Adolescent pregnancy and parenting — formative SAQs

SAQ 1 — Pregnant 15-year-old presenting to clinic (10 marks)

A 15-year-old presents with eight weeks of amenorrhoea and nausea. She has not told her mother and is frightened. She is sexually active with a 16-year-old partner and used condoms inconsistently. She is well, with normal vital signs and no pain or bleeding. ^{[1] [2]}

Questions

1. Outline your immediate clinical actions and how you confirm and date the pregnancy while excluding an emergency. (4 marks) ^[1]
2. Describe your approach to options counselling and safeguarding, including who you involve and how you frame confidentiality. (3 marks) ^[2]
3. Outline the antenatal care plan, naming the adolescent-specific obstetric risks you will screen for. (3 marks) ^{[3] [8]}

Model answer

Immediate actions (4). Greet the young person first; establish time alone and state conditional confidentiality with lawful limits. Confirm pregnancy with urine β-hCG (serum β-hCG if equivocal), establish gestational age from LMP, and arrange a dating pelvic ultrasound to confirm a viable intrauterine pregnancy and exclude ectopic. Absence of pain or bleeding makes ectopic less likely but does not remove the need to confirm location; ask explicitly about abdominal pain and bleeding at every contact. ^{[1] [2]}

Options and safeguarding (3). Present continuing with parenting, continuing with adoption, and termination (where legally available) in a non-directive, balanced way within the relevant time window; do not steer. Complete a safeguarding review: clarify the partner and consent context; a 15-year-old with a same-age partner in a consensual relationship is different from coercion. Assess capacity (decision-specific) and agree who is involved; where local age-of-consent or mandatory-reporting thresholds are met, follow local statute, telling the young person what you must share and why. ^{[2] [1]}

Antenatal plan (3). Multidisciplinary care — midwifery, obstetrics, paediatrics, social work, mental health, education liaison. Routine antenatal screening (blood group and antibodies, full blood count, ferritin, blood pressure, urinalysis, syphilis/HIV/hepatitis B) plus STI screening (chlamydia/gonorrhoea) given sexual activity. Name the adolescent-specific risks: anaemia, pre-eclampsia, preterm birth, low birthweight, STI. Supplementation with folic acid, iron and iodine per local guidance. Plan mental-health screening, nutrition, and education re-entry from the outset. ^{[3] [8]}