I imagine what people must think with the recent whirlwind of laws being passed in my lovely state of Florida. We have the “Parental Rights in Education” Bill, the “Reducing Fetal and Infant Mortality Act,” and I am sure that there will be many more to come in this robust legislative session. I imagine that those who support these bills must rest easy thinking of the many children whose lives they will save by limiting abortion rights and strengthening parental rights. But, humor me for a minute and close your eyes. Picture the mother of that unborn baby. Is she a 30-year-old unwed mother who has opted out of motherhood just because she couldn’t afford it? Is she a woman in her late twenties who has already had “too many children” and didn’t practice adequate family planning? Or a twenty-something who has made bad relationship choices and finds herself in some new and unique predicament? Who are you picturing? What is her story? What judgment do you harbor in your mind about this woman?

What if I told you that as a pediatrician, a practitioner who smiles at babies, treats sore throats, assesses fractures, and reassures my patients of their temporary ailments, I have now added the role of pre-teen pregnancy counselor to my list. Why you ask? Because in all of this hubbub, shouting, and politicking, there is another vulnerable population of children affected by pregnancy, teen mothers. 

It is so easy to pass them over as girls who made the wrong choices, deviated from some social norm regarding their promiscuity, and must now pay for their decisions with their lives. One could argue that I am being completely dramatic. That I only want to hear the sound of my voice; I could even be painted into a particular political party. But, I assure you that doing so would compromise one’s integrity.

Imagine looking into the eyes of a young teenage girl of 14 or 15 years. You have known her most of her life, tracked her milestones, tended to bumps and bruises, held her hand when she was sick, and tried to put a smile on her face for reassurance when she seemed to feel down. You are her physician who delights in treating her family. You greet her always with a smile so that she can stand proud in knowing what a beautiful and strong young woman she is becoming, and you wait and hope to see where her life will take her.

You do all the right things during her visits. You ask her about the common teen questions like menstrual history, recreational drug use, alcohol consumption, tobacco usage, and sexual history, all with negative answers. You screen for depression and anxiety, and this girl has none of it. You smile and shine, knowing that she has so much in front of her and can feel the warmth of the glow of her stellar future as she looks you in the eyes. There is pride and hope there, in her pupils’ deepest recesses, and it is to be celebrated.

Now imagine that you are still looking into those eyes, staring up at you on a day when she is sitting on the examining table, and you have just learned that this bright star is with child. A child who is set to have a child. Can you feel the weight that hangs in the room? Can you see the mother and father cowering with permeating angst? What about the expression in the girl’s eyes? What if you know that the calm in her eyes has more to do with innocence than confidence?

I have another exercise for you. Please put down this article and ask your (12-year-old or older ) daughter, niece, or granddaughter how babies are made. Ask them about the mechanics. Speak with them about physiology. How are babies made? It is a question that had become a cute and whimsical point in season one of the hit Netflix series (and bestselling novel) Bridgerton. In the story, Daphne, the main character, has to navigate her way through the Regency Era without knowledge of her body, its functions, or its purpose. As an audience, we are in awe at how the main character finally receives the correct information timed beautifully for her pursuits into motherhood.

However, it is 2022, and I have been astounded at how many girls don’t know the basic mechanics of sexual activity. They have no concept of contraception and no knowledge of getting pregnant and how to avoid pregnancy. These practices are essential because health professionals realize the true toll of pregnancy on a girl’s body. Regardless of the outcome, it always causes a gaping wound- physical, emotional, or both. 

Imagine the pelvis of a 12-year-old girl with a belly full of her baby. Her hips are not wide enough to give birth without issue, and in some cases, the infant can tear out her insides, or she could die during childbirth. Sure, her insides can always be put back in and sewn back up, but she will never be the same again. Likewise, should she choose to have an abortion, the procedure is no less traumatic. She will still have cramping, bleeding, swelling, and possible all-consuming trauma from her decision. Both choices offer years, if not decades, of recovery and can change the course of a girl’s life forever.

So, let’s go back to education, you say. Try talking to the kids about sex in the schools? The conundrum is that the “Parents’ Bill of Rights” among many other things, limits educators from talking about sex in schools. Moreover, it is up to parents to choose how to educate their children and decide if they want to do it. I have seen some teens who can’t even refer to their anatomical body parts as they are and still use “cute” nicknames for them. How am I supposed to ask my teen patient if she believes that she is pregnant when she still refers to her vagina as a cupcake and has been taught that the stork drops babies off on doorsteps? As a physician, I can only do my part, give some medical expertise, and help my patient weigh all sides… But how do I do this when some parents like arming their children with mythology. So, where are children supposed to learn how babies are made? How are they supposed to know?

I have accepted that most laws concerning the child’s welfare fail to take all children into account. But, the teen mother is still a child. As a pediatrician, who am I to choose one child’s life over the other? Is one more important than the other? It is easy to say that the teen mother is now a woman. Until you look into her eyes and see the dulled glaze of fear, feel the deflation of hopes, and the silent hum of despair. This is the nuclear aftermath of the result. There is no screaming, shouting, or jumping up and down with joy and anger. There is only a pall cast as the future remains indelible, ambiguous, and charged like a pulled, undetonated grenade.

It is not for us to judge. It is up to us to help. As a society, we cannot condemn one child in favor of another. We cannot state that we value the unborn child’s life and then scatter to the wind when that baby is born to a young mother. We cannot turn our eyes away and cover our ears to hide from some profound truths. Young girls get pregnant by their boyfriends, yes. But, they also get pregnant by much older men in the community and their own families. Who is there for the pregnant girl shunned by her family after being molested by a family member? What laws are there to protect her?

Many of us have gotten the wrong idea about how things come to be. A teenage mother is not a deviant. Neither are any of the women that I mentioned above. Rather than judging each situation, it is better to listen and see. I guarantee that by listening, we will be able to see how similar others are to ourselves. It is easy to cast another person away and blame them for their choices instead of acknowledging that there are many other factors in play.

I have now had to develop a new treatment plan for my patients. It is called the Pre-Teen Pregnancy Plan. I know that there will be more pregnant patients to come, and I have just begun to make changes to accommodate this trend. So, I need you to do the same. There is no better way to care for your daughter than through the education of her mind and body. Ask her, tell her about the mechanics of sex. If you are uncertain, read up and teach. Don’t forget to ask your son the same thing and teach him. We need to raise the bar for our excellence at this very hour. Time is wasting, and every minute counts. Silence is not an option.