Saturday, March 15, 2008

Mama mia!

Yesterday afternoon, as newFNP looked at the pregnant seventh grader sitting across the room from her, she searched her eyes for a glint of fear, of recognition of the gravity of her gravid situation, and for a seed of doubt that would allow newFNP to introduce the topics of abortion or adoption.  She struck out.  She brought them up anyway.

Perhaps it was because this young woman appeared to have the IQ of a toadstool.  Perhaps it is because her sister is twenty-one and has five, yes five, children.  Perhaps it is because her dad was deported a few years ago or because her brother recently died.  Perhaps the ole 1-2-3-4 punch - shitty life circumstances leading to seeking love and affection in the arms and bed of a horny fifteen-year old boy, infinitely desirable in his scowl, his Nightmare Before Christmas hoodie and his Vans slip-ons.

Whatever the reasons, this just-turned-fourteen-year old girl was convinced that motherhood was the best option for her.  OK.  NewFNP took a deep breath, attempted to put her judgements aside and started talking more about self-care, about breastfeeding, about finishing middle school and then high school, about bringing her frigging mother to her next prenatal appointment.
NewFNP auscultated fetal heart tones, reviewed lab results, talked a little about fetal development and the importance of nutrition and then exited the exam room to have a shit fit and find the prenatal care coordinator who would hook this very young lady up with prenatal case management, parenting classes and God knows whatever else a fourteen-year old needs in order to become the best parent she can be.  

NewFNP's prenatal care coordinator, PCC, is lovely.  She is twenty-four and she also got pregnant for the first time when she was thirteen.  As she tells it, her Pentecostal preacher father was none too pleased.  She delivered her now ten-year old son at the age of fourteen and her daughter at the age of eighteen.  Despite many bumps in the road with her children's father, they remain married and, as far as newFNP knows, happy.  She started out several years ago as an MA in newFNP's clinic.  Because she is personable and talented, as well as smart, she was promoted to the position of prenatal care coordinator and has done remarkably well with the new responsibilities.  

NewFNP's patient is no PCC.  NewFNP is concerned the PCC is the exception and newFNP's patient is the rule.  Nevertheless, newFNP will continue to support her in having a healthy pregnancy and baby and, if she decides that adoption is a good plan after all, newFNP will be there with the referrals.

As an aside, since when are fourteen-year olds in seventh grade?  NewFNP was a sophomore year in high school when she was fourteen.  Aren't we at least supposed to be in ninth grade?


Anonymous said...

14 is still young for 7th gr. i have 16 year olds in the 8th grade.

Anonymous said...

after slowly savoring your blog for the last few months i am finally caught up to the present. let me, like many before me, thank you for writing this blog. i am a very soon to be new FNP and you both inspire and entertain me. even though you are very subtle, i have deduced that we went to the same undergrad and the same nursing school.
thanks again,

bostonfnp said...

So, I may have already given you my tally since 1/1/08, but here it is again... 15 pregnant women, none over the age of 18, youngest in 13 and they are all planning to become parents. Teen pregnancy down, CDC? I beg to differ...