Messages from mothers calling on behalf of their teen daughters are commonplace in my work day. Mother’s phone to report problems their daughters’ are having like irregular bleeding, nausea in pregnancy, and vaginal irritations. Many are women I know as I was their midwife years ago when I delivered their daughters who are now my patients. This is sweet for me and brings my midwifery practice full-circle in a community I have been devoted to for over 20 years. But, regardless of history and the eternal bonds women forge through their childbearing experiences, having a conversation about someone’s symptoms and health via proxy is only reasonable if the patient is developmentally delayed or in a coma. When the patient is awake, sentient, and available after third period English I neither encourage nor recommend it. Further, pre-existing acquaintance with the midwife doesn’t give mothers a free pass on calling.
When I was a teenager, the last thing I would have wanted was my mother joining me in a discussion about birth control and sex – with anyone! Nor would I have agreed to her calling my GYN practitioner with a related question. Teens in my generation created as much distance between themselves and their parents where sex was concerned. And mothers helped by claiming their daughters were virginal until being proven otherwise when birth control packs accidentally fell out of their purses. This approach had its drawbacks and share of bad outcomes. But the pendulum has swung too far over to the other side now. Today’s mothers believe it is necessary and normal to stay involved in every aspect of decision making when it comes to their daughter’s sexual health. From my vantage point this is a serious mistake.
When a teen comes to see me for care – with or without her mother – I make it clear that she is my patient and my loyalty is to her first and foremost. I am her unyielding confidante and resource person, willing and capable of helping her safely explore her sexuality. I do not feel that the majority of sexually active teen girls I see are promiscuous or lack the capacity to make sound and informed choices. In fact, most girls understand and will follow my advice when given a chance to think it through. When mothers are in the exam room (instead of the waiting room), girls abdicate their power, won’t speak honestly with me, and become unmoored in their thinking. When mothers are so actively involved, I can’t help but wonder under what auspices – parent, friend, or envious (and sometimes) seething middle-age interloper?
When a teenager is sexually active her mother’s support and watchfulness is most helpful when maintained from a distance. Should a daughter tell her mother: I am having problems with my birth control then all that’s necessary is a suggestion: Sounds like you should give Evelyn a call. Expecting a daughter to call on her own behalf helps her practice self-advocacy skills, fosters a relationship with a health care provider, and conveys a mother’s confidence in her daughter’s abilities to make good decisions with advice from a reliable adviser. Last I knew this was what growing up was all about.
Sexuality has inherent risks for people of all ages – broken hearts, embarrassments, and method failures. This goes with the territory. At the risk of sounding glib, mothers should stay out of their daughter’s sex lives and foster their maturation by referring them back to their skilled health care provider. Keep the boundaries well-defined and suggest she put my office number on speed-dial.