The Pregnancy Pact

(2010)

Directed by Rosemary Rodriguez

Written by Pamela Davis and Teena Booth

Starring Thora Birch, Madisen Beaty, David Clayton Rogers, Max Ehrich, James McCaffrey, Camryn Manheim, Nancy Travis

Executive Producers Robert M. Sertner and Frank von Zerneck

Lifetime

Rating:  TV-PG

Nursing rating		Rating guide: excellent = 4 stars; good = 3 stars; fair = 2 stars, poor = 1 star
Artistic rating

Lifetime's The Pregnancy Pact portrays several high school girls who intentionally get pregnant, apparently seduced by fantasies of loving, carefree motherhoods. The movie was "inspired by a true story" and it's a competent made-for-TV issue melodrama, engaging enough if somewhat schematic and bland. Some might also see in the movie a "ripped from the headlines" exploitation of a serious and complex problem, particularly since the film references some events that really happened in Gloucester, Massachusetts, in 2008, but it reportedly invents key story elements. The movie does make a fairly serious effort to explore some basic aspects of teen pregnancy, showing young females who see little future beyond child-rearing. It seems like almost everyone involved here--teens, parents, and community leaders--is lying to someone. The film presents the school nurse as a forceful advocate for better pregnancy prevention, a compassionate professional who takes on the school administration and a "family values" group to try to stem the school's teen pregnancy "epidemic." The nurse might have done some direct counseling of the pregnant students, as a real nurse would. And the character is limited. She never gets at the deeper issues involved in the pregnancies, and she resigns in protest roughly a quarter of the way through the movie, never to reappear. The main force for a more progressive approach to teen pregnancy in the film is actually a relentless young New York video blogger who bonds with the teens and does far more to get to the bottom of the epidemic. Still, the portrayal of the nurse as an articulate professional who is willing to make a big personal sacrifice to advance public health debunks the popular notion that school nurses are just about aspirin and band-aids. And that's especially helpful at a time when U.S. school districts face extraordinary pressure to cut costs.

The Lifetime movie starts with a disclaimer that it's "the story of a fictional 'pregnancy pact' set against actual news reports from June 2008, and although some of the locations and public figures are real, any resemblance to actual persons is purely coincidental." Got that? So basically we're going to present something with obvious similarities to real recent events, and set it in the same real place, with some real characters, but we'll feel free to invent things as we see fit. The disclaimer is followed (and arguably undermined) by a sampling of snippets from real television reports about the 2008 story from Gloucester. But regardless of whether the story is literally true in every respect, viewers will form impressions of those portrayed, including the nurse, based on what they see. In fact, the staff of the real Gloucester high school clinic--a nurse practitioner and a pediatrician--did reportedly resign after their pleas for better birth control measures at the school were rejected. On the other hand, it appears that contrary to the movie plot, there may have been no actual "pact" among the teens to get pregnant. And the crusading blogger character, who drives much of the film plot, does seem a bit far-fetched.

Anyway, the film's depiction of the Gloucester high school is of a place where students walk around with books, couples hang out, and female students push baby strollers down the hall. We see one student in the nurse's office, giggling as the nurse unwraps a pregnancy test. The student's giggly friends wait outside. Nurse Beth--we'll call her that now though she is actually not named till her last scene in the movie--asks the student if she thinks this process is funny. The student says no, seemingly chastened. Beth explains how to do the test. She is serious and professional, but also trying to be comforting. The student emerges from the bathroom and gives Beth the test, sneaking a big smile at her friends outside, but looking crestfallen when Beth informs her that she's not pregnant. The student walks away, and her friends console her. 

Then we see Beth go to two apparent school administrators, who turn out to be the principal, Bachman, and the assistant principal, a former student at the school named Brady. Beth tells them there's something they both need to know. We assume she's going to tell them about an apparent sub-culture at the school in which the girls are actually trying to get pregnant. (The film does not raise the confidentiality issues that would be involved here, but we never see Beth disclose the identities of any of the pregnant students.)

