despite the fact that the set up was suspicious and he must know how unlikely this is, Dr. Drew does not challenge that assertion or ask the couple if they were sure they were using it correctly. Similarly, when the next couple says they were using condoms and, once again the guy claims that it broke, Dr. Drew just repeats the words “it broke” and continues. 

Like any birth control method, condoms have a method failure rate.  This refers to failures caused by a defect in the actual product such as a tear.  Method failure of the male condom is very rare; it is estimated to occur less than 2 percent of the time. Moreover, not all condom breaks pose any risk for pregnancy—a condom that breaks while a person is putting it on for example, would not lead to pregnancy as long as the couple used a new condom for intercourse.

The truth of the matter is that when it comes to condoms (all birth control in fact), most failure is user failure; the failure of the couple to use the condom correctly and to use it every time.  User failure rates for condoms are closer to 17 percent, which means that out of 100 couples who use condoms as their primary means of birth control, about 17 will become pregnant in the first year.  It’s really important to understand that for the purposes of this calculation, couples are counted as a condom users (and any pregnancy is counted as a condom failure) if they say that it is their main form of birth control—even if they were wearing the condom on their pinky finger or there was no condom in the room the day they got pregnant.   

It would have been nice if Dr. Drew had challenged these couples’ assertions that it was all the fault of the condom. Instead of smiling and nodding, he could have asked if they were sure they had used a condom every time and if they were sure they knew exactly how to use one.  Though I suppose few people mistakenly wear them on their finger, I am surprised by research that suggests that people put them on upside down, open the package with a sharp object like scissors, put the condom on too late (after intercourse), and take it off too early (before ejaculation). This would have been a great opportunity for Dr. Drew to remind the couples (and the viewers) of the steps in using condoms or even better to have demonstrated them.  It’s not hard to use a condom but everyone should be taught how.

Emergency Contraception is an Option Even if You Just Forgot

Instead, Dr. Drew went on to talk with each of these couples about emergency contraception (EC).  While this is also a worthwhile educational opportunity (he told viewers they could get it at a pharmacy and that if they take it within 3 days of unprotected sex it markedly reduces the risk of pregnancy), he managed to throw condoms under the bus while doing so as his explanation started with “if there’s a failure with a barrier method like a condom….”  That is certainly one of the times people use EC, however, it seems more likely that the failure would be one omission—simply not using birth control for whatever reason.  MTV’s audience should understand that emergency contraception can also be used under those circumstances. 

One of the young women interviewed claimed that not only did the condom break but she took emergency contraception the next morning and it didn’t work either. Dr. Drew seems alarmed by this (though his reaction shot is from the back so it’s hard to tell) but he doesn’t express this alarm and throws her a lifeline by saying “that’s the thing about morning after pills, if you’re already pregnant you’re going to stay pregnant, you must have just ovulated….” She agrees, and says that her doctor said the same thing.  If she was already pregnant, EC would not work but it also wouldn’t have been the “fault” of the broken condom.  The idea that she ovulated that very day and that’s why EC failed is a little hard to believe.  That is some really bad luck.

Personal Responsibility

I hate to be the cynic here but in an Occam’s Razor sort of way—the simplest explanation is most likely to be true—these young people didn’t use condoms and they didn’t use emergency contraception. They weren’t using birth control and they got pregnant.  That’s not bad luck.  That’s an expected outcome of unprotected sex.

I’m not really suggesting that Dr. Drew call his interviewees liars on national television, but I do worry about the example being set by these teens who, by blaming the birth control methods, are essentially refusing to take personal responsibility for what happened.

I don’t fault them entirely for this refusal to take the blame given what we as a society tell (and don’t tell young people) about sex. We bombard them with images and messages that invoke sexuality but remind them that “good” kids don’t have sex. We hold back information about birth control and make the methods themselves hard to come by based on the warped theory that if we provide information and access we are giving them license to have sex.  And then we remind them that good kids really don’t get pregnant.

