In the wryly sweet 2007 comedy “Juno,” a precocious teen deals with her pregnancy and searches for the right young couple to adopt her baby.
But that’s Hollywood. And here in Spokane County, where 13.2 percent of eighth-graders in 2010 reported being sexually active, that particular plotline never seems to unfold.
Dr. Sasha Carey, an adolescent medicine specialist and pediatrician at Rockwood Clinic, finds her patients are remarkably honest. During confidential health histories, a significant minority of those in their early teens report being sexually active.
In Spokane County, Carey says, when teens become pregnant, 90 percent keep the baby and 10 percent terminate the pregnancy. Virtually no one carries the child full term and puts it up for adoption. “ ‘Juno’ was a great movie, but it’s just not reality,” she says.
That’s the backdrop here in Spokane County to last week’s news that the U.S. Food and Drug Administration decided to allow stores to sell the Plan B One-Step morning-after pill over the counter to girls as young as 15. At the same time, the U.S. Justice Department is appealing a judge’s ruling that removed age restrictions entirely.
We’ve allowed misty-eyed delusion to guide the politics surrounding this benign form of backup contraception. Here’s a list of the myths the white-picket-fence crowd argues:
1. Parents should be involved when teen girls need the morning-after pill. The reality: Of course, they should. But while some parents of sexually active young women are smart and supportive, many more are not. Consider this: A 5-year-old Kentucky boy shot his child-size Crickett rifle and accidentally killed his 2-year-old sister last week. We can’t always count on the wisdom of American parents.
2. Young teens are at increased risk of harming their health with this pill. The reality: The Plan B pill contains levonorgestrel, one of the safest hormonal birth control medications available, says Carey. It’s also found in birth control pills, it’s up to 89 percent effective in the first three days and it rarely has even mild side effects.
3. If teens realize this pill is available, they’ll decide it’s safe to become even more sexually active. The reality: The pill is called Plan B for a reason, Carey says. It’s designed to be a backup form of birth control, in case a woman’s Plan A should fail. The cost varies. A generic form called Next Choice One Dose sells for $36.50 at the Fifth and Browne Pharmacy in Spokane. Compare the cost of this medication with that of a package of condoms, and it’s not hard to figure out which one an eighth-grader’s allowance might cover.
4. The pill somehow ends an existing pregnancy. The reality: That’s just not how this pill works. It prevents pregnancy by delaying ovulation. (A fact rarely shared in those puberty preparation films everyone watched in school: Sperm can hang out for days waiting for an egg to appear.) The pill can be effective for up to five days after sexual activity.
5. It just doesn’t feel right to allow eighth-grade girls to walk into a U.S. pharmacy and buy this drug. The reality: No, it doesn’t. Like Carey, I’d prefer eighth-graders abstained from sexual intercourse. But it feels even more wrong to deny these girls – the most desperate of all sexually active females – this effective emergency contraceptive.
The consequences of a teen pregnancy are lifelong. According to the Centers for Disease Control, only about 50 percent of teen mothers earn a high school diploma by age 22, compared with 90 percent of their peers. Their children are more likely to struggle in school, drop out of high school, suffer more health problems, be in jail during their teen years and become teen parents themselves.
At one point in the film, Juno’s father asks her where she’s been. She answers, “Out dealing with things way beyond my maturity level.”
Had Juno taken the morning-after pill, her young life wouldn’t have shipwrecked in the first place. The character would have quickly recovered, and filmmakers would have lacked the plot complications required to propel a movie. And that, dear viewers, is precisely the point.
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