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David A. Grimes, MD

JAMA. 1996;276(14):1163-1170.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Dr DALEY:

Ms B is a 17-year-old student and mother of a 3-year-old daughter who desires to avoid pregnancy. She lives in Boston with her mother and attends a high school program for students with children. Her health care insurance is through the Massachusetts Medicaid program.

Ms B became sexually active at 12 years of age and presented to her primary care physician, Dr J, within 2 months of becoming sexually active requesting contraception. A combination oral contraceptive (norethindrone [1 mg] and ethinyl estradiol [35 µg]) was prescribed. At age 13, the patient became pregnant and had an uneventful pregnancy resulting in the birth of a healthy daughter. At the first postnatal visit, the patient reported being sexually active and was not using contraception. The same oral contraceptive was again prescribed, which the patient used for only 2 months. The patient was also treated for a cervical chlamydial infection. Depot . . . [Full Text PDF of this Article]

Author Affiliations
Discussant

Footnotes
Dr Grimes is Chief, Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco General Hospital, University of California, San Francisco.

Dr Grimes serves as a consultant for Alza Pharmaceuticals, Palo Alto, Calif; Gynopharma Inc, Somerville, NJ; Mead Johnson & Co, Evansville, Ind; Ortho Pharmaceutical Corp, Raritan, NJ; Schmid Products Co, Little Falls, NJ; and G. D. Searle & Co, Chicago, III. Dr Grimes also receives research support from Berlex Laboratories, Wayne, NJ; Ortho Pharmaceutical Corp; and Wyeth-Ayerst Laboratories, Philadelphia, Pa.

This conference took place at the Obstetrics and Gynecology Grand Rounds of the Beth Israel Hospital, Boston, Mass, June 26, 1996.

Reprints: Division of General Medicine and Primary Care, Beth Israel Hospital, 330 Brookline Ave, LY339, Boston, MA 02215 (Ms Hartman).

Clinical Crossroads at Boston's Beth Israel Hospital is produced and edited by Thomas L. Delbanco, MD, and Jennifer Daley, MD; Erin E. Hartman, MS, is managing editor. Clinical Crossroads section editor: Margaret A. Winker, MD, Senior Editor, JAMA.

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