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Why can't I stop being so scared of pregnancy?

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lucyinthesky asks:

I have a problem, and I'm ready to crack with the stress of it. I've been on birth control (Yaz) for a year, to help with my acne, though I don't always take it at the same time every day. Sometimes I've missed pills or taken them over 12 hours late. That shouldn't really matter, though, because I'm not sexually active. My boyfriend and I have decided to wait until we get married to have sex. We only ever make out. Still, I find myself worrying about pregnancy risks even though there are no apparent ways to get pregnant from what we do. Some small part of my mind will whisper things like, "What if he has pre-ejaculate that seeps through his clothes onto you? What if he had a nocturnal emission that night he stayed over?" Nobody else I know seems to have this constant paranoia. I don't understand why I spend half my time worrying about a pregnancy that most people understand is impossible. I'm not sure what I'm asking here, other than, have you ever seen this before - a girl terrified of something happening when it isn't even likely? Is there any way I can help myself and get peace of mind? Thanks.

Heather Corinna replies:

Not only have we seen this before, it's something we see at Scarleteen often. At our message boards, at least once or twice a week a user comes to us feeling exactly like you are. I promise, it's not just you. Over the years, I've looked and looked for some kind of study on pervasive pregnancy worries when there's not a likely risk, or when it's been made clear someone is not pregnant, and when someone also really knows they're not pregnant, but I've yet to find anything, beyond information on false or "hysterical pregnancy," which isn't what this is. So, I'm afraid I can't offer you much of anything clinical, but I can certainly offer you my observations from seeing this over the years.

Some people do have a phobia specifically about pregnancy, birth or parenting, tocophobia (sometimes spelled tokophobia or parturiphobia). In other words, just like some people have pervasive or seemingly illogical fears about heights or small spaces, some phobias are pregnancy-based, about becoming pregnant, being pregnant and/or giving birth. This is more common than most people think, especially in people who can actually become pregnant. Given what a huge deal and big life-changers pregnancy, childbirth and parenting are, that's not that surprising. This phobia, like any, is best addressed with a qualified therapist who treats phobias. If you feel this may be the case with you, it is something you'll want to seek treatment for to feel better. That's going to be particularly important if you ever do want to become pregnant, because even wanted pregnancy can be very emotionally difficult for someone with a pregnancy phobia.

Sometimes people may also have anxieties like this because they have an underlying general anxiety disorder that presents with sex, other intimacy and/or pregnancy. The teens and twenties already tend to be full of big worries and heavy pressures, and sex and/or pregnancy certainly gives us some reasonable things to have big concerns about, but your generation is also often reported as having higher rates of anxiety than previous generations, particularly for young people who have come of age in the burbs and/or in higher income brackets. I certainly feel we see more young people reporting anxiety of all types over the last few years than we have in years previous. As well, many people of your generation have been exposed to a lot of intentional fear-factoring about sex and pregnancy in your sex education, in the media and through other cultural messaging, which can really play on a person's existing anxieties.

My best advice for someone who thinks or knows they may have an anxiety disorder or phobia is to start at a general or psychological healthcare provider's office. It never hurts to go, have a chat, and just see what a doctor says. In the case this is about anxiety as a whole, or a specific phobia, you probably won't feel better without treatment, whether that's talk therapy, a support group, medication or another way of managing anxiety, as well as qualified care to help you learn how to manage anxiety triggers and stress. For someone with anxiety or phobias, just taking away a given thing triggering them can help some, but often they'll just wind up being triggered by other things that replace that one.

For those who don't have anxiety in any area BUT this one, and who aren't thought to have a phobia that is situational, there can be a few different things that may be going on, and a few different routes to feel better.

Do you feel well-informed about how pregnancy realistically happens? Paranoia is about illogical fear, but if a person doesn't know what is and isn't real, they may not be paranoid, but validly afraid of something they just don't know they don't need to be afraid of.

The idea that a pregnancy could happen by pre-ejaculate seeping through clothing is not sound. For a pregnancy to happen, a lot of factors need to be in play. You need to have an available ovum (egg) to fertilize, for one, which very rarely happens when someone is using a combined birth control pill properly. (However, you would probably feel at least a little better if you started taking your pills properly.) There also needs to be enough sperm and semen to create a pregnancy. While the typical idea is that it only takes one sperm, that's not actually true. It only takes one to fertilize an ovum, but it takes a few hundred "helper" sperm for that one to do so. Seminal fluid is also important: it balances out the acidic nature of the vagina, keeps sperm viable and aids in their motility. Just like you'd have a hard time taking a long swim in a tiny rain puddle, sperm have a hard time swimming without enough fluid, too. Additionally, pre-ejaculate often does not contain any sperm at all, and when it does pull trace sperm from the urethra, it's not usually enough to create a pregnancy.

