Episode 4 - The Secret Life of the American Teenager

Thanks for stopping by our blog! You can read about previous episodes of "The Secret Life of the American Teenager" by clicking the label "Media" here or at the end of this post. You can watch the two most-recent episodes online here (click the tab called "Full Episode"). Here are a few points from the show, with some items to discuss with your teens.

Amy's dad expects Amy to love the news video of Grace being attacked in a bad part of town at midnight "because we're family. You gotta dislike who I dislike. That's called loyalty. I dislike the Bowmans, so this is funny to me and to our family." What do your teens think about this? What does loyalty mean to them? How do they think loyalty should be expressed in a family? How do they think loyalty should be expressed between friends? Share your thoughts about these questions, too.

Dad continues, "These two high-faluting church-goers have a problem child on their hands." This kind of statement expresses rejection and may contribute to your teen not being honest with you, in fear that they too will be rejected. How could you reword this type of statement so that you reject wrong behavior without rejecting the person? What do your teens think a 'problem child' means? How would you define it?

Lots of parent-child confrontation in this episode. Amy's dad confronts her about whether she knows who the shirtless guy on the video is. Amy's dad confronts Ashley about her more modest outfit, accusing her of being on drugs and of lying. Grace's parents confront her about the video of her on the news in a bad part of town, and then sneaking around to date Jack. Ricky's foster mother confronts him about being shirtless and about lying about being home. Most of the confrontations we're shown are pretty calm, without shouting. What are confrontations like at your house? What could you change to make confrontations less painful? What do you wish your kids could change to make confrontation less painful?

Amy realizes that she'll have to tell her parents she's pregnant. She feels bad about her sister Ashley getting in trouble as a way of distracting her parents from her secret. Amy's friend tells her "Be responsible - talk to your parents, and get some help."

Grace temporarily gives up being on the cheer squad because that's the punishment she came up with for lying to her parents. What kinds of consequences do your kids think would be appropriate for Grace's sneaking around and lying?

Amy's mom says to Amy, "I'm not accusing you. You're perfect. Close to perfect. Both my girls are. Although I really don't know why Ashley wants me to think she's having sex. I don't think she's having sex. ... Thank you for being such a wonderful daughter." Both parents and kids sometimes have mental images of each other that are not entirely accurate. Very few of us are actually 'close to perfect.' On the flip side, both parents and kids who behave badly likely have good qualities to them somewhere. Both kids and parents can do a better job of being realistic about the good parts and bad parts of each other. Take care not to go to extremes of either putting someone on a perfect pedestal or of putting someone in the garbage dump. Talk to your kids - how would they describe you? How would they describe themselves? How do they think you would describe them? Do your kids think you never made any mistakes growing up? Have you been afraid to express your wishes about any topics because you made a mistake in that area when you were younger? Are you willing to share with your kids (at the appropriate level of detail for their age) about mistakes you made when you were growing up? There is some value in "do as I say, not as I do"...but how can this attitude be kept in balance?

Later in the show, Amy tells her dad that Ashley is not having sex but that Ashley is covering for someone. Amy tells her dad that she had sex and he responds angrily, "You did not have sex. I know you!" Amy replies, "Dad, you don't know me! I did have sex." Her dad is stunned, but the conversation is interrupted. When we learn something new about someone we love, the shock can make us suddenly feel like we don't know that person. The revelation that your child is sexually active or pregnant can easily trigger a grief cycle. Pay attention to your feelings and give yourself the room to work through your reactions. Seek counsel.

Jack is talking to Adrian and says, "Every relationship needs a good foundation. And if our relationship was Christ, I think even you and I could make it. I want a girlfriend, a real girlfriend. And in order for you to be my girlfriend, we need more than just being physically attracted to each other." Though Jack's motives in this conversation (to make Grace jealous) are pretty rotten, he makes some interesting points. Talk to your kids about what Jack said. What is a 'real' girlfriend/boyfriend? What things make a good foundation for a relationship? How important is physical attraction in the foundation of a relationship? How much of a role does physical attraction play in your kids current dating relationships? Ask your kids what happens to a relationship as they age and looks fail? What about 'missionary' dating (a believer dating a non-believer with the motive of trying to induce faith in the non-believer)? Does it seem like a good idea? In what ways might each of the people in such a relationship be affected by the other person, and how likely are those outcomes?

