Problem
As part of good prenatal care, it is vital that patients share with their physician their medical histories prior to pregnancy. This information provides a baseline record for patients who will undergo major physical changes during pregnancy, and it helps to identify high-risk patients who may develop medical complications that are potentially dangerous to the mother and fetus. What pre-pregnancy conditions should be tested at the onset of pregnancy?
Susan, a medical assistant in an obstetrics and gynecology practice in Maryland, is scheduling an obstetric work-up for a 15-year-old patient, Joan. As Susan takes her medical history, she realizes that Joan is seeking medical help without her parents' knowledge, despite the fact that she lives at home. It is clear to Susan that this patient knows the importance of seeking medical care at the onset of pregnancy and understands the proper use of birth control. Despite this, Joan says that she chose to become pregnant. Should Susan contact Joan's parents? What can Susan do to encourage trust and ensure that medical care will continue for this mother and her fetus?