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Heather Corinna replies:
Me and my boyfriend want to get me birth control pills, as we've had the condom break three times on us already, and we're really fearful of pregnancy. I've already seen on this site a question on how to get birth control, but I have more questions than were answered. I'm 16, as is my boyfriend. Neither of us are able to drive yet because we didn't get our permits at the correct time (though we can take a cab to get somewhere), my mom would be highly unsupportive of the fact me and him are having sex (and even more unsupportive of me being pregnant), but we don't want to stop or anything, we just want more ways to protect ourselves against pregnancy. So, I need a way to get birth control without my mom's know. In the question I've read, you guys said that the doctor would ask for my name, address, phone number, and social security number. By giving them any of these things, would my mom be able to know I had seen the doctor? One of my main fears of getting birth control is my mom finding out somehow. Also, I don’t know where my mom keeps my social security card, and I haven’t memorized the number, so how can I find it out? Can I not have to tell the doctor?
I thought someone who'd be perfect to answer your questions is one of my favorite young sexual health educators, the marvelous Joanna Dawson, MPH, Teen Health Educator at United Action for Youth. She had some great information and helps for you!
Joanna said: To start, good on you and your partner! It looks like the both of you work on communicating, and I’m happy to see that you’re supportive of one another in figuring this all out. There’s a lot of things to touch on, so let’s get to it!
Before we get to the birth control pills themselves, I want to review the condom issue. Condoms can be finicky things, but are an important part of protecting your sexual health as they are a very effective way to prevent sexually transmitted infections! This may seem like a low priority since you’re in a relationship with what looks to be one person, but it’s still important to protect yourself, and STIs are just as much of a risk as pregnancy. It’s not all about trusting the other person to be free of STIs, but about your body too! The most important and long-term relationship you will ever have is one with yourself, and it’s gotta come first. Plus, mixing and matching methods like condoms and hormonal pills can keep all your bases covered. So how do we get condoms back in play?
Condoms are a great way to avoid pregnancy and STIs, but there is risk for user error. You can review the in-depth steps to using a condom properly here at Scarleteen, and I’ve got a trick for you, too. It may be difficult to follow each step in the heat of the moment when you're first learning, so you can do a few things like practice. Get comfortable using them with and without your partner, figuring out which lubricants and types of condoms you like best.
Once you’re poised and ready to go, you can make sure you’ve covered all the important steps to proper condom use by remembering a certain influential woman: OPRAH! No, not actually the queen of media herself, but the letters in her name can help if you’re in a bind:
O = Open Carefully! Don’t use your teeth, make sure the condom is squished to the opposite side of the package from where you want to rip it open. Once the condom is out, you or your partner can put a dot of lube just inside the condom for the wearer's comfort.
P = Pinch the tip! Be sure to pinch the tip of the condom to keep out air bubbles and to leave room for the seminal fluid if and after your partner ejaculates.
R = Roll down! While you’ve got the tip of the condom in hand (pinch!) roll the condom to the base of the penis shaft. Don’t pull down too hard, you want to keep that space in the tip of the condom! This is the part where you also add lubricant to the condom on the outside.
A = Action time! This is the fun part right? Keep in mind that among other things, condoms can slide off. If that happens in the midst of your go time, keep calm! Toss the used condom out, and start again with a new one.
H = Hold fast! H is two-fold step. First, you want to be sure to hold the base of the penis and condom to extract the penis from whatever action was going down following ejaculation. Second, hold the tip of the condom when removing the condom from the still-erect penis. This is important to keep seminal fluid from coming in contact with anyone or accidentally causing a spill.
OPRAH doesn’t quite cover all the ins and outs of putting a condom on correctly, but it can sure be helpful if you’re stuck on a step and not sure how to move forward.
So, you know all the steps, you’ve used condoms before and still - they keep breaking! This may be for a variety of reasons. Without knowing exactly how you and your partner are using condoms, let’s go over some of the big things that may cause a condom to break.
Are you following all the steps? We went over those already, so let’s presume you’ve got it down. Next, it all comes down to lube! Not using lube as needed to keep the condom (and your genitals!) from getting too dry or using the wrong type of lubrication may lead to the ultimate demise of your condoms.
Lubricants are like condoms - they are not a do-it-yourself project! Buy them from the store, get them from a clinic, ask your parents/friends to give them to you. Making condoms from plastic bags, latex gloves, or other things you find around the house won’t work! Same goes for lube. Food, lotion, spit, water or other products in your house are not intended for condoms. Oil-based products like Vaseline are something you especially want to avoid because they can weaken the condom and make them easier to break. Plus, products like that are not easy to wash off your body and can be full of bacteria that will stick to your skin easier and potentially lead to infection. All around not good!
If you are utilizing latex condoms, you want to be sure you have water-based lubricants. This is something that will be clear on the packaging of your lubricant. There’s all sorts of brands and styles so feel free to experiment until you find the best lube for you! A special note to consider, if you have silicone-based lubes, these are safe to use with latex and latex-free condoms, but they should not come in contact with sex toys. The silicone in the lubricant will react with the silicone in the toys and cause holes and other problems.
Now that you’re all set with the right type of lube, the other thing to do is make sure you use it! Lube is not up for negotiation. If you’re using condoms (and hooray for that), then you’ve gotta use lube. Using lube will be more pleasurable for all partners involved, and help keep the condom from breaking by reducing the amount of friction or force that pulls on the condom itself.
Alright, that was the condom review. Thanks for sticking it out!
Let’s get onto the real meat of your question. I see this as two main issues: 1) how do you get birth control and 2) how is your privacy protected when you go to the clinic? I’ll try and focus on those main points, and if you want more check this out. I’m going to approach your question as a user in the United States: not all countries (or states) have the same policies and laws, but we'll address ours for you.