Later, when Jack is picking up Adrian to go to church, Adrian tries to seduce Jack. She asks, "Didn't you have a good time last time?" He says, "Yeah, I had a great time. But it wasn't worth all the guilt and trouble it caused." Adrian says, "Everyone's going to think we're doing something so we might as well be doing something, right?" Jack replies, "Wrong. I don't care what everyone else thinks. I care what I think. I think that sex before marriage is a sin." Adrian says, "Well, aren't we all sinners? ... We'll go to confession afterwards." Jack says, "We [protestants] don't have confession.... we have guilt, shame, regret." Jack says that they could make out, but couldn't do anything more than that, "anything more than that would be a sin." Adrian asks, "What, is it in the Bible?" Jack says it is, but has no idea where. So we hear that Jack says he is feeling regret for having sex. According to the National Campaign to Prevent Teen and Unplanned Pregnancy, "Most teens who have had sex wish they had waited. Almost 70% of teens regret having had sex as early as they did." Ask your kids if they have had sex. If so, do they feel guilt, shame or regret? Do they need counseling from a religious leader to help them process these feelings? Jack says that making out is ok. Where do your kids think they should "draw the line" in sexual activity at their age? What about when they are unmarried college students? What limits would you prefer they follow?

Depression After Childbirth

We've written about postpartum depression previously, but it's a topic worth covering repeatedly.

A recent survey found that many Oklahoma women suffer from depression after childbirth. These results are likely very similar to what would be found in other areas too. Here is the text of a press release from the Oklahoma Department of Health, with commentary added:

One in four (25%) new mothers in Oklahoma report symptoms of maternal depression after giving birth, according to a recent study conducted by the Oklahoma State Department of Health (OSDH).

Using the Pregnancy Risk Assessment Monitoring System (PRAMS), an ongoing statewide survey of maternal behaviors and experiences, OSDH officials found that 40% of Oklahoma mothers did not discuss postpartum depression, or PPD, with their health care provider.

Of special concern were adolescent mothers, who were 2.5 times more likely to indicate symptoms of PPD as mothers age 35 and older.

“These findings are of major concern to health care professionals and should place families on alert to watch out for signs and symptoms of depression in new mothers,” said Secretary of Health and Commissioner of Health Dr. Michael Crutcher.

The symptoms of postpartum depression include:

• loss of interest in pleasure in life;
• change in appetite;
• less energy and motivation to do things;
• having a hard time falling asleep, staying asleep, or sleeping more than usual;
• increased crying and tearfulness;
• feeling worthless, hopeless or overly guilty;
• feeling restless, irritable or anxious;
• and having unexplained weight loss or gain.
• Additional symptoms include feeling like life isn’t worth living,
• having thoughts of hurting yourself or worrying about hurting the baby,
• or someone else hurting the baby.

Among the stressors found to increase the risk of depression symptoms are:

• arguing with a partner more than usual during pregnancy,
• having bills one cannot pay, and
• having an unintended pregnancy.
  

Additional highlights from the Oklahoma PRAMS survey on PPD include the following:

• Women ages 20 to 24 were twice as likely to indicate symptoms of depression when compared to women 35 or older.
• Women with infants placed in the Neonatal Intensive Care Unit (NICU) were at a higher risk for depression.
• Mothers are at special risk for postpartum depression when caring for infants born prematurely or infants with special health care needs.
• Women who did not receive a postpartum checkup were also at a higher risk for symptoms of postpartum depression when compared to women who did receive their postpartum checkup.
  

To address PPD, public health officials recommend the following:

Ask your daughter's doctor to screen your pregnant daughter for maternal depression before birth at a late-term prenatal visit.

Ask your daughter's doctor to screen your daughter for maternal depression at each doctor visit during the first year after the birth of her child.

Make sure your daughter understands the importance of returning for her postpartum checkup around six weeks after delivery.

If your daughter has an infant in the NICU, search for support groups near your home and in the hospital, and research more information on PPD.

Ask your Medicaid provider if there are any maternal and infant health licensed clinical social work services available to your daughter.

Ask your doctor, nurse, and hospital staff for education about PPD awareness, referrals for treatment and follow-up care.

Encourage new mothers with signs and symptoms of depression to call the PSI national hotline 1-800-944-4PPD. Information is also available at http://www.postpartum.net.

Ask your daughter's school counselors what support they can provide for pregnant and postpartum adolescents to cope with the stress of motherhood, schoolwork and feelings of isolation.

State Medicaid Information

One of the things that visitors to this blog are looking for is information about medicaid eligibility for their pregnant daughter.

