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This happens at least once per month, the last time just three weeks ago. A teenager comes into the Emergency Department complaining of abdominal pain, vomiting in the morning for a week or two; and by the way, has not had a period for three months. When her pregnancy test comes back positive, her denial is profound. "No way, its impossible that I'm pregnant!" she cries. In fact, sometimes the teenager seems so convinced that she can't be pregnant that I begin to wonder if the test was wrong. Then after further questioning, her denial begins to fall apart. "I didn't have sex" becomes "I didn't have sex in the past four months." That is followed by "I didn't have sex in the bad part of my cycle." Did you use birth control? "Yes!" How many times? "Once." Aha. Teenagers who get pregnant sometimes mean to get pregnant. Many times though, they get pregnant because they had wrong ideas about pregnancy prevention. Not only do teens have wrong beliefs about how pregnancy happens, they often have almost magical thinking about how they cannot get pregnant. Here are some of the wrong beliefs teens have about getting pregnant (remember, the following are ALL WRONG!): You can only get pregnant at certain times of the month. You can't get pregnant the first time you have sex. Drinking Mt Dew, sipping a little clorox, or doing jumping jacks after sex can prevent pregnancy. Furthermore, some teens get even more odd, almost magical, beliefs about their invulnerability to pregnancy. For example, they come to believe that they or their partner are sterile. How they get to this idea is strange, since sterility is a diagnosis that is pretty much made after seeing a fertility specialist and a battery of tests. What teenage male of female has undergone that? Or sometimes, a teenager just plain denies that she can get pregnant. Oh no, not me. However, the truth is this: if you have sex once, at any time, you can get pregnant. Period. End of Sentence. No Buts. Birth control or not. If you don't want your teen to get pregnant, and you want to get around the odd beliefs, start talking to her (and him!) before they are teens and are prone to magical thinking. Talk to them when they are in elementary school and junior high. Make sure they know that sex = risk of pregnancy, and only abstinence or birth control can prevent it. And birth control is not perfect. After all, birth control requires forethought and can be a little tricky to get right, like driving a car. How good is your teen at driving a car? Finally, I have one more thing to say. Any time you have sex, you can get pregnant. Got it?