Teens and the pill

“Are any of your friends on the pill?” I ask my fifteen-year-old.

By now she’s used to the fact that my questions sometimes come of out left field.

“Another article?” She doesn’t even blink. “Some girls in my school take the pill. We learnt all about birth control in Health. Year 9 was a joint class for both boys and girls. They split us up in Year 10.”

A brief discussion later, I’m happy that the national curriculum covers all the basics, together with sexually transmitted infections (they are no longer called diseases) and putting condoms onto wooden representations of male anatomy.

In addition to birth control pills and condoms, they learn about IUDs (small coil-like devices placed into the womb by a doctor or nurse), as well as implants (match-like rods inserted under the skin, also by a health provider). Both of these methods can prevent pregnancies for several years. The other option is an injection which you get every three months, or a hormone patch which needs to be worn for 3 weeks then discarded. The downside is that none of these methods (nor indeed the pill) provides any protection against sexually transmitted infections.

The school curriculum reminds the teens that no birth control is 100% effective (apart from abstinence), and goes to the trouble of discussing peer pressure, boyfriend pressure, social media hype, and how it’s all your own personal choice. Oh, and that the legal age of consent in New Zealand is sixteen.

But back to the choice issue. Some parents don’t want to make birth control available to their teen, because they believe it amounts to giving teenage sex their stamp of approval (I was going to say “permission”, but it’s not as though they need it). However, children in New Zealand can get contraception at any age without their parents’ knowledge (even when they’re below the age of legal consent). They can go to a family planning clinic, or speak to the family GP who will be bound by doctor-patient confidentiality. So if your daughter were to bring up the topic with you and ask for help in obtaining birth control, your hypothetical refusal would not prevent her from becoming sexually active or practising safe sex.

Other parents consider it prudent to put their daughters on the pill as a matter of course, as soon as they turn fifteen or sixteen, reasoning that it’s better to be safe than sorry. Teenagers, however, may not welcome such an intrusion into their personal lives. Remember, the very definition of a teenager is – or at least should be – a rebellious know-it-all with a temper who believes that nobody should be the boss of them. “I have the right to choose what goes into my body” is a sentiment a friend of mine heard from her daughter, the double meaning apparently not lost on the sixteen-year-old.

Of course, the birth control pill is more than a tool to prevent pregnancy. Over the years, doctors have prescribed it to keep irregular periods on schedule, to curb heavy menstrual bleeding, to help with PMS, and to clear up acne. In America, one out of three teenage girls who take the pill does it for medical reasons unrelated to birth control. Having said that, in all the cases my teenager is aware of, the girls take it to prevent getting pregnant. “Nobody uses it for acne, Mum, not with Accutane around. And because you put on weight when you’re on the pill, you wouldn’t do it just to regulate your period.”

Now for the boring medical side of it: birth control pills prevent pregnancy by stopping ovulation. If no egg is released, it can’t be fertilised by sperm, and the woman cannot get pregnant. Most birth control pills contain synthetic forms of two female hormones (oestrogen and progestin) that suppress the natural hormone levels and prevent the ovaries from releasing mature eggs. The progestin-only pill (otherwise known as the mini-pill) can be prescribed to women who cannot tolerate synthetic oestrogen.

Those who oppose the pill point out that the hormones it contains are artificial. Whereas the natural progesterone produced by our bodies reduces insulin resistance, its artificial counterpart has the opposite effect. This may be why many women who take the pill report unexplained weight gain. The hormones in the pill have also been linked to depression, strokes, heart attacks and some forms of cancer. And if that is not scary enough, consider that the pill will work only if it’s taken regularly (every day at the same time), so it may not be the best birth control method for forgetful teens. Taking a course of antibiotics, or having a stomach bug, will also render the pill ineffectual.

“This one girl at our school skipped a day, like, she forgot to take the pill. And she totally freaked,” my Subject Matter Expert tells me.

“What did she do about it?”


(Perhaps the curriculum didn’t cover it, but what you’re supposed to do is take the pill as soon as you remember, and take the next pill at the usual time. If you skip more than two consecutive pills, consult your doctor.)

So, to summarise: broach the subject with your teen, but respect their right not to want to engage in the discussion. After all, as long as your child is in college, they will have covered the basics in Health. The pill sounds like an easy solution, yet it may have unwanted side-effects, it doesn’t offer 100% protection against unwanted pregnancies, plus it provides zero protection against sexually transmitted infections. As with most other birth control methods (excluding condoms), your teen will need to see a doctor or a health carer from Family Planning for a chat and a prescription.

At the end of the day, we as parents can only offer advice and remind our teens about the family’s value system. The teens will ultimately be the ones deciding when to start having sex and what birth control to use.

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