Let’s start by locating and figuring out where you should go to get birth control. There are many different credible sources like the American Sexual Health Association, Planned Parenthood, and even the MTV Get Yourself Tested (GYT) campaign that can help guide you to available clinics in your area. Once you’ve found a place to go, call and make an appointment! If you’re worried about the clinic calling home and breaking the news to your mom, don’t worry! We’ll get more into your legal protections shortly, but rest assured that if you tell the clinic NOT to notify you by phone to send a reminder, they are legally obligated not to do so. This is protected by Griswold v. Connecticut, a landmark 1965 Supreme Court ruling that shot down laws prohibiting distribution of contraceptives. Additionally, this ruling addressed rights to privacy for married couples and found a “zone of privacy” protected by language in the US Bill of Rights. These protections were extended to minors in a 1977 ruling. As a 16 year old woman, you have the full legal capacity to obtain a prescription and purchase birth control options.
When it comes to specific states, there are a few that have restrictions in place for parental consent. You can click here to check out your specific state restrictions (if any), and to make sure you know your protections. Overall, as a 16 year old, you pass most of the restrictions listed for states and should have no problem legally obtaining birth control without parental consent. Beyond sexual health regulations, there are additional rules in place to protect all of your health information. HIPAA rules force any health care providers to have securities in place to protect your information and maintain your privacy. This means if your mom (or anyone!) suspected you had an appointment at whatever clinic and called to ask them about you, the clinic is not going to tell her anything or even acknowledge that you are a patient there. If you want to share any of your information, you will have to sign documents that give them the freedom to do so. I mention all this because I think it is important for everyone to know their legal rights and protections. Health care is not out of your control - it is your body and you have the right to be aware! If you have heard of anyone being manipulated around these rulings, feel free to throw these cases back at them!
Off my soap box now: at this point you’ve found a clinic, made an appointment and are ready to figure out how to get there. Your question mentioned being able to get a cab - which is awesome that you two can pool funds to get to the clinic, but what can you do if you don’t have the fare? Public agencies like your county Department of Health and Human services would be a great first call and be able to direct you to a specific place that may offer bus passes for youth. If you’re unsure about bus routes, or live too far away from any public transportation, they can still work with you to figure out a solution. Some cities even offer free or reduced public transportation for students.
At your appointment, you are going to need to give them basic information like your address, phone number and other things. I’m glad you mentioned needing your social security number (aka SSN) because I doubt you’re the only one who doesn’t have the number off the top of your head! Clinics may ask for your SSN and other information in order to ensure you are who you say you are, to keep in touch with you for payment or notifications. With that, as I stated above, you will not be notified about any of those things without approval!
In 2007 the Federal Trade Commission instated Red Flag Laws in order to help protect from information fraud. There are no regulations that say you HAVE to disclose your social security number at a clinic, but they may ask for it, anyways. You may be able to get around that request by offering to pay cash, giving the last 4 digits of your SSN if known, offer to provide a different form of identification, or just ask what their policy is about social security numbers. Be aware that the clinic can ultimately refuse to serve you, however you may find some flexibility at a women’s health center or other clinic that caters to teens. If you are uncomfortable talking with your mom about knowing your SSN, you may find some alternatives!
During your appointment, you’re probably going to have to go through some basic exams and testing before you’re set up with a birth control option. Not all clinics have the same policies about that, and some make those things optional. If you have options and don't want to get a pelvic exam just yet, at the very least, it's wise to get an STI screening, especially since birth control methods can't protect you from STIs, and you have had condoms break, which will have increased your STI risks.
There are many options to help prevent pregnancy beyond birth control pills, and I encourage you to speak with your doctor honestly about what you’re looking for. Other hormonal options like Implanon or the vaginal ring may be options to consider since they don’t require remembering to take a pill at the same time every day, which is hard for a lot of young people.
Worried about paying for whichever method is best for you? Never fear! In 1970, the Title X Family Planning program was enacted, which is dedicated to providing you with comprehensive sexual health services. This includes financial support for clinics to provide information and prevention services like contraception. This means that you may be able to pay for services on a sliding scale based on your income, or even get free services. Not every method of hormonal contraception is available at the same cost, but talk with your clinic and you’ll get more information about what they’re able to do based on your information. Some clinics are able to offer long-acting-reversible contraceptives like Implanon and IUDs entirely free of charge, so it’s worth finding out!
After you’ve been set up with whichever option, keep in mind that this doesn’t have to be the ONLY method you use for the rest of your life. If there are aspects that you are unhappy with or cause problems in your life, return to the clinic and they’ll work with you to trying another method that may be better. Sometimes it takes a few tries to find the method that's just right, and sometimes a method right for one time of life isn't a good fit for another. Remember to review the health information you receive with your method! Most hormonal birth control methods require a period of time before they are at their most effective, so being sure you understand how it will impact your body and potential side effects is important.
That’s the whole scoop! To review, you are old enough to seek health services at a clinic and obtain hormonal birth control options without parental consent, for potentially reduced cost. Plus, we had a bonus discussion about correct condom use because it is important to keep on protecting yourself against STIs even if you have another method of contraception, and condoms make a great birth control backup if something goes amiss with your other method.
The last thing I want to encourage is for you to consider how you can reach out about some of these issues with your mom. I understand there’s a lot of specific ins and outs to every relationship, but feeling free to disclose your sexual health decisions with your parents can demonstrate your maturity, responsibility for yourself and show that you’re interested in keeping your mom involved with your life. Chances are she wants to be involved and to know about big choices in your life, but only you can fully understand if that’s an option available to you. It may be awkward and stressful - but it could reap great rewards!
Here are a few more additional links you may find helpful: