Q&A: Columbus pediatrician discusses impact of pregnancy on someone as young as 10

Dr. Catherine Romanos, with the Women's Med Center in Kettering, near Dayton, performs a sonogram on a woman from Kentucky on June 30. When Roe v. Wade was overturned by the U.S. Supreme Court, Kentucky shut down all abortions because of trigger laws.
Dr. Catherine Romanos, with the Women's Med Center in Kettering, near Dayton, performs a sonogram on a woman from Kentucky on June 30. When Roe v. Wade was overturned by the U.S. Supreme Court, Kentucky shut down all abortions because of trigger laws.

Days after the U.S. Supreme Court overturned Roe v. Wade, many people didn't want to believe reporting from the Indianapolis Star indicating that a 10-year-old girl from Ohio was forced to cross state lines for a legal abortion.

Some prominent Republicans, including Ohio Attorney General Dave Yost, publicly cast down on the article's veracity.

But in late July, The Dispatch confirmed it to be true.

The girl did become pregnant after she was raped. And because of an Ohio law implemented on June 24 barring abortion procedures after fetal cardiac activity is detected, she was forced to travel to Indiana to terminate the pregnancy.

What we know: 10-year-old Ohio girl sought abortion in Indiana

The news rippled across the country and has remained at the forefront of the national conversation as the man accused of raping the girl, 27-year-old Gerson Fuentes, was arrested and indicted with two counts of child rape.

Latest on case: Gerson Fuentes, accused of raping 10-year-old girl who got abortion, held without bond

The heartbreaking situation drew ire and raised questions. How could someone so young even become pregnant? How would she find out? And what physical toll would a pregnancy take on an adolescent?

Dr. Elise Berlan, a Columbus pediatrician and a professor in the Department of Pediatrics at the Ohio State University College of Medicine, spoke to The Dispatch about those questions and more.

On the day the Supreme Court issued its ruling on Roe v. Wade, Berlan also co-authored two policy statements on behalf of the American Academy of Pediatrics regarding options counseling for pregnant adolescents and adolescents’ rights to confidential care when considering an abortion.

Dr. Elise Berlan
Dr. Elise Berlan

Q. Is there evidence suggesting that young girls are going through puberty at a younger age?

A. What we have found in the research is puberty has advanced a small amount over the last several decades. The major change, though, has been more at the timing of puberty and not as much on the age of the first menstruation.

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Q. By "small," it seems you're suggesting any increase is almost insignificant? 

A. It's something that’s received a lot of attention. People are concerned of the timing of puberty because it’s so impactful on a young person's life, and people are often concerned about what could be the reasons behind it. 

Q. Has research indicated what might be behind even a small advance in how early girls are reaching puberty?

A. The primary determinant of puberty is actually genetics, and we understand that to be not changed in the last several decades, but the overall young person’s health status and their social environment can impact the timing of puberty. Young people's overall health as well as their social environments have changed in the last several decades.

Q. How so?

A. The research is still in process on this but some of the health impacts on the timing of puberty include being overweight and we’ve definitely seen changes in the proportions of young people who are overweight or obese, and that tends to push puberty earlier. We've also seen changes in the stress young people are dealing with.

For subscribers: 10-year-old who sought abortion was rare case. Fewer minors in Ohio are getting procedure

Q. Is it surprising to you to hear that a 10-year-old girl could become pregnant?

A. Not at all. Girls start with puberty as early as age 8, so it’s normal to start puberty anywhere between age 8 and 12. The idea that a young girl could be pregnant at age 10 is not itself a surprise because really, any person who is menstruating can become pregnant. The circumstances are tragic and alarming, but the biology of it is not unusual.

Q. How does pregnancy affect someone so young?

A. They are certainly at higher risk for adverse health outcomes. Young people who are pregnant may not be aware of it in the same way adult women may be aware of a pregnancy. Young people tend to have more irregular periods than adults and a young person who is pregnant may not be familiar with the signs and symptoms of pregnancy and may be delayed in seeking medical care.

Abortion in Ohio: Do 10-year-olds meet 'life of mother' abortion exemptions? Ohio lawmakers, doctors divided

Q. So considering that, how would someone so young, or the child's parents, learn about a pregnancy?

A. Typically, pregnancy presents with a missed period. As pediatricians, we understand that periods are a vital sign and an indicator of the underlying health status of the girl. A person who has a missed period or irregular periods really should have an evaluation from their health provider. That’s really the best way to be aware of a pregnancy: to be familiar with the normal menstrual pattern and if there’s a deviation.

Eric Lagatta is a reporter at the Columbus Dispatch covering social justice issues and nonprofits. Reach him at elagatta@dispatch.com. Follow him on Twitter

@EricLagatta

This article originally appeared on The Columbus Dispatch: Columbus pediatrician talks child pregnancy after 10-yr-old's abortion