As the story unfolds, the focus is on the experience and eventual interactions of two women. One is 15-year-old Sara Dougan (right), a fairly quiet student who seems to be at the margins of what we might call the school's pregnancy pack but who becomes intensely focused on having a baby with her baseball-playing boyfriend Jesse. The other central character is the progressive New York video blogger Sidney Bloom (below), who learns of the pregnancy epidemic while doing her teen-oriented blog TeenUp.net. Sidney notes that teen pregnancy rates are up all over the U.S. for the first time in years, and then she travels to Gloucester, where she herself attended high school a decade earlier, to figure out what is going on. Neither of these characters actually interacts with nurse Beth, who is on a different track and destined to bow out before things really spin out of control.

None of the pregnant girls we see appears to have consulted the babies' fathers about their intentions to get pregnant, but Sara differs from her friends in one key respect:  She wants to have Jesse's baby because she really loves him, and is interested only in marrying him and raising a family. By contrast, her friends appear interested only in the babies, and their relations with the fathers range from indifference to hostility. What the film suggests the girls do have in common is parenting issues, particularly a lack of good communication, understanding, and information about options. One girl is herself being raised by an overwhelmed single mother who had her as a teenager. Another mother is clearly ineffectual, weakly urging her young son not to share his cigarette with his sister, the expectant mother, as they sit in their living room.

And while Sara has two loving parents who are doing their best, her mother Lorraine is a somewhat clueless ideologue who leads the local "Family Values Council" that is stymieing efforts to introduce modern birth control measures in the school. Lorraine insists not only that abstinence is the only way but also that teen pregnancy should not even be publicly discussed, since it is (as she says over and over) a "private" matter between the young women and their families. At one point, Lorraine suggests to Sara's father that they can trust Jesse because he goes to church. Sara's parents spend a lot of time lecturing and laying out strict rules, but not much time paying attention to what their daughter is actually saying or going through.

As the girls become pregnant and their parents learn of it, we begin to see what the girls' maternal fantasies have not taken into account:  the threats posed to the girls' ability to get higher education or good jobs, the financial burdens that their families may not be able to assume, the hardships associated with having a child, including difficult deliveries and squalling infants, and the risks to the children raised in environments like these.

Nurse Beth does not have a chance to lay much of this out. But she does play an important role in some early scenes that illustrate how the community got into the situation, and she advocates strongly for a way to at least reduce the incidence of teen pregnancy generally. Early on, we see Beth telling one student, in a grave voice, that she is pregnant. "Thank you," the teen squeaks, and departs without another word. Outside, the teen tells her friends that they were right, "this is the most amazing feeling." Later, Beth tells assistant principal Brady about this.

Beth:  Another sophomore had a positive pregnancy test today. And this woman [handing him a newspaper] is saying it's not a school problem.

Brady (looking at the newspaper):  Lorraine Dougan, president of the Family Values Council. Sara's mom, right? Runs the restaurant on Fourth Street?

Beth:  Right, she runs a restaurant, she's not in my clinic every day, she doesn't know the first thing about what we're dealing with here.

Brady:  True, but it's an opinion piece, she's entitled to her--

Beth (seeing the principal Bachman pass by):  Excuse me, Mr. Bachman, can I please have a minute with you--

Bachman:  If this is about your request to the school committee--

Beth:  It is, and I would really like your support before I go into the meeting next week.

Bachman:  I'm sorry, but you know I don't believe in providing contraceptives here at school, it's not our job--

Beth:  Yes, but now the numbers have gone up so dramatically--

Brady:  I agree.  I think that we should at least consider changing our policy--

Bachman:  There are girls trying to get pregnant at this school, which means birth control wouldn't make a bit of difference. This is an issue for families and the school committee, so let's not waste time in a debate.

He and Brady leave. Beth seems stunned that they wouldn't devote any more attention than this to the issue, though she seems to have made progress with Brady at least. Beth has no response to Bachman's last point, and it's actually a pretty good one as far as it goes:  What difference would contraception make to girls who are so determined to get pregnant? Perhaps one answer might be that any responsible program to provide contraceptives would include at least some family planning counseling, and that this would entail providing the teens with some information about why it might make sense to wait to get pregnant. And it's not clear that every pregnancy at the school was intentional; surely contraception could prevent at least some of them.

