[sedachv]

> Note that many of the working poor got themselves into that position because of their choices, generally they had a kid at 16 and dropped out of school as a result

The vast majority of teenage mothers in the United States do not choose to get pregnant and do not have the choice of terminating their pregnancy. They either do not have access to abortion providers - the majority of women in the United States do not have access to abortion clinics because of fundamentalist Christian activists and politicians: https://www.guttmacher.org/united-states/abortion/state-poli... - or they are coerced by their fundamentalist Christian parents into not having an abortion.

[exclusiv]

Everyone has access to birth control though. It's common knowledge how reproduction works. You have condoms, birth control pills and copper rings among other options. If you miss that you got plan b. Let's set aside your personal vendetta against the pro lifer Christians. How can you claim that the vast majority of pregnant teenagers don't choose to get pregnant?

[tptacek]

Respectfully, I'm not sure you fully understand these issues that you seem to have a very strong opinion about.

Teenagers around the US do not as a rule have convenient access to contraceptive pills. That's because the FDA refuses to approve them for OTC sale, despite their safety relative to many other OTC meds. The stated reason for refusing OTC sales is that allowing them would prevent women from seeing their doctors for other medical issues (this is also the reason you can't buy extremely useful and safe meds like Ondansetron OTC). I feel like I'm on firm ground when I add that this is unlikely to be the only reason you can't buy OTC contraceptive pills.

Meanwhile, about half of US states require parental consent for most minors before doctors can issue prescriptions for birth control.

As a fun additional wrinkle, churches, and in particular the Catholic church, run some of the largest hospital and health chains in US metro areas. Church-run hospitals routinely refuse to provide access to contraceptive services. In Chicago, the Loyola health system --- an otherwise well-regarded health services chain! --- won't prescribe contraceptive pills to adults even for non-contraceptive reproductive health purposes!

I don't think we need to spend too much time talking about Planned Parenthood clinics; the issues there are obvious to anyone familiar with the state of reproductive health in the US.

So, no, I don't think it's reasonable to argue that any teenaged girl in the US should be expected to be fully armed with all the tools of modern contraception.

[justinjlynn]

The lack of access to chemical birth control is a major issue, I agree. However, to the best of my knowledge, condoms are still fairly universally available to members of both sexes - which, while not ideal for a number of reasons, are certainly more effective in preventing the transmission of STIs as well as being effective in preventing unwanted pregnancy. Perhaps that might be a more charitable interpretation of the grandparent post, even if it's clearly not correct on the whole.

[tptacek]

Beyond pointing out the obvious fact that teenaged girls in the US are living in a society that goes to some lengths to actively obstruct them from using the most reliable forms of contraception, I'm not really interested in digging further into the details here.

[justinjlynn]

Fair enough.

[exclusiv]

You didn't mention the most obvious solution which is condoms. I bought them easily as a teenager 18 years ago. You can get them for free in many places these days.

You're also giving teenagers a pass for having unprotected sex as if they don't know there's a risk of 1) getting pregnant and 2) getting an STD.

Certainly some birth control measures are less accessible to teenagers, but what I'm arguing is the parent's claim that "The vast majority of teenage mothers in the United States do not choose to get pregnant"

That's not accurate unless what is meant is that "the vast majority of teenage mothers don't want to get pregnant (but choose to forego readily available birth control / condoms)". I'd believe that.

[tptacek]

Without getting into any of the rest of this comment: that's not what you said. You blamed teenaged girls in part for not taking advantage of contraceptive pills. Specifically, you wrote:

It's common knowledge how reproduction works. You have condoms, birth control pills and copper rings among other options.

That's simply not a reasonable argument. Don't move the goalposts now.

[exclusiv]

I'm not moving the goalposts. If you're a teenager and you don't use a condom or other means and get pregnant - that's on you. You wrote a long retort which ignored condoms. That's unreasonable.

If you don't use a condom no matter what age you are and get an STD - same thing - that's on you too.

Your argument about post-conception options - I agree that not everyone has the same access. But I'm not talking about that.

Condoms work. Teenagers know the risk. They're just being dumb and it's on them.

Now - your argument that making birth control more available - sure I think that's a good thing too. But the notion that "the vast majority of teenage mothers in the United States do not choose to get pregnant" is irresponsible because almost all of them got pregnant by being wreckless while viable options are readily available. Specifically condoms.

[tptacek]

The comment that you wrote and that I quoted from just now is still right there for everyone to read. It's weird to write as if it wasn't.

(The comment I just replied to was edited extensively after I replied to it. That's OK; I said what I wanted to say.)

[notlob]

Ondansetron is associated with long QT. The FDA does not like that side effect for OTC meds.

[candu]

Easy: a lot of states teach abstinence-only sex education, and there's a prevailing set of social norms (often imposed by "pro lifer Christians") that makes frank discussions of birth control, sex, reproductive biology, etc. all but impossible. It sounds crazy - and, IMHO, it is - but large parts of the US operate as de facto theocracies, especially where it comes to education.

Under those circumstances, it's not surprising that teenagers have sex, don't know how to do so safely, and end up pregnant without meaning to. That is: a teenager absolutely can choose to have sex without choosing to get pregnant, simply because the society around them has conspired to make sure they don't understand how one leads to the other.

[mahyarm]

Americans don't have universal healthcare, can't just go walk in some clinic / pharmacy and get a doctor / pharmacist to Rx you some birth control.

You also have minimal->zero private money and come from a poor background so it's too expensive. Your parents are religious and it's difficult to privately have & use birth control. Copper IUDs create pretty bad periods and are more painful to insert if you never given birth. Giving yourself a megadose of hormones with other implants is pretty freaky.

But your 16 years old and have a lot of hormones...

That is part of the reason why the entire obamacare free birth control fight was pretty emotional in the USA.

[adrianN]

I'm pretty sure that you can buy condoms in America. They're not that expensive and work reasonably well.

[bluGill]

Last I checked condoms were the only birth control that prevents STDs. All the other birth control named is not appropriate for teens who are unlikely to have settled on a lifetime monogamous partner.