A 37-year-old mother of two, who has just started her pursuit of a Ph.D, approached me and said, “If you ever need anyone to go with you to a civic organization to talk about unintended pregnancy, I’d be willing to tell my story.”

I had just finished announcing efforts to determine what nontraditional messages might work to educate 18- to 30-year-old women about new birth control options, how to access them and why it’s important to plan when and how often to have children.

Tina’s message seemed pretty conventional at first: I didn’t talk about it then. I want to talk about it now. Maybe if I tell my story, this won’t happen to someone else.

In fact, her story was surprisingly unconventional. This young woman, identified by the newspaper as one of the leaders in her community, was offering to talk publicly about a subject still taboo at lunches.

Maybe if we openly talk about unintended pregnancy, we’ll send a clear message: We want you to be physically and emotionally healthy and strong. It’s your responsibility to ask your health care provider questions until you get the answers you need to prevent the chronic health problems that will plague Tina the rest of her life.

She was a freshman in college, with lots of family baggage that left her feeling insecure. She became sexually active. When she started bleeding continuously for a month, she called her family doctor. He assured her women her age bleed this way on occasion, — not to worry, — but contact him when she came home for spring break if she was still having problems.

A month later, when she started vomiting blood, she sought help at the emergency room in her college town, only to learn that a tubal pregnancy was close to erupting. She had no idea that she was pregnant. Gangrene had set in and she could have died. The result of her unintended pregnancy was that she lost some of her reproductive organs and parts of other vital internal organs.

Later she married, and is now a mother, but she’s plagued with chronic health problems because she didn’t have the information she needed to make informed decisions. Her parents, school and health care professional hadn’t prepared her the realities of leaving home — she might decide to have sex and, if she makes that decision, she should be prepared. Her doctor assumed that a college-aged woman he had known was not having sex.

Because of the stigma of pregnancy in the ’80s, her mother made up a story to tell friends and family in their small town about Tina’s intestinal “illness.”

“Maybe I’m old enough to talk about it publicly now,” she said. She and her husband have talked about how they will share Tina’s story with their daughters, who will soon be old enough to hear and learn from it.

None of us is too old or too young to talk about health issues. Pregnancy planning should be just as much a part of the health care discussions at the dinner table, in the legislature and in Congress as getting vaccinations, learning how to eat healthily to avoid diabetes or coughing into our sleeves to prevent the spread of the H1N1 flu.

When I was ready to publish Tina’s story, I talked with her again to be sure she still felt okay with it. She did, but she needed to talk with her mother to get some closure, because they’d never resolved the secrecy surrounding her pregnancy and emergency surgery. As it turns out, her mother is not ready.

As a result, I changed the woman’s name to protect her mother’s privacy, but it also changes the point of telling her story. It’s no longer a story about shedding the stigma and shame of unintended pregnancy, but a story that highlights the ambivalence we feel about this issue. In this case, a woman of one generation wants to talk about it, but the other does not.

Christie Vilsack is executive director of the Iowa Initiative to Prevent Unintended Pregnancies.