The Australian Journal of General Practitioners released its report in June on Teenage Pregnancy and it includes advice for GPs in supporting pregnant teenagers. See here for the full report.
Supporting the pregnant teenager
Providing quality healthcare to young women requires an understanding of the particular issues that are associated with teenage pregnancy and how to manage them (Box 1). In addition, programs supporting Aboriginal and Torres Strait Islander women must be culturally appropriate, and Aboriginal controlled models of pregnancy care have been developed in various parts of the country to address this. General practitioners play a part in recognising such vulnerability and improving the health literacy of these young people to support them in what is often a scary time, which can enhance the outcome for this pregnancy and for a future family.
|Box 1. Interventions and practice recommendations for the general practitioner to manage teenage pregnancy (adapted from Marino et al)62|
|Act to reduce the risk of unintended adolescent pregnancy In a sensitive and developmentally appropriate way, explore pregnancy intentions and contraceptive beliefs. Do this over time to accommodate changes in social situation. Encourage long-acting reversible contraception (LARC), which has been shown to be more reliable in this age group and should be the first-line recommendation. Check that young men and women know how to obtain and use condoms for sexually transmissible infection prevention. Check knowledge of emergency contraception.|
|When unintended adolescent pregnancy occursProvide nonjudgemental support and counselling, including all options (check with local teaching hospital social work department or Public Health Networks for referral pathways). Screen for sexual abuse and exploitation, and be aware of the possibility of coercive relationships when the adolescent is pregnant to an older partner.|
|Antenatal care Refer to the local specialist service for teenage girls (or Aboriginal or Torres Strait Islanders if applicable/available). Recognise that teenagers may have less anatomical knowledge and will be less likely to understand what is happening to their bodies so may benefit from explanations at all stages. Assess nutritional adequacy. Use the local protocols for antenatal care, with special consideration of fetal growth. Screen for chlamydia as recommended in the first trimester; consider retesting later in pregnancy. Screen routinely for alcohol use, substance use, violence and mood disorders each trimester. Provide access to smoking cessation support. Teach about signs and symptoms of preterm labour and the importance of noting fetal movements. Discuss contraceptive options before delivery. Encourage and facilitate breastfeeding. Include fathers where possible.|
|Postpartum and beyond Encourage uptake of home visiting programs and the use of early childhood facilities and age-appropriate mothers’ groups. Encourage return to school, education or training and continuing healthy lifestyle changes made during pregnancy. Encourage continuity of breastfeeding, direct education on safe use of formula and provide ongoing advice about infant nutrition. Assess nutritional adequacy, particularly of breastfeeding mothers. Provide access to smoking cessation support.|