Here are links to as many state medicaid websites as we could find:

Alabama Medicaid Agency

Arizona - Arizona Health Care Cost Containment System

Arkansas - Arkansas Medicaid

California - MediCal

Colorado - Department of Health Care Policy and Financing

Connecticut - Department of Social Services

Delaware - Department of Social Services

Florida - Agency for Health Care Administration

Georgia - Department of Community Health

Idaho - Department of Health and Welfare

Illinois - Department of Healthcare and Family Services

Indiana - Indiana Health Coverage Programs

Iowa - Iowa Medicaid Enterprise

Kansas - Kansas Medical Assistance Program

Kentucky - Cabinet for Health and Family Services

Louisiana - LaMOMS program

Maine - Office of MaineCare Services

Maryland - Maryland Children's Health Program (includes pregnant women of any age)

Massachusetts - MassHealth insurance

Michigan - Department of Community Health

Minnesota - Department of Human Services

Mississippi - Mississippi Division of Medicaid

Missouri - Department of Social Services

Montana - Department of Public Health and Human Services

Nebraska - Department of Health and Human Services

Nevada - Division of Welfare and Supportive Services

New Hampshire - Department of Health and Human Services

New Jersey - Medical Assistance and Health Services

New Mexico - New Mexico Human Services Department

New York - Department of Health

North Carolina - Division of Medical Assistance

North Dakota - Department of Human Services

Ohio - Department of Job and Family Services

Oklahoma - Oklahoma Health Care Authority

Oregon - Oregon Health Plan

Pennsylvania - Department of Public Welfare

Rhode Island - Medical Assistance Program RIte Care

South Carolina - Department of Health & Human Services

South Dakota - Department of Social Services

Tennessee - Bureau of TennCare

Texas - Texas Health and Human Services Commission

Utah - Utah Department of Health

Virginia - Department of Medical Assistance Services

Washington - Department of Social & Health Services

Washington DC - Department of Human Services

West Virginia - Bureau for Children and Families

Wisconsin - Department of Health and Family Services

Wyoming - Department of Health

Challenges of poverty

In a report called "America's Children in Brief: Key National Indicators of Well-Being, 2008" there are some recent statistics that highlight the challenges your single parent daughter may need help with. In a previous post, we noted the statistics that more and more women are choosing to be single parents. As you see below, many single parents live in poverty. So if your daughter is a single mother, know that you are not alone in the challenges you face!

Economic Circumstances
In 2006, children living in families with a female head with no husband present (female-householder families) continued to experience a higher poverty rate (42 percent) than children living in married-couple families (8 percent). If your single parent daughter and her child live below the poverty line, your grandchild is exposed to the possibility of several other challenges: education, health care, and housing. Will every single parent face these challenges? No. Will every family living below the poverty line face these challenges? No. But if your daughter is a single parent, these are possible additional challenges.

Children's Education Challenges
Children in families with incomes of 200 percent or more of the poverty threshold were more likely to be read to daily by a family member (65 percent) than were children in families with incomes 100–199 percent of the poverty threshold (60 percent) or those in families with incomes below the poverty threshold (50 percent) in 2005.

Dental Health Challenges
Good oral health requires professional dental care as well as routine personal care. The American Academy of Pediatric Dentistry recommends regular dental visits beginning at 1 year of age. Among children living in families with incomes less than 200 percent of the poverty threshold, 68 percent had a dental visit in the past year, compared with 82 percent of children in families with incomes of 200 percent or more of the poverty threshold.

Housing challenges
Inadequate, crowded, or costly housing can pose serious problems to children's physical, psychological, and material well-being. In 2005, 40 percent of U.S. households (both owners and renters) with children had one or more of three housing problems: physically inadequate housing, crowded housing, or a housing-cost burden of more than 30 percent of household income. Cost burdens have driven significant increases in the incidence of problems since 2003, when 37 percent of households had one or more of these housing problems, as well as over the long term. Severe cost burdens—housing costs exceeding 50 percent of income—are especially prevalent among the lowest-income renters, affecting 45 percent of very-low-income renters with children in 2005.

Talk with your teens about these statistics. If your teen daughter is pregnant, brainstorm with her about ways your family can address these possible challenges should they arise. In what ways do these possible challenges affect your pregnant teen's thinking about single parenting and her thinking about adoption? Does your community or church offer a support group for single parents? Does your community have a pregnancy resource center that offers support to single parents? Are there any housing options that your daughter's family could safely share with another single parent's family in order to reduce expenses? Does your single parent daughter have any interest in marrying? What could your family do to read to the children every single day? Brainstorm ideas for getting dental care for your daughter's children.

