Teen Librarian Toolbox
Inside Teen Librarian Toolbox

Take 5: 5 New Titles Coming from Simon & Schuster

Of Metal and Wishes by Sarah Fine

Publisher’s Description:There are whispers of a ghost in the slaughterhouse where sixteen-year-old Wen assists her father in his medical clinic—a ghost who grants wishes to those who need them most. When one of the Noor, men hired as cheap factory labor, humiliates Wen, she makes an impulsive wish of her own, and the Ghost grants it. Brutally.

Guilt-ridden, Wen befriends the Noor, including their outspoken leader, a young man named Melik. At the same time, she is lured by the mystery of the Ghost and learns he has been watching her … for a very long time.

As deadly accidents fuel tensions within the factory, Wen must confront her growing feelings for Melik, who is enraged at the sadistic factory bosses and the prejudice faced by his people at the hand of Wen’s, and her need to appease the Ghost, who is determined to protect her against any threat—real or imagined. She must decide whom she can trust, because as her heart is torn, the factory is exploding around her … and she might go down with it.”

Note: Historical fiction, ghosts,and a good book to add to help us all meet our active goal of trying to make sure our collections and TBR piles have more diversity.

Publishes by McElderry Books on August 5, 2014. ISBN: 9781442483583

Rumble by Ellen Hopkins

Publisher’s Description: “Eighteen-year-old Matthew Turner doesn’t believe in much. Not in family—his is a shambles, after his brother’s suicide. Not in so-called friends who turn their backs when the going gets rough. Certainly not in some omnipotent master of heaven and earth, no matter what his girlfriend, Hayden, thinks. In fact, he’s sick of arguing with her about faith. Matt is a devout atheist, unafraid of some Judgment Day designed by decidedly human power brokers to keep the masses in check. He works hard, plays hard, and plans on checking out the same way. But a horrific accident—one of his own making—plunges Matt into a dark, silent place where the only thing he can hear is a rumble, and eventually, a voice. And what it says will call everything Matt has ever disbelieved into question.”

Note: I recently mentioned that one of the authors I hear YA librarians they have to replace a lot is Ellen Hopkins. She writes very gritty, realistic novels – in poetry. This latest title deals with a teenage boy who proclaims atheism as his belief system. The topic of atheism has been getting more coverage in the press, so this is a timely novel. And no doubt for many it will be controversial. In other words, awesome and classic Hopkins.

Publishes on August 26, 2014 from Simon & Schuster. ISBN: 9781442482845

In Deep by Terra Elan McVoy

Publisher’s Description: “Ultracompetitive Brynn from The Summer of Firsts and Lasts craves swimming victory—and gets in over her head—in this irresistible novel from Terra Elan McVoy.


Nothing else matters to Brynn as she trains her body and mind to win. Not her mediocre grades and lack of real friends at school. Not the gnawing grief over her fallen hero father. Not the strained relationship with her absent mother and clueless stepdad. In the turquoise water, swimming is an escape and her ticket to somewhere—anywhere—else. And nothing will get in her way of claiming victory.

But when the competitive streak follows Brynn out of the pool in a wickedly seductive cat-and-mouse game between herself, her wild best friend, and a hot new college swimmer, Brynn’s single-mindedness gets her in over her head, with much more than a trophy to lose.”

Note: I was at a S&S event last year at ALA annual where I watched teens vote between two covers for this title. This is the cover that won.

Publishes July 8, 2014 from Simon Pulse. ISBN: 9781481401364

Trouble by Non Pratt

Publisher’s Description:In this dazzling debut novel, a pregnant teen learns the meaning of friendship—from the boy who pretends to be her baby’s father.

When the entire high school finds out that Hannah Shepard is pregnant via her ex-best friend, she has a full-on meltdown in her backyard. The one witness (besides the rest of the world): Aaron Tyler, a transfer student and the only boy who doesn’t seem to want to get into Hannah’s pants. Confused and scared, Hannah needs someone to be on her side. Wishing to make up for his own past mistakes, Aaron does the unthinkable and offers to pretend to be the father of Hannah’s unborn baby. Even more unbelievable, Hannah hears herself saying “yes.”

Told in alternating perspectives between Hannah and Aaron, Trouble is the story of two teenagers helping each other to move forward in the wake of tragedy and devastating choices. As you read about their year of loss, regret, and hope, you’ll remember your first, real best friend—and how they were like a first love.”

