Posted: December 15th, 2022

What do your peers say about your pregnancy?

16-year-old white pregnant teenager living in an inner-city neighborhood

Initial Post

My specific patient is a 16-year-old white pregnant female living in an inner-city neighborhood. This specific patient is a pregnant female. I would focus my assessment on women’s health and examining the fetus. First, before I begin collecting information, I would introduce myself. The introduction is essential; it establishes your professional role. I would also ask the patient for permission to be involved in her care. Often patients do not want the opposite sex providing care. Respect for the patient’s beliefs, attitudes, and rights enhances patient rapport. It is crucial to communicate empathy because this encourages patients to express their concerns. I would focus my questions on an open-ended format; this way, I can understand what kind of care the patient has received previously. Open-ended questions also allow for the patient to speak freely 16-year-old white pregnant teenager living in an inner-city neighborhood.

Several important points need to be addressed to assess health risks for a pregnant woman properly. I would focus on what kind of prenatal care has been completed. What are the plans this patient has as far as breastfeeding? I would also inquire about any cigarette smoking and alcohol use. “Entry into prenatal care represents the beginning of her new life. The adolescent should be praised for beginning prenatal care, particularly if it is in the 1st trimester” (Montgomery, K. S. 2003). Another critical factor that needs to be addressed is the mothers feeling and attitude towards her pregnancy. A potential health-related risk that should be taken into consideration is possible postpartum depression. This is a 16-year-old girl who hasn’t experienced much in life. Poverty and a high-risk pregnancy due to her age are important factors that need to be monitored. I would complete a functional assessment for this patient. “Quite simply, functional assessment is an attempt to understand a patient’s ability to achieve the basic activities of daily living” (Ball, J 2019). It is important to understand how this young woman plans to raise her child.

Questions-
Have you been pregnant before?
What do your peers say about your pregnancy?
Have you set up the baby room?
Is your partner excited?
What hospital have you chosen?

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.) 16-year-old white pregnant teenager living in an inner-city neighborhood

Montgomery, K. S. (2003). Nursing care for pregnant adolescents. Journal of Obstetric, Gynecologic & Neonatal Nursing, 32(2), 249–257.

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Response

We get a lot of women under the age of 18 and pregnant, admitted to our floor.   The main issue we deal with most of the time is these women are addicted to opioids. Opioid dependence in pregnancy carries clear identifiable maternal and fetal risk (Shainkar et al., 2012). Most are admitted for issues ranging from cellulites to endocarditis. Many of them don’t know they are pregnant or they do, and they don’t care.  It can be very challenging as a nurse to separate your emotions from these particular cases. A significant barrier to treatment for pregnant women is caregiver attitudes. Pregnant women who abuse substances are the mostly likely group to be stigmatized and treated punitively for their addiction-related behavior (Crawford et al., 2015).  Some of the questions we need to ask them are “if they have a desire to have the baby” and if so, “are they willing to get help to stop doing drugs”.  Unfortunately, a large majority of them have no plans to stop their drug use.  The questions would appear as if they could be answered very cut and dry, although many if not all of the patient population we receive have very complicated pasts that range from histories of sexual abuse, homelessness, mental health issues, and little to no family support.  In these particular circumstances it can be very frustrating to know all the right questions to ask, but subsequently end up feeling defeated and helpless when a patient refuses help and elopes during treatment 16-year-old white pregnant teenager living in an inner-city neighborhood.

References

Crawford, C., Sias, S., & Goodwin, L. (2015). Treating Pregnant Women With Substance Abuse Issues in an OBGYN Clinic: Barriers to Treatment.

Shainker, S. A., Saia, K., & Lee-Parritz, A. (2012). Opioid Addiction in Pregnancy. Obstetrical & Gynecological Survey, 67(12), 816–824.

Response 2

Women ages from 15-19 who are pregnant are at a risk for maternal death related to maternal complications (Amjad, et. al., 2019). With this risk of complication for this patient it is important that she continues with prenatal care for herself and the baby. This will assist in any early detection of complications from the pregnancy. Another risk area that needs to be considered and reviewed postpartum is depression. Within this age range these individuals are finishing high school and have many other stressors in their life. Now they will be having an addition of a baby. Depression occurs two times the rate for adolescents who are raising children as opposed to those who are not raising children (Russotti, et. al., 2020) 16-year-old white pregnant teenager living in an inner-city neighborhood.

Continued effective communication for this individual is needed so that they will sustain prenatal and postpartum care. They will need assistance with knowledge regarding community resources. One question that should be asked is what support do you have at home to assist with the baby?  Another would be what resources are you aware of within the community for assistance?

References

Amjad, S., Macdonald, I., Chambers, T., Osornio-Vargas, A., Chandra, S., Voaklander, D., & Ospina, M. B. (2019). Social determinants of health and adverse maternal and birth outcomes in adolescent pregnancies. A systematic review and meta-analysis. Paediatric and Perinatal Epidemiology, 33(1), 88-99.

Russotti, J., Handley, E. D., Rogosch, F. A., Toth, S. L., & Cicchetti, D. (2020). The interactive effects of child maltreatment and adolescent pregnancy on late-adolescent depressive symptoms. Journal of Abnormal Child Psychology, 48(9), 1223-1237.