America's Birth Rates

CNN titled their article "Teen pregnancies up for first time in 15 years", based on data from this year's "America's Children in Brief: Key National Indicators of Well-Being, 2008" from the Federal Interagency Forum on Child and Family Statistics. CNN says that teen pregnancy went up for the first time in 15 years. But that's not explicitely what the data is saying! The data says live BIRTHS to teens increased. Was there an increase in pregnancy, or simply an increase in choosing birth over abortion? Or were there fewer miscarriages? Or was there an increase in multiple births? The data does not talk about any of these factors, so concluding that pregnancy is up is not proveable based on this data. The only thing the data proves is that births were up. It is quite possible that the total number of pregnancies was stable; the data does not say one way or the other.

There were 51 births (not just pregnancies, so these statistics do not include abortions and miscarriages) for every 1,000 unmarried women ages 15–44 in 2006, up from 48 per 1,000 in 2005 (figure 2) [1]. This increase in birth count has many influences: multiple births have increased due to infertility treatments, abortion rates may be lower, as demographics change we may see more births due to varied cultural values, etc. Since abortion rates are not a mandatory reporting category, we have no way to officially and formally compare births to abortions. Some agencies give estimated comparisons based on the limited data that is available. Note that this statistic does not count births to women under the age of 15. I don't know whether this information isn't collected or isn't tabulated, but procedures need to change to account for all births instead of assuming a particular 'childbearing age' range.

In 2006, the adolescent birth rate (to unmarried teens AND married teens combined) [3] was 22 births per 1,000 young women ages 15–17 (138,920 births), up from 21 births per 1,000 in 2005 (Figure 3). This was the first increase in this measure since the increase between 1990 and 1991 [4, 5, 6]. Again, the data is not proving an increase in total numbers of pregnancy, simply an increase in the number of women giving birth.

Between 1991 and 2005, the birth rate for Black, non-Hispanic teenagers ages 15–17 dropped from 86 to 35 per 1,000. The birth rate for this group increased in 2006. Are Black teens choosing birth over abortion slightly more than they did in the past?

Between 1991 and 2004, the birth rate for White, non-Hispanic teenagers dropped from 24 to 12 per 1,000 [4, 6]. The birth rate for this group increased in 2006. Are White teens choosing birth over abortion slithly more than they did in the past?


The birth rate for unmarried women has risen rapidly since 2002. [2]

• The rate had been relatively stable between the mid–1990s and 2002, following a long-term increase between 1960 and 1994.
• In 2006, 38 percent of all births were to unmarried women, up from 37 percent in 2005.

Between 1980 and 2006, the percentage of births to unmarried women rose sharply for women in all age groups:

• Among teenagers, the percentage rose from 62 to 92 percent for ages 15–17 and from 40 to 81 percent for ages 18–19. So apparently teens in the 1980s were much more likely to get married when pregnant than they are currently.
• The percentage tripled for births to women in their twenties, from 19 to 58 percent for women ages 20–24 and from 9 to 31 percent for women ages 25–29. Again, apparently 20-somethings were much more likely to get married when pregnant than they are currently.
• The percentage of births to unmarried women in their thirties more than doubled from 8 to 18 percent. Again, apparently 30-somethings were much more likely to get married when pregnant than they are currently.

If you are the parent of a daughter who is pregnant and single (at any age group), you are certainly not alone!

[1] Hamilton, B.E., Martin, J.A., and Ventura, S.J. (2007). Births: Preliminary data for 2006. National Vital Statistics Reports, 56(7). Hyattsville, MD: National Center for Health Statistics.
[2] National Center for Health Statistics. National Vital Statistics System. (2007). Unpublished tabulations.
[3] The birth rate for adolescents ages 15–17 includes married and unmarried teenagers.
[4] Martin, J.A., Hamilton, B.E., Sutton, P.D., Ventura, S.J., Menacker, F.J., Kirmeyer, S., and Munson, M.L. (2007). Births: Final data for 2005. National Vital Statistics Reports, 56(6). Hyattsville, MD: National Center for Health Statistics.
[5] Hamilton, B.E., Martin, J.A., and Ventura, S.J. (2007). Births: Preliminary data for 2006. National Vital Statistics Reports, 56(7). Hyattsville, MD: National Center for Health Statistics.
[6] Hamilton, B.E., Sutton, P.D., and Ventura, S.J. (2003). Revised birth and fertility rates for the 1990s: United States, and new rates for Hispanic populations, 2000 and 2001. National Vital Statistics Reports, 51(12). Hyattsville, MD: National Center for Health Statistics.