Note: Received a starred review in Publisher’s Weekly 5/01/2014

Publishes June 10, 2014 from Simon & Schuster Books for Young Readers. ISBN: 9781442497726

The Actual & Truthful Adventures of Becky Thatcher by Jessica Lawson

Publisher’s Description: “In 1860, eleven-year-old Becky Thatcher is the new girl in town, determined to have adventures like she promised her brother Jon before he died. With her Mama frozen in grief and her Daddy busy as town judge, Becky spends much of her time on her own, getting into mischief. Before long, she joins the boys at school in a bet to steal from the Widow Douglas, and Becky convinces her new best friend, Amy Lawrence, to join her.

Becky decides that she and Amy need a bag of dirt from a bad man’s grave as protection for entering the Widow’s house, so they sneak out to the cemetery at midnight, where they witness the thieving Pritchard brothers digging up a coffin. Determined to keep her family safe (and to avoid getting in trouble), Becky makes Amy promise not to tell anyone what they saw.

When their silence inadvertently results in the Widow Douglas being accused of the graverobbery, Becky concocts a plan to clear the Widow’s name. If she pulls it off, she might just get her Mama to notice her again and fulfill her promise to Jon in a most unexpected way . . . if that tattle-tale Tom Sawyer will quit following her around.”

Note: Received a starred review in Publisher’s Weekly 5/05/2014, for Middle Grade readers ages 8 to 12.

Publishes July 22, 2014 from Simon & Schuster Books for Young Readers. ISBN: 9781481401500

Why I Teach Salvage the Bones by Jesmyn Ward in My High School, a guest post by author Brendan Kiely

During our recent #SVYALit Project Hangout, author Brendan Kiely (The Gospel of Winter) mentioned that he taught the book Salvage the Bones by Jesmyn Ward in his classroom. Today he is talking with us about teaching this book in his classroom, sharing the who, what, why and how his teens respond.

Jesmyn Ward’s Salvage the Bones is the story of Esch, a 15-year-old girl who has recently discovered that she is pregnant, and her family’s struggle to survive Hurricane Katrina as it hits the Mississippi Gulf Coast.  The novel takes place over the twelve days leading up to, during, and just after Katrina.  It is a shocking, heart wrenching, beautifully told story, and I use it in my 10thgrade English class because it is an expertly crafted novel that provides myriad possibilities of literary analysis and, even more importantly, inspires complicated discussions about important contemporary social issues that teenagers find meaningful, engaging, and personally relevant.

Esch’s family lives on the impoverished outskirts of the fictional town of Bois Sauvage, and although they know Katrina is on the way, they don’t have the means to leave and they have nowhere else to go.  Like most good stories, the characters are stuck in a seemingly impossible situation and have to find a way to look that danger in the eye, if not survive it.  For Esch’s family, while they scramble for food and try to prepare their home for the imminent disaster, it is the fierceness of their loyalty to each other that braces them for the storm.

The family is motherless, and so in the twelve days of the novel, Esch must also come to terms with the realities of becoming a mother on her own, in a life surrounded by boys and men. 

The novel is gripping, sometimes terrifying, and ultimately transcendent because lurking just below the surface of the gritty realism and gorgeous prose is the pulsing and haunting influence of the myth of Medea.

During our year together, I want to help students better understand how to read actively and write analytically, and I structure the practice of these skills with texts I think my students will find challenging and will also enjoy and which force us to confront, in a safe community of open-minded learners, conversations that examine contemporary social issues and conflicts. 

The teens I teach love Salvage the Bones because they connect with the way Esch articulates her emotional state—her complicated and very real conflicting desires—and they also love it because Esch and her family’s struggle becomes a springboard for conversations about difficult issues my students are eager to discuss, debate and learn more about because they find them immediately relevant to their own lives: teen pregnancy, consent in sexual relationships, the pressure of sex as a form of social acceptance, single parent homes, poverty, racism, dog fighting; and likewise more triumphant themes, too, such as family bonds, love, ingenuity, loyalty, and the influence of mythic stories and archetypes in our contemporary life.


I use Salvage the Bones to teach more about the broader, sociological discussion of income disparity in the United States and the powerful effects of systemic inequality in the lives of individual families.  Sometimes having conversations like these can all too quickly reduce real people to abstract statistics, and this is why I like to use a novel like Salvage the Bones to ground these conversations.  Ward’s characters are complex and fully human, and our conversations in class have to recognize their full humanity—their humor, love, strength, and fallibility—and they serve to remind us that the facts and figures we study in the broader conversations also reflect the lived experience of real people in our society. 

Because our school is also a highly privileged institution in New York City, we begin our study of the gulf coast, Katrina, and the novel with a critical examination of what it means to be an outsider looking into another community.  And before we get to the novel, we study Hurricane Katrina through news stories, personal essays, and the excellent movie, Trouble the Water.  None of my students experienced Hurricane Katrina—we all experienced Hurricane Sandy, however, and we use that personal experience to discuss to what degree we can sympathize or empathize with the characters in the novel—and the real people in communities affected by Katrina.

As Ron Charles remarked in his review of the book in the Washington Post, “Salvage the Bones has the aura of a classic about it.”  It does.  It has the scope and vision of “the great American novel” as it provides a rich foundation with which to discuss the important and complex socio-political issues of our day, and the important and complex emotional-psychological issues that teens face as they try to understand their place in the world and who they want to become tomorrow.  This is why I read, teach and write literature—I want to create a safe space in which young people and adults can discuss difficult questions.  Isn’t that why we turn to fiction in the first place?  It provides us an opportunity to look beyond ourselves, to engage in meaningful conversations about questions that are the hardest to discuss, but also the most important.

About Brendan Kiely:

Brendan Kiely is the author of the recently published novel, The Gospel of Winter. TGoW is “a fearless debut novel about the restorative power of truth and love after the trauma of abuse.” (Goodreads Page).  He teaches literature and writing at an independent high school in New York City. 

The Gospel of Winter has received starred reviews from Booklist, Kirkus, and Publisher’s Weekly – and me.  Publishes January 21, 2014 from Margaret K. McElderry Books.  ISBN:  9781442484894. 


Teen Issues: Teen Pregnancy and Complications

The teen girl trudged through the mall like a zombie; obviously pregnant and with a strange backpack on her back with a tube going into her body.  She barely walked a few steps before she had to find a bench and sit down, tired and out of breath.  Never before must a small mall have seen so huge and overwhelming.  While her teen friends went off and explored things like Hot Topic (which studded collar should I buy today?) and the food court, the pregnant teen wanted nothing more than a moment – just one moment – to remember what it was like to be healthy and have a future.  I understood everything she was feeling and walked up to give her a look of encouragement and let her know that I cared because you see, like her, I too suffered from Hyperemesis Gravidarum and I knew what this teenager was going through.

Hyperemesis Gravidarum is a rare pregnancy complication that causes excessive nausea and vomiting and is characterized by severe weight loss, dehydration and malnutrition – and all the health effects that can come from that.  I have been pregnant with HG three times and I have 2 living daughters to show for it.  The medical backpack that the young teen was wearing contained TPN, her source of nutrition, that was being fed to her via a PICC line.  HG is not morning sickness – it is debilitating and life threatening.  It is believed that the author Charlotte Bronte died of HG in her 5th month of pregnancy.  This was never the way I thought I would identify with one of my favorite authors and yet, here we both were suffering from HG.  The only difference is that I survived, but just barely.

It was my second pregnancy when we found out that what was happening had a name.  At 7 weeks pregnant I was lying on my bathroom floor and vomiting more than 50 times a day.  I lost 30 pounds in less than a week and began to have heart complications.  My body was shutting down from metabolic acidosis.  We lost our baby and we almost lost me.  I stood at the edge of a cliff and stared death in the face and knew that just one more vomit would send me plummeting to the depths of death.  As for hell, well – I was already there.  I had to take heart medicine for the next 9 months while my body tried to repair itself from the damage caused by only 10 weeks of pregnancy.

In some ways that was my worst pregnancy; I don’t know if the 3rd was worse or just better treated.  From the get go I received home IV therapy; The Mr. would set his alarm for 3 a.m. so that he would wake up and change my IV bag as this was the only thing keeping me and the baby alive.  At 19 weeks they told us that my placenta had completely separated from the force of the vomiting and she would not make it through the weekend.  They were wrong; but it was literally hell getting her here.

This year for the first time ever there is going to be an International Hyperemsis Gravidarum Awareness Day (May 15th).  This year we are joining forces to raise awareness so that all pregnant women – including teens – can get support.  Our goal is that people everywhere will recognize the symptoms and get adequate medical care. If information is power – and as a librarian I believe it is – then helping teens get the information about possible pregnancy complications is my goal.  Being a pregnant teenager is hard enough, being a pregnant teen with any type of pregnancy complication must be earth shattering.  It is fun to read about and speculate about zombies, it is not fun to feel like one.

If I could ever write a teen novel (it is a dream of mine), I would write a contemporary novel about a teen with HG.  Sometimes I write it in my head and it begins like this . . .

She stared into the bowl of her toilet once again, willing herself not to throw up.  Her body shook but not with fever; the coldness tore through her frame more and more each day as she shed pounds vomit by vomit into the porcelain god.  She said a silent prayers to please, please let this be the end of it.  They said she was going to have a baby, but she knew the truth.  Something must have gone terribly wrong and there was an alien parasite living in her body, taking over and kicking her out.  She knew it wasn’t true of course; but it was hard to think that a miracle was occurring inside her when she was fairly certain she would die if they didn’t help her soon.  This is definitely not what it looked like on 16 and Pregnant  – and she was angry.  The anger burned white hot inside her soul because if it wasn’t bad enough that she was pregnant; no, everything had to go wrong.  She couldn’t even worry about what type of mother she would be or how she would balance finishing high school and changing diapers – she was too busy worrying whether or not she would even survive.  For just a moment she laid her head on the cold bathroom floor.  There was no use in going to another room, she would be back here soon enough and the movement would just make her start vomiting again.  Again she prayed: please please please please please let this stop.  As she thought the last please her head jerked back up and she once again found herself on her knees staring into the once clear water of the toilet while violent retching racked her body.  Today, she thought, is the day I am going to die.

For more information on Hyperemesis Gravidarum, visit the HER Foundation at www.helpher.org.  You can also purchase the book Beyond Morning Sickness by Ashli McCall for your library collections.  Please read this previous guest blog post about how HG led this woman to terminate a pregnancy in her teen years.  Remember that for every teen that gets pregnant, a small percentage of them will have complications or experience some type of pregnancy loss and they will need a different type of resource then we are used to giving teens about pregnancy.  In most of these cases, you will need to refer to your adult nonfiction collections because there aren’t specific titles written for teens.  Please join us on May 15th, 2012 in helping to raise awareness to patrons of all ages because HG doesn’t just affect women, it affects families.

Teen Issues: Having a Child with a Chronic Health Issue

In the February 2012 edition of VOYA, I write an article about food allergies and teens. In it I share that my passion for this topic began because I am the mother of a toddler with severe food allergies that cause her chronic health issues.  One of her symptoms is chronic, silent reflux.  Silent reflux is GERD disease, she basically has heartburn so severe that she can’t sleep through the night.  Sometimes she can’t even run down the street.  There is another side to this for me when I think of teens: it’s not just about teens that have food allergies, but what about teen parents who suddenly find themselves parents to a baby, infant or toddler who has some type of severe or chronic health issue.  Not just a food issue, but any health issue.

A couple of times a week there is a teen mom, 14 years old, who brings her 5 week old baby into my library.  She has a lot of support from her family and is a very lovely young lady.  Her baby is always asleep on one of our library chairs and is just adorable.  I can’t help but wonder what it would be like for her or any teen parent out there trying to balance school, being a teen, and not only being a mom – but being a teen mom to a child with some type of health issue.  One time when taking my child to Children’s Hospital I did run into a teen who was the mom of a child with Downs Syndrome and they were there having his heart checked.  Suddenly, their need  for information expands outside of typical teen parameters.  They need to know how to research and find not only important information, but how to advocate for their child.  Now they don’t need you to help them find what the next vampire book they want to read might be, they need you to help them find safe foods, treatment options, etc.  They are thrust into a very overwhelming adult world.

If you have never been the parent to a child with any type of special needs, it can be difficult to understand how isolating and stressful and heartbreaking it can be.  Every component of parenthood is taken to the next extreme: there is more planning, more preparation, and always, it seems, just more.  I would also be interested in reading more about teen parents who find themselves the parent of a child on the Autism spectrum.

It is important to remember sometimes that we do and will serve teens with experiences outside of the norm, including teen parents (though these may be more inside the norm then we would wish for our teens.)  Below I share with you an essay I wrote while in the throes of my child’s illness and trying to get a diagnosis and a handle on it.  I hope by sharing that we will all take a moment to think about our teen parents that we serve and reflect upon the fact that for some of them, their challenge is harder then we can imagine because right now their babies are being diagnosed with something that no parent is prepared to handle, let alone a teen parent.

It was only because I spent a TON of time at my library researching, researching, and researching some more that we were able to bring our child to the point that she is at now.  We researched treatments, which included sleeping positions and diet restrictions; we researched doctors; we found online support communities; and most importantly, we found the right questions to ask.  Teen parents won’t have these skills and will need your help to develop them.

A couple of things to remind teens:

  • First, when dealing with a health or medical issue, remind teens they should always work with their doctor and not try anything they run across in their own research without the assistance of a doctor.
  • When dealing with something that has a name, there is often an established foundation – direct teens here first.  Rule number 1 still applies, but this information will often have more credibility then other sources.
  • For support, there are often various forums or yahoo types of groups that teens can join to share their experience with those having similar experiences.  The emphasis should be that these are for support primarily and any medical advice they may receive should be discussed with their doctor.
  • This is a good opportunity to introduce teens to your journal databases and guide them away from general Internet searches.
  • Remember that as library professionals we know all of the above, but teens often don’t and there is a sort of fear and desperation that can cloud rational thinking in the midst of these times.  Be kind and patient (as I know you will be).
  • If you know of any local support groups, this is a good direction to point teen parents.

 A look at a parent in the midst of the chronic illness of a child . . .

Trying to Slay the Reflux Demon

Most moms like to go in and sneak a peek and watch their baby sleep. Me, I couldn’t stand it. It was our first sign that something was seriously wrong with our baby. She looked like she was possessed by demons while she slept. She would flail. Arch her back. Make that startled movement you make like you are dreaming that you are falling off of a cliff. She would scream. And most horrifyingly – she would stop breathing for a few seconds.

My husband and I would take turns holding her throughout the night to make sure she lived. He worked until 4 a.m. and then he would come in and take over. I would get about 2 hours of sleep and then get up and go to work. When it happened, when you realized it had been a few seconds since you felt that rhythmic in and out of her chest – you would jostle her a little until it resumed. Whenever we mentioned it to the doctor he would say, “as long as she doesn’t turn blue – it is okay.”

And then that moment happened. My 6 year old and I sat there playing on the computer while the 6 week old slept in her swing. My husband was out looking for the new car he was sure we needed with a new baby. Suddenly I looked over and threw the laptop across the room as I screamed, “holy sh&t she’s blue.” We grabbed the baby, called the husband and raced to the ER. The simple act of grabbing her out of the swing scared her into breathing. At Children’s Hospital they made us take Infant CPR classes and monitored her for the day and night. Then they sent us home with an apnea monitor.

This was already our second trip to Children’s. The first occurred at 5 weeks when we thought she was having seizures. They pulled us right out of line when they saw it happen and rushed us in to see a doctor. She was being treated for infant reflux and after a few tests and observation the doctor’s assured us that she wasn’t having seizures but that it too was caused by her infant reflux.

They used to call it colic. Now they call it infant reflux. Me, I don’t care what they call it – I call it the reflux demon. I just know that it sucks – for the entire family. The first 7 months of her life she screamed 24/7. I wore her in every type of babywear gear you could fathom. We held her all night long as she slept. We bought specials beds. We tried various diets. And we gave her medication.

But nothing has ever really stopped the pain for her. She still sleeps like she is possessed by demons. Flailing, flinging, arching and making a variety of noises to try and get the pain out of her chest. She often coughs and is rubbing her nose because it bothers her all the way up to her nose. And often she cries – when she wants to eat and can’t because of the pain, when she wants to sleep but can’t because of the pain . . . it always comes back to the pain.

There are fewer things in life I think that will ever piss you off than seeing your baby be in pain and having absolutely nothing you can do about it. I mean seriously full out seething below the surface anger that makes you want to cuss out the universe that dares to hurt your baby. If another human being hurt my child I could have some type of recourse. We often say to ourselves, if anyone hurt my child I would kill them. I wouldn’t think twice about it. And yet, here my child is hurting and there is no one I can kill. No one I can lash out at. No one I can make pay. No one I can make stop. The universe is kinda too big for me to beat up I think.

So instead I continue to try to find the foods that she doesn’t digest well – that she is intolerant to – that make the reflux worse. I spend all my time researching and trying and visiting doctors. Not to mention all my money. I pray every night before we go to bed that somehow this night will please please please somehow be different and the demons will leave her alone and let her sleep in peace. In 20 months, she has only had 4 nights where she wasn’t visited by the reflux demon. I’m still trying to find my reflux exorcist. And tonight when I go to sleep again, I’ll pray that my prayers won’t be in vain. I can not slay the universe, but damn it – I want to slay the reflux demon.

Guest Blog: Teen Issues – Teen Pregnancy and Complications

A little over 1,000 teens gives birth every day.  Just yesterday I held the 5-week-old baby of one of  the teens that visits my library.  The majority of teen fiction that deals with teen pregnancy focuses on only one part of the discussion: will the teen mother keep the baby or will she either end the pregnancy or decide to give her baby up for adoption.  But what about pregnancy complications, where is that depicted in the literature?  In an earlier blog post we discussed pregnancy miscarriage and infant loss, but that is only part of the story.  Because at the end of the day pregnancy is pregnancy, there is a chance for a wide variety of complications such as eclampsia, placental abruption, gestational diabetes, hyperemesis gravidarum and more.  When teens suddenly find themselves facing not only a pregnancy, but a complicated one at that, where do they turn for information and support?  Information regarding pregnancy complications tends to be complication specific, not age specific (with the exception of dealing with pregnancy after the age of 35).

The other day I was walking through the mall and saw a pregnant teen who was quite obviously very ill carrying a backpack that carried a feeding tube that was keeping her and her baby alive; she had a pregnancy complication known as Hyperemesis Gravidarum (HG).  HG is a debilitating, life threatening illness that is marked by extreme vomiting which can result in dehydration, malnutrition, and a wide variety of health complications including kidney and liver failure.  Today’s guest blog is by a woman named Shelley.  This is her story of what it is like to be not only a pregnant teen, but a teenager with pregnancy complications . . .
When I was 18 years old, I got pregnant and sick. Very sick. This is my story.
“Hyperemesis Gravidarum (HG) is a severe form of nausea and vomiting in pregnancy. It is generally described as unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids.” (helpher.org).
Labor Day weekend in 1992, my boyfriend at the time came home from college for a long weekend. That was the weekend we conceived. We had unprotected sex and when people tell you “it only takes one time”, they are telling you the truth. That was the one time we had had unprotected sex and the one time I got pregnant.
I had no idea at first. I was completely oblivious to what had happened (and what was going to happen). I was a freshman at the local community college full-time, while working 30 hours a week at a local daycare center. At the time, I thought my life was pretty good.
In early October I started to notice that I wasn’t feeling so well. It started with a headache that just would not go away. Later more symptoms came and increased. Headaches became migraines, vomiting once a day became on and off all day, light and sound would just make these symptoms worse. I honestly thought I had the flu. On October 16, 1992 I went to my family doctor with complaints of vomiting and migraines. The first question he asked me was, “Do you think you are pregnant?”. I was in shock. No, I didn’t think I was pregnant, I’m too sick to be pregnant. I saw girls in high school that were pregnant and none of them were vomiting all day. No, I definitely was not pregnant. My doctor insisted I get a pregnancy test before I left the office, just to be certain. He also gave me a prescription for migraine medication. I left his office still sick. I filled the prescription at a local pharmacy and took one of the pills. Within 15 minutes I was violently vomiting. The pills did not help and I couldn’t keep them down long enough for them to even work.
The following day (Saturday) my boyfriend came home from school. At 9 AM the phone rang. It was the blood lab with my results. I’ll never forget her voice. It was soft. She said, “Michelle, your test results came back positive. You are pregnant. I am so sorry.” Her voice silent as I started to cry. She said again how sorry she was. I hung up the phone and cried.
The vomiting had increased over the next two days. The pain from the migraines was horrendous. I was now confined to my room with a puke bucket. I couldn’t even sit up without vomiting. My boyfriend and I told my mom about the pregnancy. That disappointed look in her eyes as they welled up with tears was the worst day of my life. Without words, I knew I hurt my mom terribly. Even though she was disappointed in me, she was concerned. She was concerned with how sick I had become. She called the family doctor who had seen me two days earlier. She explained to him that I could not stop vomiting and that the pain from the migraines were debilitating. She begged him to give me something to stop the pain and vomiting. He refused, saying that I was sick because I was too young to be pregnant. The only way to stop being sick was to terminate the pregnancy. There was nothing more he could for me.
My mom, my boyfriend and I talked at length about what to do. Do I continue being confined to my bed, sick from pregnancy, or terminate the pregnancy? I can tell you that it was not an easy decision. I wouldn’t wish that conversation on my worst enemy. We decided together that my doctor was right, I was too sick to continue. We were too young to have a baby.
On October 21, 1992 I terminated my pregnancy. Three days after the termination, I was still sick, although the vomiting and migraines lessened. After about 3 weeks, my symptoms of vomiting and migraines cleared. I had no more pain. No more vomiting. No more symptoms that I was pregnant. I told no one. It was my secret.
I never knew in 1992 that what I was experiencing was Hyperemesis Gravidarum. For 14 years I was lead to believe that I was sick during pregnancy because I was too young to be pregnant. I believed that. I had watched my sister get married and have two pregnancies with no illness. It confirmed what I had been told. Too young to be pregnant. You will get sick.
In 2006, my husband and I conceived our daughter. After 8 long months of trying, we finally were pregnant. And then it began. It started with the headaches, then the migraines, and then the vomiting. My mom, who had been so disappointed years earlier was concerned. She was the one who pointed out how sick I was in 1992 and how my symptoms now were so similar. She was determined to find out what was wrong with me. While I lay in bed delirious from vomiting 20 times a day, she was 8 hours away in another state desperately trying to find answers. She found it. She told me, you have Hyperemesis Gravidarum Michelle. Call your Ob and tell them you have this disease. Tell them about 1992.
Although my treatment was much better than in 1992, my disease was recognized and I was treated for Hyperemesis Gravidarum. My daughter and I are survivors. I will never forget 1992 or the horrific disease Hyperemesis Gravidarum is.  
In my 18 years working with teens, I have spent time consoling a 16-year-old girl who developed eclampsia and was rushed to the ER; she lost her baby and almost her life 22 weeks into her pregnancy.  I have seen a teenage mother bring her toddler into Children’s hospital to get a heart scan because he had Down’s Syndrome with heart complications.  The doctor that day told me that one of the things you don’t hear discussed very often is that young teen mothers have a higher incidence of Down’s just like older mother’s because their eggs are not yet fully matured when they conceive (a brief research of the topic shows that this is a questionable fact) .  What must it be like for a teenager, who tends to live with the myth of “it can’t happen to me” due to the unique brain development of the teenage years, to suddenly find themselves faced with very grown up realities of pregnancy complications?