But for all of that to even matter, there would have to be direct contact between your vulva or vagina and semen. If you two are wearing clothes, that can't happen. Even with minimal clothing, it's still unlikely with a full ejaculation, and I feel comfortable saying it's not possible when we're only talking about pre-ejaculate. Pre-ejaculate is a very small amount of fluid, certainly not enough to seep through two sets of clothing and then still get into your vagina. Same goes with wet dreams. Someone sleeping over who has one in the same bed won't create a risk of pregnancy unless they happened to have that emission while their penis was inside your vagina.

Not knowing what your sex education has been, I can't know what you do and don't know about pregnancy, so let's be sure you have those bases covered. Even if it doesn't help with how you're feeling, it is something you'll want to know. Here are a couple links to get started with:

Did you already know all of that already, but find that you still feel really scared about becoming pregnant? Do you also feel like you're pretty sure you don't have any kind of anxiety disorder or phobia, something you've verified with a qualified healthcare provider?

One common denominator I often discover with feelings like yours, when I can really talk to someone about them deeply, is that they can often be traced back to sexual guilt or shame. I once counseled a young woman who was absolutely convinced, despite many negative pregnancy tests, menstrual periods and even an ultrasound that confirmed she wasn't pregnant that she was pregnant. At a certain point, she knew it wasn't reasonable, but she also just could not seem to let those feelings go. In talking with her, she eventually voiced that because her family and culture was so strongly unaccepting of someone unmarried having sex, she felt she deserved to be punished, to pay some kind of price for choosing to have sex. So, she had convinced herself she must be pregnant because that's the kind of "punishment" women who have sex that isn't socially sanctioned get, and she wasn't worthy of being spared. This is one common thread I've seen in women having these kinds of pervasive and unfounded fears, especially for women who have grown up with very socially or religiously conservative communities or views or with sexual shaming.

I don't know what your background has been like or how you feel about whatever kinds of sex you are engaging in. But if you feel that in some way it's very much not okay for you to be having whatever kinds of sex you are having, or moving towards other kinds of sex, or people you care about or are strongly influenced by feel that way, this could be part of the issue.

You voice that you and your boyfriend are saving sex for marriage and that you are not sexually active, but if you are having some kinds of sex -- like the dry humping, or oral sex -- some of these feelings may be coming up because those things are kinds of sex. That's a lot more obvious once people have had intercourse and know it's only so different, but it's still something people can intuitively feel because you know when you or a partner are having sexual feelings and desires and know when you're putting them into action. If your personal values are such that you feel sex needs to be saved for marriage, it'd be understandable that having some kinds of sex may not be making you feel good because it may be outside your values, and only be something you're rationalizing as being within them. Sometimes when we rationalize things in a way that isn't sound, while our brains may accept those rationalizations, our deeper feelings don't fall for it.

I don't personally share those kinds of ideas about sex and marriage, so please be sure that I'm not making judgments here or suggesting you've done something wrong or bad. But if you have different values than I do in this regard, which you clearly may given what you've said, you may need to check in with yourself to be sure what you're doing does fit with what your own values and sexual ideals are. This might also be something to talk with your boyfriend about, because even if you're feeling okay about this, if he isn't, his conflict might be something you're reacting to. If you feel like those values aren't really yours, but the values of others, then you may want to spend some time trying to clarify what your own values are, and some time letting go of values you may have grown up with, but don't share as you're coming into your own.

Something else that often comes up in discussions with other women feeling like you have been are problems with the interpersonal context it's happening in. In other words, these feelings can be emotional cues that a relationship isn't a good one, or isn't the right one for a given person at a given time in their lives. How supportive and responsive is your boyfriend being to these fears you're having? Has he suggested you two spend time talking them through, maybe step back with any kind of sex, made clear that there's no pressure on you to do anything sexual, even just making out, if you don't feel okay about it yet? If he hasn't, some of your feelings may be about feeling pressured or unsupported, or worrying that soon enough, you will have valid reasons to be afraid of an unwanted pregnancy.

The very best advice I feel I can ever give someone feeling like you are if this isn't about overall anxiety or a phobia is to suggest you think deeply about if any kind of sex or intimate contact is truly right for you right now. It may not be, and your feelings here may be intuitive cues about that. If one isn't trying to create a pregnancy, the primary reason for having any kind of sex tends to be about feeling good, physically and emotionally, for yourself and also in relationship to the person you're having sex of any kind with. If how you wind up feeling before, during and/or after is mostly not good, but instead worried, terrified and freaked out, and/or isolated in your concerns, then it really doesn't make much sense to have any kind of sex or making out that's eliciting those feelings because you're getting very little, if any, of the good parts.

It might help to sit down and make a list of pros and cons: of the ways physical intimacy makes you feel good, the ways it doesn't, with positive feelings on one side and negative feelings on the other. I'd also include what you have experienced as good outcomes and as bad ones, or what COULD be good ones and could be bad ones. Then you can look at all of those things on paper, and perhaps better assess if this is right for you right now or not. There's so often a lot swimming around in our heads about sex and relationships that being able to see it on paper, in black and white, can be very helpful.

