Building Strong Patient Relationships Begins in Adolescence

While many people are eager to leave their adolescence behind them, as ob-gyns, we know all too well that the development that occurs during these years lays the foundation for the rest of our lives. Not only are bodies and minds maturing, but adolescence is also defined by exposure to new ideas, experiences, and beliefs. Ideally, it is also the age where girls and young women begin to routinely visit the ob-gyn.

ACOG recommends that girls have an initial visit for screening and the provision of reproductive preventive health care services and counseling between the ages of 13 and 15 years. Caring for patients beginning in adolescence gives ob-gyns an important opportunity to focus on establishing a relationship of trust and ensuring young women are empowered with comprehensive knowledge about their reproductive health. Ensuring women get this knowledge helps them at every stage, not just adolescence. It informs all kinds of life decisions– from becoming sexually active to planning when and if to have a baby.

Of course, we cannot have these important conversations without acknowledging that while the United States has made progress reducing rates of unplanned pregnancy among teenagers, our rate remains among the highest in the developed world. Recent guidance, “Adolescent Pregnancy, Contraception, and Sexual Activity,” directly addresses the role ob-gyns can play to support adolescent girls in preventing unintended pregnancy. Contraceptive access to highly effective methods remains one of the most important factors, but comprehensive sexual education is also critical.

The success of this education relies on trust. In new guidance out this month, “Counseling Adolescents About Contraception,” ACOG highlights the importance of listening carefully to young patients concerns and priorities when discussing which contraceptive method choices are best for them. By the time they are teenagers, many young women have already been exposed to different ideas about contraception through friends, family, and pop culture. At the same time, they’re making decisions for themselves about their health care and what is important to them; physicians should be aware of these preferences and concerns and should partner with young women to assist them in making choices about their reproductive health.

Listening and respecting a patient’s perspectives and priorities truly should define the patient-provider relationship, not just one conversation. In many instances, ob-gyns may be the most trusted adult for teens who are ready to have essential conversations about their reproductive health, sexual activity, sexual orientation, gender identity, and/or mental health. We must be mindful of the sensitivities around these topics, and do our best to provide each patient with the care and knowledge she seeks. This also may include helping patients and parents navigate this new territory together; ob-gyns should encourage and support this communication when appropriate.

As late summer approaches, and more adolescents cross our paths, checking off annual doctor visits before the school year begins, we should each take time to reflect on our effort to have a lasting impact on patients’ reproductive health knowledge and relationship to their ob-gyn.

For a comprehensive overview of ACOG’s adolescent health care guidance, head to: https://www.acog.org/About-ACOG/ACOG-Departments/Adolescent-Health-Care

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About Haywood L. Brown, MD

Dr. Haywood L. Brown is Professor in the Department of Obstetrics and Gynecology at Duke University Medical Center in Durham, NC. He received his undergraduate degree from North Carolina Agricultural and Technical State University in Greensboro, NC and his Medical Degree from Wake Forest University School of Medicine in Winston-Salem, NC. He completed his residency training in Obstetrics and Gynecology at the University of Tennessee Center for Health Sciences in Knoxville, TN, followed by subspecialty fellowship training in Maternal and Fetal Medicine at Emory University School of Medicine/Grady Memorial Hospital in Atlanta, GA. Dr. Brown has participated in ACOG activities in District IV, V and VII over his 30-year career in Obstetrics and Gynecology. This includes being the Scientific Program Chair and General Chair (2001-2002) for the Annual Clinical Meeting. He chaired the steering committee for the District of Columbia National Institutes of Health Initiative on Infant Mortality Reduction, the Perinatal and Patient Safety Health Disparities Collaborative for HRSA and serves as the Chief Evaluator for Indianapolis Healthy Start. Dr. Brown is especially committed to the care of women at high risk for adverse pregnancy outcome, particularly those disadvantaged. Dr. Brown has served as Chair of CREOG and has been on the Board of Directors for the Society for Maternal Fetal Medicine and is past President of the Society. He is past President of the American Gynecological Obstetrical Society (AGOS) and Chair of the Ob-Gyn Section of the National Medical Association. He also served as a Director of the American Board of Obstetrics and Gynecology. Dr. Brown is past president of the North Carolina Obstetrical and Gynecological Society and is immediate Past District IV Chair of ACOG.

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