Special considerations in pregnancy prevention for the mentally subnormal adolescent female

Eight retarded teenage girls are presented whose cases highlight some of the considerations in pregnancy prevention for this population. Their mean age was 15.8 years, and 7 were considered to be educable (IQ 50-70) and 1 of borderline intelligence. Presenting complaints included pregnancy, sexual molestation, salpingitis, and a request for contraception in 2 patients each. Pelvic examination with no anesthesia was accomplished after multiple educational sessions in 7 patients. Contraceptive choices included an intrauterine device (2 patients), postcoital estrogen (1 patient), abstinence (1 patient), no contraception (2 patients). Of the 2 pregnant teenagers, 1 elected to continue and 1 to terminate. Unique considerations were the need for current information about consent, alternatives to sterilization, specific risks of contraception for the retarded with medical problems, and communication skills for eliciting sexual information and attitudes. The 8 patients presented reflect the special features posed by the interaction of adolescence, sexuality, and retardation.