Sara continues trying to get pregnant with Jesse. Sidney does her blog from Gloucester, "ground zero of a teen pregnancy epidemic." As Jesse, Sara, and their families leave church, Sara's mom Lorraine's friend mentions that the school nurse has gotten the birth control issue on the school committee agenda. Lorraine promises her friend it will never get through on her watch. Later, Sidney tries to see nurse Beth, but learns she is at the meeting of the school committee, which appears to be the school board. Sidney attends this meeting, and what we see of it amounts to a showdown between Beth, who stands at one lectern, and Lorraine, who stands at the other.

Lorraine:  The Family Values Council is adamantly opposed to putting contraceptives in the school. Birth control is a private family matter, it does not belong in a public school.

Beth:  That is clearly untrue. We have day care centers in our schools.

Lorraine:  Yes, yes, that's so that the girls who have babies can stay in school.

Beth:   Right, but basically, we're dealing with teen pregnancy in our public schools after the fact. Why can't we just prevent it before the fact?

Lorraine:  But we are, we are preventing it before the fact with abstinence programs. But you provide birth control, you're all but encouraging these kids to have sex.

Beth (clearly frustrated):  They're gonna have sex anyway! Listen, I am sorry, I have given almost 150 pregnancy tests this year. We have to provide birth control options at our school because our kids are having sex.

Lorraine:  Yes, yes, some are. And some drink alcohol and some do drugs. But does that mean we should hand out beer on Friday nights or hand out pot? You can't possibly teach the importance of waiting for sex if you're handing out condoms at the same time, you undermine the whole abstinence message.

Beth:  Right, so while you and I are arguing about the message, our girls are getting pregnant at an epidemic rate--

Lorraine:  Excuse me, it is hardly an epidemic.

Beth:  Really? Because 18 girls are pregnant. You don't think that's an epidemic?

Lorraine:  The number reported to me was 10.

Beth:  Yes, that's right, it was 10 two months ago--it's 18 now.

Lorraine:  Well then, it is even more important to provide higher standards for our kids, and stick with those standards no matter what. If you give birth control, you might as well say to these kids, we give up on you. Go and do what you're gonna do. We cannot give up on our kids like that.

Throughout this exchange, Beth is somewhat agitated, maybe even disgusted at the arguments she hears, but she remains in control, an advocate fighting a tide of tradition that seems to be too strong. Most viewers will understand what the film means by "family values":  an obsession with moral strictures like pre-marital abstinence even at the expense of science-based health practice and efforts to address the real needs of a diverse modern community. Beth definitely holds her own here, though we might have wished for some better arguments from her. For instance, Lorraine's drug analogy doesn't quite work because handing out condoms is not the same as actually providing the students with sex or making them pregnant; at worst it might be analogous to giving them something to blunt a drug's side effects. And Beth does not cite the research about the effectiveness of "abstinence only" pregnancy prevention programs.

In any case, the exchange seems to inspire Sidney to file an outraged video blog report, asking why this problem isn't a bigger deal, and lamenting bitterly that "it's just another day in Gloucester, where being a young teenage mother is practically a rite of passage." For her part, nurse Beth has had enough. We see her in Brady's office, having apparently tendered her resignation letter.

Nurse:  I'm resigning, in protest.

Brady:  Why not stay and fight?

Nurse:  Because no one will back me up. And you haven't been much help either.

Brady:  I'm trying to keep the lines of communication open here, because I know how important this is. Please, Beth, try to be a little more flexible.

Beth:  Brady, when you have to give pregnancy tests to children, I'll talk to you about flexibility. [She gets up, and her voice seems to break a little.] Until then, just take my damn letter.

She leaves, and that's the last we see of her, though there is one last mention of her later, when Sidney is told that Bachman can't see her because he is doing "crisis management" following Beth's resignation. That at least suggests that the school nurse's role is important enough that her sudden absence is a crisis. But Beth's last scene could have been more convincing, and despite the distress that the talented actress Camryn Manheim conveys, the pedestrian dialogue diminishes the power of the nurse's exit.

