Parents of preteens and teens say that in the past, they had only to explain to their children how sex works and what pregnancy is.
Since the US Supreme Court's Dobbs ruling ended 50 years protected access to abortions last year, many families report that these discussions include details straight out of spy movies, such as how to rent an out-of-state box if they need abortion pills. They also say that the conversations now include information that sounds like it belongs in a spy film, including where to use WiFi and how to delete personal details on phone apps.
Parents say that the changing legal landscape surrounding reproductive health care is causing new concerns and an urgency in conversations and decisions regarding birth control, which were previously more distant.
Christine, a Wisconsin mother from the southeast, described her feelings of shock and sickness after Dobbs' decision was made official. She also took action.
CNN has not used Christine's last names because she works at a Catholic School and was afraid that telling her story would put her job at risk. CNN doesn't use the names of her kids to protect their privacy.
Two of Christine’s children live at home. A teenage son, and a young woman in her 20s who moved in to her parents’ house in order to save money as she finished her degree.
Christine views Wisconsin as a purple-colored state that takes pride in its levelheadedness. She said the Dobbs tragedy was terrible enough, but then, a state statute that has been in place since the 1800s came into effect. It made it illegal to have an abortion except to save a pregnant woman's life. Many providers have stopped performing terminations as a result.
Christine's biggest change as a parent since Dobbs was the feeling she needed to protect her children urgently. "Like I would to keep a kid from falling off a cliff." She said, 'That's where I feel the situation is at.
She taught for over 20 years and said, "I've seen many good children make one poor choice that changes their trajectory forever."
Christine understood that she had to stress to her son, and to one of his close friends, the dangers. She said that the friend was making 'bad choices'.
She said that she had slammed him. This was something she would never have done without the Supreme Court decision.
She told both boys that things had changed. The stakes were higher for having sex.
She said: "I told you guys that you have to work if want to be able to have sexual relations these days."
She told them that they would need to save money if their girlfriends wanted to travel to another state for an abortion.
"Kids, you'd better have at least two grand in your savings because Plan B isn't always successful, right?" Condoms are not always effective,'' said the woman. You'll have to travel out of the state and stay there for at least three days. If you don't have that, you should make better choices. '
Christine told me that her son's best friend was shocked. She said that no one had ever spoken to her son's friend about it.
The issues and conversation for her daughter of 23 years were quite different. Her daughter's been using birth control for medical reasons since middle school. The first doctor she saw in November refused to renew her Nexplanon implant, which releases hormones continuously over a three-year period.
Around that time, the Alliance for Hippocratic Medicine and other conservative groups sued the US Food and Drug Administration to revoke its approval of mifepristone - a medication used in abortion pills - creating a new front for the fight for reproductive health care.
The nurses refused to replace Christine's implant after asking her daughter a series baffling and confusing questions about her age, whether she planned to have children, and if she had thought of more natural birth control methods.
They told me that they would have to wait on this or I could have to find another place to stay, as we were not able to accommodate this at this time. '
Christine's daughter doesn't know why the parents refused. She claimed she was afraid to ask more questions because of the visit. She believes that even though birth control is legal in the US, there may have been some anticipating.
I think they were afraid of the repercussions... of a possible legislation that could be implemented within the next couple of months and being royally sued. Her daughter called it "absolutely ridiculous".
She eventually found another provider to perform the procedure. However, the experience left her and her mother shaken.
Christine and her daughter made plans for what to do in the event that she would need an abortion.
Christine: "We discussed how you would need a burner telephone to ensure that it could not be tracked." The women discussed where she could go for a procedure, and how she could get abortion medication mailed to her if needed. If that were the case, where could you find a P.O. How could you get a P.O. Christine replied, "We went through this all."
Christine also said that they discussed how to deal with medical bills and deleting apps on your phone which track your cycle.
Moving up the timeline
Adam and his spouse were discussing the best way to raise their honors student daughter who is a member of her school's robotics squad.
Adam agreed to share his family's story with CNN on condition that CNN only use his first name in order to protect his family's privacy and safety.
He said about his daughter, "She's an excellent student." She's going to college. She has already scored 32 on the ACT and just completed her sophomore year of high school. We didn't wish to derail her bright future.
He said they had intended to tackle birth control at around the age of 16, but that after Dobbs' ruling, they were worried about states pursuing birth control next.
'We had discussed it with her previously, and she made the decision to take birth control without any influence from [the end of] Roe v. Wade. Adam explained that the Roe v. Wade issue had just moved forward in time.
Adam explains that when they went to make an appointment for her to receive an IUD (intrauterine device), which releases a small dose of hormones to act as a long-acting form of birth control, they had to wait two months. This suggests they weren't alone in thinking this way.
Adam's wife said that they were unable to wait for the Supreme Court decision as they watched with their daughter.
We felt that our choices as women were taken from us. What's next? She said.
They say their daughter feels safer with the IUD. It should last her until she turns 22. They hope that it will allow her to complete at least a bachelor's degree.
Adam's spouse said that she can decide for herself whether she wants to have a new toilet installed or not.
Of course, these kinds of direct and open discussions about sexuality don't occur in every family.
Title X is a federal program that provides low-income patients with family planning services for little or no charge. Now, that program is also under threat.
Fighting for access
The website of Jane's Due Process in Texas, an organization that helped teens get birth control without telling their parents until recently, displays a banner: "Safety alert: Computer usage can be monitored, and it is difficult to clear completely." You can exit the website quickly by pressing the ESCAPE button twice.
Guttmacher Institute for reproductive health reports that 24 states require parental consent before minors are allowed to access birth control.
Texas is among the most restrictive in this regard. Anyone under 18 must have their parents' permission to use birth control, even if the person is already a parent.
There was, however, a significant loophole that existed until recently. Title X clinics across the nation and in Texas offered teens free, confidential contraception.
In December, District judge Matthew Kacsmaryk ruled Title X violated parental rights and state laws by allowing minors access to birth control without consent from their parents.
The appeal is underway. Title X clinics have stopped offering birth control to teenagers unless their parents give permission. According to advocates, it is a disastrous decision for Texas, which according to the US Centers for Disease Control and Prevention ranks ninth nationally for the rate teen pregnancy.
Graci D'Amore is the senior manager for direct services at Jane's Due Process. She said that even after the Dobbs ruling, Texas teens can still access birth control via Title X. Her group received a flood of calls and text messages from teens who wanted help finding Title X clinics in cities.
She said, 'Now we have stopped advertising, because they can't get it.' She says the group raises money instead to help teens get abortions in other states.
She said that teens are denied the most effective methods of preventing pregnancy. It's atrocious, unjust and teens in Texas, particularly, deserve better.
Birth control pills available over-the-counter could be a major step in easing access for teens. Experts who advise the FDA about drug approvals unanimously voted in May that the FDA should approve Opill, a hormonal birth control option available over the counter. The FDA is expected to announce their decision in the summer.
The drugmaker claims that if approved, Opill may be available in pharmacies by the end the year.
Breaking the Cycle
Kathleen was a teenage mom, and she swore to never let her kids go down the same path.
She said, "I don't wish for my children to suffer financially as we have done over the years." I don't want it. I also feel that I am protecting several generations by discussing birth control with my children.
She has now three daughters and three sons. CNN uses only her first initial to protect her family's privacy.
Kathleen's conservative Florida friends and family were furious with her for getting birth control pills to treat her oldest daughter.
She said that giving a teenager birthcontrol was the same as giving her permission to engage in sexual activity.
She blamed me. She asked, "Why would you put on birth control when she is not sexually active?" '
Her daughter took birth control pills to treat a medical condition, but suffered from significant side effects. Doctors said that she needed another option.
When she returned to the gynecologist for a second visit, either the daughter or the physician dismissed each alternative. The couple left without receiving anything.
Her daughter became pregnant three months later at the age of 16. Kathleen said that it was the first time she had ever had sex.
Families agonized over what to do for weeks. Kathleen says that her daughter weighed all of her options, but decided to keep the child. She is happy with this decision. The baby will be born any day now.
Kathleen asked her 15-year-old daughter last week what she would do to protect both her health and future. She says that the teen "hasn't had a kiss" yet but knows how quickly things can change.
Kathleen tells her that she said, "It's like saying, "This is the way the world is now." This is the situation your sister faces and what she has to deal with. It's what I had to deal with when I was in the same situation 17 years ago. How do you feel' '
Kathleen's 15-year old daughter is against abortion. She's my political child.
She said, 'She told my 16-year old that if she had an abortion she would not speak to her ever again'.
She said that her middle daughter, based on her beliefs, has chosen to use birth control in the hope she will never have to make this decision for herself.
Kathleen stated that'she doesn't want to take the pill, because she feels she won't be reliable taking it'. I think she is more or less inclined to the implant in her arm.
Kathleen also began talking to her fifth-grade daughter, a thing she had never considered doing before Dobbs.
She said, 'I have already begun the conversation with my 15-year old, though not in as much depth, but rather more about her rights and her choices'.
She said, 'I feel like I have been pushed. Not just by the laws, but also the current situation at home.'
She says that for now, despite her best efforts, her children will not be protected or supported. No matter how hard you try to guide and teach them, their decisions are theirs.