Sexual Behavior in America's Children

Data from this year's "America's Children in Brief: Key National Indicators of Well-Being, 2008" from the Federal Interagency Forum on Child and Family Statistics.

In the "Behavior" section of the America's Children report:

• Early sexual activity is associated with emotional [1][2] and physical health risks. (See also our post on the benefits of delaying sexual debut. Share the research studies with your kids and talk to them about the findings. What do your kids think about the study results?)



• The percentage of students in grades 9–12 who reported ever having had sexual intercourse declined from 54 percent in 1991 to 46 percent in 2001 and remained stable from 2001 to 2005. (In your opinion, does this decline and stability argue that abstinence education works or does not work?)



• In 2005, 18 percent of students in grades 9–12 who had sexual intercourse in the past 3 months reported that they or their partner had used birth control pills before their last sexual intercourse and 63 percent reported condom use. While there was no statistically significant change in the use of birth control pills, condom use among high school students has increased from 1991 (from 46 percent to 63 percent). (In your opinion, if abstinence education is a failure, why are more teens using condoms now?)

[1] Hallfors, D., Waller, M., Bauer, D., Ford C., and Halpern, C. (2005). Which comes first in adolescence—sex and drugs or depression? American Journal of Preventive Medicine, 29(3), 163–170.
[2] Meier, A.M. (2007). Adolescent first sex and subsequent mental health. American Journal of Sociology 112(6): 1811–47.

Episode 3 - The Secret Life of the American Teenager

You can watch the two most-recent episodes online here (click the tab called "Full Episode"). Here are a few points from the show, followed by some items to discuss with your teens.

• Ashley's mom comments on Ashley's tubetop and miniskirt outfit, saying "Be mysterious. Less is more." Clothing choices are not message-free. Look through catalogs with your kids and call out what message each outfit sends. Then go through your closets...what messages do your kid's clothes send? Ashley is 13, and a man stares at her, prompting mom to tell him he's a pervert. When do your kids think its okay for a girl to start dressing in revealing ways?
• Amy's clothes are starting to not fit. Later in the show we see she is having other pregnancy side-effects: swollen feet, growing breasts, nausea, appetite change
• Ben's friend Henry asks "If you're not going to kiss her, what's the point in going out with her?" What do your kids think the point of dating is? Is sexual activity of some kind a mandatory and expected part of dating?
• Jack taunts Grace, "How old do you think you'll be when you stop letting your parents make your decisions for you?" Talk with your kids about the process of gaining independence in your family. As they mature they should be taking on more decisions - what kinds of decisions do you think they are ready to make on their own right now, and what kinds should they still be obeying you? Later in the show, Grace's dad say his household is not a democracy, its a kingdom. What is your family like? Are there some areas where the family is a democracy and some where it is a kingdom?
• Jack continues, "All the guys think I'm a big wuss because they think you're in charge of me. You and your parents." Talk with your kids about this kind of attitude. What does masculinity mean to them? How should men and women interact in terms of 'being in charge'?
• Amy's friends say, "Eww. Don't say things like 'fetus' to us." Fetus is a latin term. Find out what it means.
• Amy's friend's brother Jason says, "You know mom and dad aren't going to let you hang out with her anymore when they find out." If your teen told you their friend was pregnant, what would be your response? Would you allow your kids to continue to hang out with them? Why/why not? What do your kids wish your reaction would be?
• Grace is talking to her family about Jack and says, "Sometimes liking someone doesn't always make sense. It isn't always logical. Maybe I have no reason to like this guy, but I do. We dated all summer and he never gave me or you any reason not to trust him." But her parents both say they do not want her dating Jack. Talk about the feelings and actions of infatuation, lust, and love. How are they different? How can you tell them apart?
• Dr. Hightower is talking to Amy on the phone and says, "Your mother is a very nice woman. She's going to be a big help to you. Once she gets past the news." She offers to help Amy tell her mother she's pregnant. Many parents are upset when they find out their teen daughter is pregnant. But they do also love their daughter and want to help her.
• Dr. Hightower continues, "Every day is important in a pregnancy... You're in charge of another life now." If your daughter is pregnant, help her get prenatal care as soon as possible.
• Ricky talks Grace into letting him help her 'sneak around' to date Jack without her parent's permission. A lot of lying is involved in order to get out the door. How would this behavior go over in your family?
• Amy admits to her sister, Ashley, that she is pregnant. Ashley promises not to tell their parents. If one child knew a big secret about another of your kids, would you want them to tell you?

The National Campaign to Prevent Teen and Unplanned Pregnancy also has a discussion guide online for this episode (PDF file).