Bristol Palin touches upon these conflicting messages in her account of her sexual history when she explains that part of the reason she kept having sex with Levi was the idea that she had already broken her moral code and therefore it was not such a big deal to do it again. And one of the teens on Life After Labor touches on another message when she admits that she didn’t take EC after the condom broke because she didn’t want her mom to know that she was having sex.  While I’ve never met her mom or seen the show, I’d bet most parents would rather find out their daughter was having sex when she came to ask for help obtaining EC than when she came to announce she was pregnant.  Still, many kids do fear their parent’s reaction and disapproval and it can clearly get in the way of their ability to access contraception and make responsible decision.

I’ve spent my career arguing that teen sex is not inherently bad. I believe teenagers are capable of making mature and responsible decisions about sex.  I have suggested on many occasions that instead of trying to get teens to stop having sex, we should be teaching them how to think critically about it. And, I have repeatedly reminded others that teens often make better decisions than adults (they’re more like to use condoms, for example). All of these arguments, however, are made harder to stand behind when teens refuse to admit that they’ve made a mistake.

As adults, it is our responsibility to give teens positive messages about sexuality and to be approachable (before or after the fact) when they have questions or need help. We have to teach all teens (whether they are sexually active or not) how to use contraceptive methods properly and provide them access to these methods.  If they choose to be sexually active, it is their responsibility to use it every time and to use it correctly.  And if they make a mistake, it is their responsibility to say “sorry, I made a mistake, it was my fault”—especially if they are appearing on national TV.  

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  • anderson-evans

    When I was young, we used the diaphragm, which was annoying because you had to interrupt your passionate interactions to insert it.  But the combination of spermicidal jelly and mechanical blockage of the cervix provided double protection against pregnancy.  The fact that you only used it when you had intercourse also made it unlikely you would “forget.” I think a woman might forget to take a pill to avoid pregnancy when she is brushing her teeth in the morning, or rushing for the train.

    Diaphragms are cheap, portable, effective, and a pain in the neck, but they cause no side effects, do not require daily maintenance to avoid pregnancy, and work.

  • prochoiceferret

    The fact that you only used it when you had intercourse also made it unlikely you would “forget.”

     

    But also makes it more likely you would “ohmyGodnevermindthatIwantyouinsidemeNOW!!!”

     

    I think a woman might forget to take a pill to avoid pregnancy when she is brushing her teeth in the morning, or rushing for the train.

     

    Perhaps a method of contraception that doesn’t require any sort of regular intervention, like the IUD or a hormonal implant, might be better…

     

    Diaphragms are cheap, portable, effective, and a pain in the neck, but they cause no side effects, do not require daily maintenance to avoid pregnancy, and work.

     

    You can say the same thing about the withdrawal method.

  • dregstudios

    Like mother, like daughter.   Bristol is selling herself in any form or fashion just like Sarah, to make that money.  Talk about some successful capitalists- all body and no brains.  See what they’re willing to do for the cash at http://dregstudiosart.blogspot.com/2011/06/ecstasy-of-sarah-palin_15.html

  • equalist

    The pill actually worked quite well for me, aside from the massive weight gain I had when I was on it (upwards of 50 lbs each time, that dropped off rapidly once I was no longer on the pill).  My first pregnancy was a condom that likely wasn’t used correctly, my second was a condom that actually broke, and my third was an IUD that failed.  I’ve since had my tubes tied, and swore to my OBGYN that if this doesn’t work, I’ll be back for him to “just rip the whole damn thing out”.

  • adolmd

    I think the key with “condoms break” as you say, is to make sure people are using them properly (leave space at the end for the sperm or choose ones with reservoir tip. And that they are storing the condoms  properly (NOT in wallet, NOT in car, etc)

     

    AND to have EC ready to go, when it happens. EC works best ASAP. And as Dr. Drew said, it does NOT work AFTER you ovulate. I find that patients often have sex EXACTLY around ovulation and that is probably driven by our hormones. Our bodies want to reproduce, so they make us horny(attractive to the opposite sex) right when we are ovulating.

     

    and Yes, people need to take their birth control consistently and that’s why methods like the IUD, implanon, depo-provera are better at preventing pregnancy (because you don’t have to think about taking them every day/week/month)

     

    and realize, that 16 and pregnant is showing those people that got pregnant. so yes, EC failed in that person. It is not showing all the people for which EC worked.

     

    You didn’t mention that EC is OVER the counter for men/women 17 and older. PSA.  =)