For more information on teen pregnancy complications:
WebMD: Teen Pregnancy, medical risks and realities
March of Dimes
Livestrong.com: Complications with Teenage Pregnancy
TLC: Pregnancy Complications in Teenage Mothers

As you can see, the information regarding pregnancy complications for teenagers is short and lacks depth.  You’ll want to refer teens to more informative, disease/complication specific sites.  For example, the Hyperemesis Education and Research Foundation (HER Foundation), specializes in information on HG.  The March of Dimes is actually another good resources for a variety of complications.

Teen Issues: What does October 15th mean?

In Megan McCafferty’s dystopian world, everyone over the age of 18 is infertile due to a virus so teenage girls are paid to help bring new children into the world.  In the real world, teenage pregnancy is viewed much differently.  Popular Mtv shows 16 and Pregnant and Teen Mom illustrate some of the complications in being a teenage mother, a topic often addressed in popular teen fiction.  But what happens when a teenager gets pregnant and decides either not to keep the baby and terminate the pregnancy or decides she does want to keep the baby and then loses the baby through miscarriage?

Most teen fiction focuses on a different scenario:  teens engage in sex, they get pregnant, they have baby and struggle.  Sometimes the teenage mom leaves and the teenage dad is left to take care of the baby, see First Part Last by Angela Johnson or Hanging on to Max by Margaret Bechard.  Sometimes the teens talk about getting an abortion or putting the baby up for adoption.  But often, the literature focuses on one or both parents struggling to raise a child on their own (sometimes with the help and support of their families).

And yet statistically we know that anywhere from 1 out of 5 to 1 out of 4 pregnancies ends in a loss.  And some babies are born sleeping, or stillborn.  So this has to be true for teen pregnancy, too.  About.com presents these statistics on teen pregnancy: 3/4 of a million teens become pregnant each year, 57% of these pregnancies result in birth, 29% of teen pregnancies are terminated and 14% end in miscarriage.

