Teen Parenting Case Study
Concept: Reproduction
Can be done individually or in groups (best if there is no more than 4 students/group)
Megan is a 17-year-old Caucasian woman who is six months pregnant with her first child. She and her husband Jake, an 18-year-old Caucasian man, have just moved into the one-bedroom apartment next door to you. You have noticed them interacting with one another as they walk to and from the laundry room, bus stop, or 7-11 and you notice that they seem to be very loving toward one another.
One day, after Megan notices you returning home carrying 75 pounds of textbooks and dressed in your clinical uniform, she asks you if you might give her some advice on community resources available to pregnant women.
Here is some background information:
Megan and Jake were high school seniors and had been dating for 18 months when Megan became pregnant. Megan is the oldest of three children. Her father lost a good paying job 3 years ago when the lumber mill he worked for closed down. Since then, he has held a series of low wage jobs. Megan’s mother, a brittle diabetic, works three hours a day as a dietary aide at the local elementary school.
Jake had lived with his loving grandmother since the age of 10 after his parents, methamphetamine addicts, lost custody of him. He has not seen his parents in seven years. Neither Jake nor Megan has ever used illegal drugs and neither use alcohol, but both smoke cigarettes (although Megan is trying really hard to cut back).
When Megan became pregnant, both families made it clear that, although they would have liked to, they could not offer any financial support, nor could the young couple and their child live with either of them. Megan and Jake chose to marry, leave school, and move to a more metropolitan area in the hope that Jake could find a steady job.
Jake was able to find a job with a landscaping business that pays minimum wage. The job is full time from March-October but may drop to fewer hours in the off-season. Health insurance offered by Jake’s employer, which costs the employee $600/month and has an annual deductible of $2500, is unaffordable for the couple. Megan received one prenatal visit early in her pregnancy at the Health Department. You know that rent in your apartment complex is $850/month and utilities are approximately $125.
Time warp…..fast forward six months
Jake and Megan are the parents of a healthy baby girl, Lily, now three months old. One afternoon, as you return from clinical, you meet Megan and Lily outside and you ask them how things are going. Megan tells you that she is glad that she was able to quit smoking and not start again, and she hopes Jake will quit someday too since Lily seems to cough a lot when he smokes in the apartment.
Megan is clearly delighted with her beautiful baby, and she tells you that she is successfully breastfeeding Lily. When you say, “Oh, her pediatrician must be so pleased to hear that!”, Megan gives you an odd look and says,
“Well she hasn’t been sick so I haven’t needed to take her to a pediatrician…we’ve both been healthy. I felt fine so I didn’t go for that 6-week postpartum checkup either. And…I don’t need to go to the clinic for my birth control pills since I can’t get pregnant as long as I am breastfeeding. Other than the doctor’s office that keeps calling me and bugging me to bring Lily in for her shots, we’ve been great. Honestly, I’ve read so many bad things about immunizations and the diseases they can cause that I don’t want Lily to get them…ever.”
After reading the case study –
· Identify all issues you have associated with this situation
· Are there potential biases or stigmas involved in this situation? If so, what are they?
· Since the teaching moment presented itself to you, what information can you provide to Megan regarding health promotion for herself and Lily?
· In your area, what community resources are available for Megan and her family?
Developed by Carol Thorn, RN, MS
May use with permission for the purposes of nursing education
If questions/comments, please contact Carol Thorn at