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Case study . Dr Iram Yasin. Miss LB. 15 year old girl No remarkable PMH Attends on 30/11/2011 with mum & sister Pregnant with 17 year old boyfriend Quiet Withdrawn Little eye contact Mum says …’ well tell her then..’ Miss LB says ‘..erm.. I’m pregnant…’.

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Case study

Case study

Dr Iram Yasin


Miss lb
Miss LB

  • 15 year old girl

  • No remarkable PMH

  • Attends on 30/11/2011 with mum & sister

  • Pregnant with 17 year old boyfriend

    • Quiet

    • Withdrawn

    • Little eye contact

  • Mum says …’ well tell her then..’

  • Miss LB says ‘..erm.. I’m pregnant…’



Then…

  • Mum and sister are most talkative during the consultation..

  • …sister had similar accident at the same age and had an abortion and both feel that LB should have the same

  • …LB states ….’they don’t know how I feel its my body and my baby…’

  • Mum tells ‘ boyfriend is not going to stick around, I cant afford to have her and another mouth to feed, and she only wants this baby cos’ all her friends have babies..’

  • Sister …’ she doesn’t understand this is going to ruin her life…’


Any thoughts
Any thoughts?

  • What would you do next?

  • Thoughts about the structure of the consultation?


And then
And then…

  • Tried to engage eye contact with Miss LB

  • Boyfriend aged 17, consensual sex, not forced or aggressive.

  • Arranged follow up later that day with boyfriend and Miss LB alone

  • Mum booked next appointment for herself ..to talk about LB!!


Alternative options

? Other management ideas

Thoughts about Fraser competence

Mums appointment?!?!

Alternative options


Appoinment with couple
Appoinment with couple

  • Miss LB more talkative, expresses that she understands she is young but would like to consider keeping the baby

  • Boyfriend feels he is too young and cant cope with responsibility

  • Refer to – teenage pregnancy specialist midwife! For balanced options counselling

    at Keighley Sexual health clinic


What happened next
What happened next?

  • Phone call from mum at AGH – Miss LB admitted for ? Ectopic, currently in theatre ..’Could you ask them to get rid of baby at the same time!..’

  • d/w Obs SHO – made aware of situation

  • TOP 7/12/2011 at AGH


Post top
Post TOP

  • Multiple attendances for UTI, abdo pain

  • Two further admissions to AGH for ? Appendicitis

  • Split with boyfriend, low mood, Marie Stopes post TOP counselling arranged


What did i learn
What did I learn?

  • Complexities of consultations with imposing relatives.

  • To try to maintain structure of consultation to allow focus on patient

  • Fraser – Gillick competence and how to apply this

  • Use of MDT

  • To be able to be truly non-judgemental (personal beliefs)



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