(Continued from Tuesday)

When our teen patient showed up for her counseling appointment the day after we cancelled her abortion procedure (after a battle of wills between her mother and I over her attempt to force her daughter into the appointment to terminate her pregnancy), I wondered why she had returned. I had left our previous session feeling like a total amateur (which I was) and bully. Nevertheless, she was coming back in, and I resolved to listen and respond to her needs, rather than my own this time.

“I don’t know what to do next,” she told me upon her arrival. “I mean, I know I’m going to have a baby, but, like, what do I do?” We both knew she meant that she hadn’t secured the support of her mother around her decision to become a teen parent, and that she needed resources. Naturally, the first resource that came to mind was having a medically accurate, clinical discussion of sex and birth control methods. Unlike some of our teen patients, she had a correct understanding of sex–the definition and mechanics. Like most of our patients, regardless of age, she didn’t understand how she became pregnant using the withdrawal method, after receiving basic sex education at school, but never discussing the subject in detail with her parents. I began my explanation of pre-ejaculate, survey of available birth control methods and assessment of which would work best for her in the future, given her lifestyle and needs (as she described them). She had been having sex with her boyfriend, another young teen, for a period of several months and this was her first time being pregnant. She needed adult support and guidance desperately, and I racked my brain to figure out how to help her on that front, given her mother’s disregard and stubbornness. “Do you have a relationship with your father?” I asked, clutching at straws.

“Yes, but I haven’t told him yet. He and my mom aren’t together, but we spend a lot of time with each other,” she replied. “Is there a chance he could join us this afternoon, so we could talk to him about supporting you?” I asked. Her eyes widened, filling with tears. “He’ll be so disappointed…I just don’t know what he’ll say!” I certainly didn’t want a replay of yesterday’s disaster, when I managed to drive a wedge between the patient and her mother, yet the options were few. I decided to explore the idea further. “Would you feel comfortable having him here for our session? We could tell him together and ask for his support,” I offered. “He loves me a lot, and he doesn’t treat me like my mom does, so yes. Let me call him and see.” She made the call, and it was clear from the way she spoke to him that they enjoyed a closer relationship than what she had with her mother. His willingness to leave work immediately to join us seemed another indicator that this conversation would be different than yesterday’s.

We waited. I asked her to tell me what she most looked forward to about parenting, and her face lit up. She talked animatedly about love, taking care of a baby and making sure its needs were met, about baby clothes, about her boyfriend being a dad. It was abundantly clear this young lady was making the right choice for herself, her passion for motherhood and love for her future child plain. Without a doubt, she wanted to parent, despite the extreme difficulty teen motherhood could entail.

Her father arrived within a half hour, breathless, brow creased with worry. Father and daughter burst into tears as soon as they made eye contact, and our patient told him, shakily, though sobs that she was pregnant. Our patient’s father put his head in his hands, shoulders heaving. Hoping to connect the two, I asked our patient’s father to tell us about his reaction. He looked up, drying his eyes, drawing a breath. “Her mother and I became pregnant with her when we were her exact age. It was the hardest thing I’ve ever gone through, and I never wanted this for her,” he explained. I felt a flash of righteous indignation, wondering why, then, he never spoke openly with her about the risks and consequences of unprotected sex. Remembering my resolve not to bring my own biases into the session, I backed off from viewing him as an irresponsible parent, understanding my role was to seek adult support for our patient’s decision. It was too late, and entirely inappropriate to take this man to task for failing to protect his daughter from the exact mistakes he had made at her age. I glanced from father to daughter, sensing a divide, yet a deep affection between them, potentially accessed and used as a bridge.

“Is it possible,” I asked our patient’s father, “that because you went through teen parenthood yourself, that you’re in a unique position to support and help her through it, make it that much easier than you had it?” He looked at his daughter, who had shrunken into herself, clearly fearing rejection. He took her into his arms, tears streaming down his cheeks. “Yes,” he said. “I know all about it and I know I can help her get through it.” Our patient sagged against him with relief, and I found myself choked up in the beauty of the moment, witnessing a father’s resolve to make a better life for his child, an understanding that he had experience to share, the ability to effect a positive outcome. It was a marvelous moment, and I gave them time to revel in their connection, excusing myself to gather literature on low-cost prenatal care, birth control methods and other community resources for pregnant teens.

They left our clinic, our patient smiling and chatting excitedly with her father about parenting, his arm around her shoulders. I wished them the best of luck, allowing myself a moment of optimism, and relief I hadn’t repeated yesterday’s battle with our patient’s mother. I was deeply touched, and believed in that moment that father and daughter working together could overcome any obstacle. If we can’t get it together for prevention, may we at minimum have strong support and love during remediation.