With over 500,000 adolescent girls becoming pregnant annually, the need for unprejudiced, wide-ranging and developmentally appropriate counsel from a pediatrician is essential, according to a policy statement made by the AAP.
“Given the prevalence of teenaged pregnancy, a pediatrician is likely to make the diagnosis of pregnancy in a patient several times during his or her career,” Laurie L. Hornberger, MD, MPH, FAAP, from the division of adolescent medicine at Children’s Mercy Hospital and Clinics, and colleagues from the AAP Committee on Adolescence, wrote. “With expertise in adolescent development and experience working with families, the pediatrician is the most appropriate health care provider to counsel the pregnant adolescent about pregnancy options and support her in the decision-making process.”
According to Hornberger and colleagues, the approaches suggested have not been altered since the original policy statement made by the AAP in 1989.
The researchers suggest that all legal options should be discussed, including carrying the pregnancy to delivery and raising the infant, carrying the pregnancy to delivery and making adoption or kinship care plans or terminating the pregnancy. Additionally, the psychosocial development of the patient needs to be considered when discussing options, and limitations for abstract and future thinking should be appreciated.
Hornberger and colleagues recommend the following steps are taken by pediatricians to ensure that pregnant teenage patients are informed and counseled appropriately:
- Inform the pregnant adolescent of the options, which include carrying the pregnancy to delivery and raising the infant, carrying the pregnancy to delivery and making an adoption or kinship care plan or terminating the pregnancy;
- Be prepared to provide a pregnant adolescent with basic, accurate information about each of these options in a developmentally appropriate manner, support her in the decision-making process and assist in making connections with community resources that will provide her with quality services during and after her pregnancy; and
- Examine their own beliefs and values to determine if they can provide nonjudgmental, factual counseling for pregnancy options. If they cannot, they should facilitate a prompt referral for counseling by another knowledgeable professional in their practice setting or community who is willing to have such discussions with adolescent patients. – by Katherine Bortz
Disclosure: The researchers report no relevant financial disclosures.