Why Aren’t Teens Getting Screened?

Written by yvonnethornton on November 15th, 2012

Teen pregnancy is consistently a major social problem in the United States. While teen pregnancy has been on the decline over the past few decades, it is still an issue and more than 34% of girls will have a baby by the time they’re twenty years old. For that reason, the results of a recent study might be surprising to you. The study showed that when receiving care in the emergency room, only 19% of teen girls across the country were tested for pregnancy. Even those with abdominal pain were given other tests, and some doctors didn’t even bother asking whether or not the girls were sexually active.

Not testing for pregnancy can be extremely dangerous. Of the girls who complained about abdominal pain, 28% were given tests that included radiation.  With that said, although there is stark hysteria when it comes to inadvertent exposure to radiation from diagnostic imaging, a chest X-ray or an X-ray of the abdomen would not harm the growing embryo or fetus.  There is no evidence that suggests that there is increased fetal risk of malformations, growth restriction or abortion from a radiation dose of less than 5 rads.  Most diagnostic imaging procedures using radiation are calculated to be in millirads (one-thousandth of a rad).  Case in point, a chest X-ray exposes the fetus to only 0,07 mrad which is exceptionally small and without any significant risk to the fetus at any gestational age.   Nevertheless, not checking for pregnancy in teenage girls can result in not diagnosing an ectopic pregnancy, which carries with it an increased risk of death to the teenage mother.   Moreover, many medications could also be extremely harmful to a growing fetus.   When shown the results of the study, a few doctors claimed that their resistance to giving a pregnancy test was partly because few teen girls come to the ER alone. When a large number of family members are present, ER doctors don’t want to offend the people in the room. These doctors are almost always strangers to ER patients, so they don’t know the family history or teen’s background.

While you’re probably not an ER doctor, you can still learn from this study and apply it to your own life. Especially if you have a teen daughter, you should always make sure that she receives a pregnancy test before undergoing any other procedures in the emergency room. If the doctor doesn’t offer one as part of his or her diagnosis, bring it up and have your daughter tested. Your teenager might look at you in utter disgust, but the temporary hatred you elicit from your teen is preferable to the potential misdiagnosis and misguided plan of care formulated, which was based on an incomplete evaluation because a pregnancy test was not done.

As an obstetrician, my credo is that any young woman from 12-56 is pregnant until proven otherwise.  Emergency room doctors are trained to test for pregnancy in adult females, so it might slip their mind to test teen girls who come in. However, teen pregnancy is a serious issue, so if you have any control in the situation, always make sure your teen is tested for pregnancy before any other procedures are conducted.

 – Yvonne S. Thornton, M. D., M. P. H.



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