A lot of young people have the idea that when it comes to any kind of sex, once a person starts having that kind of sex, in general or in a specific relationship, they're tacitly agreeing to have that kind of sex ever after. But in the reality of many people's lives, and certainly in healthy relationships and self-care, that's not how it goes. Instead, there will be times in our lives, in certain relationships, even just from day-to-day, where we'll want to be sexual and feel good about it, and times when we won't. We'll have times we choose to be sexual and times we choose not to. Those choices tend to be made not just around what our own sexual or interpersonal desires are, and those of someone else, but also around what we think we and others can handle based on the whole context of our lives. For instance, sometimes we can't afford birth control or just don't want to deal with it; sometimes we're so tired from other demanding areas of our lives we just don't feel we can be fully present with sex; sometimes we're grappling with challenging feelings from something else going on that the various risks, positive and negative, sex of any kind can pose just feel like too much for us.

There's never anything wrong with determining that any given time in our lives isn't a right one for physical intimacy with others. It doesn't mean we're immature, that we don't really love someone, that we're somehow deficient: it just means we're recognizing -- usually because of maturity, wisdom and love -- that sex or intimacy isn't something that's always right at every time, but which, instead, tends to require a unique set of circumstances that we're just not always in, or which isn't always available to us.

Often when we give the suggestion that taking any kind of sex off the table for a bit might be best, one common reaction we hear is that someone feels they just can't do that because they may lose or jeopardize a relationship in which some kind of sex either feels like it's required or is tacitly required.

If you feel that way, this fear may be really useful in learning something about healthy relationships. Having any kind of sex or physical contact -- even just something like making out -- because you feel you have to to keep someone around isn't a recipe for a healthy, happy relationship or a healthy sexuality and sense of self, for either person. It certainly isn't for the person engaging in any kind of physical contact they either don't really want or don't feel ready to handle, but it also isn't for the other person, either. Healthy people who want sex with other people to actually be about both people are not going to tend to want a sexual partner who doesn't fully want to be doing what they are with them, or who is only doing so out of feelings of obligation or fear.

I can't know what you want in a romantic or sexual relationship. But I'm willing to bet that you'd probably like those relationships to have a dynamic where you and any partner are only doing things that matter and can have deep impact which you and they really want to do and that you and they feel good about, since that's what most of us want.

By all means, everyone doesn't have the same level of maturity, the same level of really seeing past their own wants, and not everyone is emotionally healthy or really ready for intimacy with other people. Some people we might pair up with may not be respectful and fair if we voice we don't want to do something sexual or physical. What I'd advise in that case is that you do yourself a good turn and only choose partners who don't behave like that. If you feel like those are the only partners available to you, something I've also heard some young women voice, then I'd say your best bet is to wait until you have better choices, because you will. However hungry I may be, if all that's available to me is food that's rotten or poisoned, it'd be better for me to just go without eating, and I'd say the same is true here.

As well, we all get to decide what kind of relationships we want, so if someone really wants a sexual relationship, they may voice that one that isn't what they want and need at a given time. They get to do that, and if and when they do, the answer isn't to make yourself do things you don't want or feel you can handle. Rather, it's to acknowledge your different needs or readiness, part ways amicably, and both seek out relationships that are a better fit for each of you.

Writer and teacher Pema Chodron wrote, about stress and anxiety, that "Everything that occurs is not only usable and workable but it is actually the path itself. We can use everything that happens to us as the means for waking up." What she means by that is that often, pervasive worries like this are valuable cues for us to potentially recognize ways we need to grow or change how we're living our lives we might not have recognized otherwise. Maybe in your case this just is not the right time of life, relationship or overall situation for you to be sexual. Maybe this specific relationship has something in it that isn't quite right, needs to be talked out, or just doesn't suit you. Maybe it's about taking a look at feelings of guilt and either clarifying or adjusting your values so they fit you better, or, if you feel your values now are authentic to you, living in greater alignment with those values. Maybe it's a cue that you're carrying too much stress in your whole life in general, and need to find some ways to manage it better, or a cue that you have an anxiety disorder or phobia you need qualified help to manage.

I'm sorry I can't give you an easy answer here, because I hate for anyone to suffer this way. But I just can't know which of any of the possibilities here is the case for you, or if this is about something I haven't identified here at all. Sometimes getting to the root of fears is really challenging and takes some time and introspection. I'd encourage you to invest time and energy in thinking about all of this, ideally giving yourself that time without doing anything that triggers those fears at the same time. Ask for any help and perspective you need: again, maybe that's asking a counselor, maybe talking to your boyfriend or friends, maybe talking to a parent, doctor, religious leader or community member. You're going to be the expert in finding your best sources of counsel and support. I'd also encourage you to try and consult your own instincts and to put trust in them: they really can tell us an awful lot, and so often, we're taught to give those feelings less weight than they deserve.

I'm going to leave you a few extra links that might help, along with my very best wishes. If you want to talk more about this, you're more than welcome to come over to our message boards, and I'd be glad to talk more with you.

written 27 Aug 2010 . updated 23 Jan 2014

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