Many women carry the silent pain of miscarriage and stillbirth; but if it happens to you, you will start to hear the stories of women around you.  They will share with you about the child they lost and never knew.  They will tell you about how they wonder what that child would look like now, what his or her laugh would sound like, and so much more . . . It’s like miscarriage is a secret world that you don’t know much about until it happens to you and you get the grim invitation to join this secret, aching world.  But what happens to a pregnant teen who loses a baby in pregnancy, stillbirth or infant death?  Do her friends come out of the woodwork and begin to share their stories?  Do the adults in her life share their stories?

On the ABC Family show The Secret Life of an American Teenager, expectant couple Ben and Adrian’s baby was born sleeping.  This was amazing to me as it was the first time that I can recall a show dealing with subject of pregnancy loss in the life of teens. 

[youtube http://www.youtube.com/watch?v=AL_rLJ7zWOk]

October 15th is Pregnancy and Infant Loss Remembrance Day.  If you ever have the unfortunate event to work with a teenager who has lost a baby, know that this resource is out there.  Know, too, that they will go through all the same emotional stages of grief that any woman would go through when experiencing pregnancy loss.  Sometimes these emotions are complicated by guilt as they wrestled with whether or not they even wanted to keep the baby (also true of many women).  Know that their loss is real and painful.

There are many resources that you, as someone who may be put into a position of supporting a teen after loss, and your teen can turn to for support:

* Our Hope Place has a guide for helping someone with loss
* The blog Living Whole Again has a list of things to say (and not to say)
* There are places where teens share their stories of loss here, here, here and a poem here
* Here Oprah talks about her teen pregnancy loss
* And here is a good list of online sites that help those suffering from loss honor and remember their babies.

You probably know where your teen pregnancy books are in your collection, there are unfortunately not a lot of books dealing with teenage miscarriage and pregnancy loss.  However, they will find help in the nonfiction books dealing with miscarriage because regardless of age, it helps to read the stories of others.  Some nonfiction titles include Silent Grief, Empty Arms: Coping After Miscarriage, Grieving the Child I Never Knew and Our Stories of Miscarriage: Healing with Words.  In addition there is a good children’s book titles We Were Going to Have a Baby, But We Had an Angel instead by Pat Schweibert that may be comforting.  This book is actually written to comfort older siblings, but many find it comforting in itself.  Although not a good library book as it is a journal, you may recommend I’ll Hold You in Heaven Remembrance Book to those that it would be appropriate.  This is a journal that helps guide you through the emotions of the pregnancy and loss.

And thanks to all the teen librarians at the Yalsa-bk list, I have some teen fiction dealing with pregnancy loss that you can use for bibliotherapy:
A Swift Pure Cry by Siobhan Dowd
Lullaby by Jane Orcutt
After by Amy Efaw
Jumping Off Swings by Johanna Knowles
My Life as a Rhombus by Varian Johnson
Newes from the Dead by Mary Hooper
Six Rules of Maybe by Deb Caletti
Someone Like You by Sarah Dessen
Plan B by Charnon Simon
Where the Heart Is by Billie Letts
Plain Truth by Jodi Piccoult
Mr. and Mrs. Bojo Jones by Ann Head

LibraryThing has a good list of books about teen pregnancy in general

One of the greatest gifts you can give someone is to acknowledge their loss, their baby.  Acknowledge their pain.  Let them walk in it and hold their hand.  For me, as I experienced my loss in 2006, reading the stories of others was essential to my healing.  I needed to know that I was not alone and that others had felt the various things that I felt.  I needed to know that you could get to the other side of this pain.  I needed the words on the pages to hold my heart and help me along on my journey.  I believe in the power of words to help and to heal and I found this to be especially true during this time.

One of the complications of teen pregnancy loss is this: everyone in her life will tell her it was probably for the best.  It is true that teen pregnancy has dramatic and often negative consequences in their life – we know that it affects their schooling and is likely to put them at a greater risk of poverty for example – and yet when they lose that pregnancy, when their baby dies, there are still strong emotional feelings associatied with that loss.  Regardless of what we as a society may think regarding teen pregnancy, that teenager’s life will never be the same.  They will always from that moment forward be a woman (or a man) who has lost a child.

The goal of October 15th is to take away the silent stigma of pregnancy and infant loss, to give those grieving a voice.  I hope this October 15th you will join me in raising awareness about pregnancy loss and miscarriage in general, but also in the life of teens.  If you do even one simple little thing, such as simply share the Pregnancy and Infant Loss Remembrance Day site on October 15th on your library FB page or website, you may just give a grieving teen a resource they need.

Dedicated to the memory of Casey Lee . . .