Preventing teen pregnancy: Emphasize honesty over abstinence

Preventing teen pregnancy: Emphasize honesty over abstinence
Preventing teen pregnancy: Emphasize honesty over abstinence

When I tell people that I'm a midwife, they often smile dreamily and say, “Oh how nice, what a happy job.” For the most part, they're right — about 92% of what I do is pleasant.  But there are a few aspects that I absolutely dread. 

Last week I saw a 15-year-old patient who was about six weeks pregnant.  She came into the office with her mother and her boyfriend for “options counseling.”  My practice does not provide termination of pregnancy nor do we offer adoption-specific services. However we do refer to other facilities, depending on patient request.   

I spent about an hour with this young woman, taking time to talk with her alone, as well as answering questions from her mom and boyfriend. An honors student and athlete with plans to attend college after high school graduation, she seemed bright and ambitious. She was confused and scared, and wanted guidance to make the right decision. 

I tried to tell her that there was no one right choice to make and that each option would hold different obstacles, challenges and emotions. I explained to her that there was also no easy way out — any decision she made now would be one that she lived with for the rest of her life in one way or another. 

I take options counseling very seriously. I don't use it as a forum to discuss my particular belief system. Instead, I try to give a woman with an unplanned pregnancy as much realistic information as possible. I attempt to point out the pros and cons of each option in order to help the patient make an informed decision. 

What I find most difficult is that in an unplanned pregnancy, there are no good options or easy choices.  This rings especially true for a pregnant teenager. 

As practitioners, we need to make an effort to speak openly and honestly to more teenagers, girls and boys alike, about birth control before pregnancy occurs and even before sexual debut. That is the time when true options exist and counseling would be most beneficial. I feel that helping prevent even one unplanned pregnancy is worthwhile. 

 I didn't know what my young patient's plan was when she left the office last week, or if she had even made a decision at that point. My job is to provide education, support and a listening ear. That's the best ‘options counseling' I'm able to offer, when there are no good options left. 

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