Still, on the whole nurse Beth is a strong, committed advocate. She plays a key role in setting in motion events that will allow at least some of the characters (and the film's viewers) to see teen pregnancy in new ways. She may not be the main catalyst in the movie, but she is certainly one. In addition, her approach is a preventative one that focuses more on conditions on the ground than dogma or abstract principles--that is, it is evidence-based--and this is a fair representative of nursing tradition. Some might wish that Beth had stayed and fought, as Brady suggested, but no one could mistake her for a meek assistant or an unskilled angel.

It's true that the Beth character might have had more dimension, to help viewers get a better sense of Beth as a person and as a nurse. Beth is in a constant state of low- to mid-level agitation, and she only manages a couple fleeting moments of compassion and sadness. She has very little meaningful interaction with the students themselves, which would be a major focus of a real school nurse's work, and she does not get to display much clinical skill beyond her familiarity with pregnancy tests. The movie never says whether she is a nurse practitioner.

Unfortunately, even in fictional media that makes an effort to give nurses credit for the key roles they play in helping those in need, there is often a character the media work values more highly who plays the really important role. Of course this is usually a physician, but it does not have to be. For example, a 2004 episode of Law and Order: SVU actually showed a sexual assault forensic examiner nurse caring for a rape victim, but unlike in real life, one of the show's main detective characters appeared to be directing the nurse's work and doing all the really important things--actually providing the physical care, emotional care, and forensic work herself.

In The Pregnancy Pact, blogger Sidney has no direct interactions with nurse Beth, but it is Sidney who really works to bond with the pregnant teens and to help the community reach some deeper understanding of the issues involved. She seems to have the more holistic approach. And this division is also reflected in some of Beth's dialogue. She keeps pushing for contraceptives, but never really gets at the core issue of why these teens want to have the babies. And she could have better responses to some of the objections from principal Bachman and Lorraine Dougan.

Perhaps we should be glad that the film did not have a physician character calling all the shots and doing the real advocacy.  It's actually somewhat shocking that the creators chose to collapse the real clinic staff into one nurse rather than one physician when it appears a physician really was involved in the real events in question. (Perhaps this dramatic decision seems unfair to physicians, but that profession seems fairly safe from the perils of media undervaluation.)

Of course, Sidney is closer in age to the teens, and we learn that she also shares some relevant personal history with them, so it's understandable that she would play a more pivotal role in the overall drama. And because nurse Beth is courageous, articulate, and committed, viewers will probably not view her as the kind of timid helper who appeared in the SVU episode.

Despite the film's missed opportunities, overall nurse Beth comes off as a health professional who is willing to go against the grain of her community's accepted practice to try to protect some of its more vulnerable members. That has been a key role of real nurses from the inception of the modern profession, but it's safe to say that it has not been a common role of nurse characters in the last few decades of television or film. You might say that in most programming with nurse characters, any resemblance to real nurses has been purely coincidental.

In this respect, at least, The Pregnancy Pact is more real than most.

Please send your thoughts on the film to:

Frank von Zerneck and Robert M. Sertner
Executive Producers, Pregnancy Pact
Von Zerneck Sertner Films
13425 Ventura Blvd
Ste 301
Sherman Oaks, CA 91423

Rosemary Rodriguez
Director, Pregnancy Pact
c/o Talent agent Lisa Strelchuk
360 North Crescent Drive
North Building
Beverly Hills, CA 90210

Teena Booth
Writer, Pregnancy Pact
c/o Talent agent Sam Gores
360 N Crescent Dr
North Bldg
Beverly Hills, CA 90210

Thank you! And please send us a copy of your letters to letters@truthaboutnursing.org.

Reviewed by Harry Jacobs Summers
Nursing Editor: Sandy Summers, MSN, MPH, RN
Reviewed August 23, 2010

The views expressed herein do not necessarily reflect those of the Board Members or Advisory Panel of The Truth About Nursing.

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