Don't miss preconception care opportunities for adolescents

To examine pregnant adolescents' desire for pregnancy and determine whether there were opportunities for preconception care for pregnant adolescents with desired pregnancies.

Retrospective chart review in a federally funded, urban adolescent care clinic. Medical records for 108 pregnant women under the age of 19 were the sample. A logistic regression model was developed to determine whether desiring pregnancy was associated with a lack of clinic visits before conception. For those adolescents who desired pregnancy and did have previous visits, preconception risks were identified.

Of the 33% of adolescents who responded that their pregnancy was desired now or sooner, 18.5% arrived at the clinic already pregnant with no previous care, whereas 81.5% had at least one previous visit at this clinic. Those who desired pregnancy and did have previous visits had a multitude of risk factors present that could have been addressed with preconception counseling (including smoking, drugs, interpersonal violence, and weight issues). The majority of these adolescents had not desired a pregnancy at the time of pregnancy diagnosis; 57.4% of those had one or more documented visits at the clinic before receiving a pregnancy diagnosis.

Nurses who provide care to adolescents have an opportunity to discuss future pregnancies and to use healthcare visits to teach about preconception health. Teaching adolescents who both express a desire for pregnancy and those who do not express such a desire is an important part of comprehensive nursing care. Teens require thorough teaching about healthcare risks such as smoking cessation, body weight control, interpersonal violence, and the need for folic acid. Adolescents should be prime recipients of preconception education at every healthcare visit.