Abstract

PIP: Although numerous reports have been written regarding the increasing rates of adolescent pregnancy and the related social, psychological and medical complications, very few have focused on methods which enable the primary care clinician to develop an effective clinical relationship with the pregnant adolescent. During the initial health care encounter, the clinician must be aware of, and responsive to, the needs of the adolescent in order to establish rapport and thus facilitate early diagnosis and open discussion of issues concerning pregnancy. The adolescent's visit to the clinic must take place in a comfortable environment which ensures privacy. Once the adolescent appears comfortable, the clinician should try to obtain subjective and objective information, including menstrual, sexual, and contraceptive histories. If pregnancy is suspected and subsequently confirmed, the clinician should encourage the adolescent to take an active role in the decision-making regarding the maintenance or termination of the pregnancy, as it is she who must live with the results of the decision. The advantages and disadvantages of 3 possible options--maintaining the pregnancy, keeping the baby or placing the baby for adoption, or abortion--must be discussed openly with the adolescent. The clinician should support the adolescent in choosing the most suitable option. Such counseling will thus enable the pregnant adolescent to make informed decisions concerning her health care.