Saturday, December 12, 2009

16 year old Gravida III

Last week, I saw a 16 year old some where during her 3rd pregnancy (no prenatal care during any of her pregnancies). She came to the ER for me to evaluate the "lump" in her "belly".

This turned out to be the baby's head, and I estimated her gestational age to be about 32 weeks. As I explained the breech presentation to her and begged her to get prenatal care at our free clinic, I recommended that she take prenatal vitamins and recommended that she stop smoking. I was really in a "public health" mood that day.

The "baby-daddy" chimed in and asked if I would write a prescription for the vitamins so that their "insurance" would pay for them (Medicaid). When I told him that a month supply of prenatal vitamins cost about the same as a pack of cigarettes, he started to get angry....but he had to answer his cell phone.

28 comments:

  1. ..and this is why I had to leave OB nursing, about the same time we had the inservice on NOT ever using the word "husband", but only the oh-so PC "Father of the Baby".

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  2. Take good care of her Doc, When we have to deliver that kid in the field, I don't want to have any complications. I mean any more than the substance abuse issues, the poor parenting skills and the perpetual destitution syndrome that the two half siblings already live with.

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  3. I'll see the child in kindergarten, dirty, chronically absent and smelling of smoke. He'll come to class not knowing how to hold a pencil let alone write his name, and he'll see no value in learning to read, as he's never been read to.

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  4. When the government starts providing for everyone, we can all devolve to that level. Then nobody will care. Problem solved.

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  5. *re-reads post*

    Erm...she's 16. And she's on her 3rd kid. Please tell me you made this entire story up, and you restore my faith in humanity.

    I'm not sure what disturbs me more, her age and number of kids, the fact that she's roughly 2 month from delivering and didn't realize she was pregnant, or the fact that the dad got angry about having to actually PURCHASE vitamins.

    If you'll excuse me, I must go make the case for forced sterilization...

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  6. Good to see you're still alive Devorrah :-)

    I feel so bad for those poor babies. Where I'm living right now, it's not inner city, but it may as well be. That's a scenario for many kids in my daughter and son's classes as school...

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  7. Amy--Yes, I'm still alive! I have several kids in my class just like this, as I do teach in the inner city. They don't know which side of a book to start reading from let alone why anyone would want to listen to a story read aloud. Where are the commercials?!
    One of these kids was asked by a visiting administrator how he liked school, as he was waiting in the office after a parent failed to pick him up *again*. He said with enthusiasm, "It's so, so fun!!"
    I feel like I'm all over him every day trying to teach him something ("Jake! Pay attention! Jake! Stop that!) and he's just grateful for the structure and happy that he's learning. That will keep me going for years.

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  8. I just don't get it. besides the missed periods, how could she not notice the baby kicking? especially if she has already had 2. those poor kids.

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  9. I'll give 3:1 odds that the current "baby-daddy" is also the third.

    She can simplify things by naming them all alike -- yell one name and they all come running.

    If she just wants one of them, she can call it by it's last-name.

    I - for one - am just frigging ECSTATIC(!!1!) that my hard-earned money is extorted from me at (.gov) gun-point so these people can breed another generation of couch-potatoes!

    God help us...

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  10. i would love to see the socialized medicine be all about accountability. You make choices you live with your life and what's gonna happen. DM type II, CHF, non compliance pt's. We don't have a nursing/MD shortage to care for the sick, it the non compliant people that take up our time and funds.

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  11. Oh, boy, I wish this were a made-up story, but I know better--I've been there. Was the cell phone a Blackberry? Mine is a five year old basic Nokia...go figure!

    Thanks...

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  12. ..but to hear the nut jobs on the far left, this has only happened because the free condom bowl at her middle school ran out...not due to any flaw in her thinking or morals. And in fourteen years her sons will be dead or in prison and her daughters will have made her a grandmother...and no one except teachers, social workers, and medical personnel will EVER have given a rat's ass about the health and well being of any of these children. The average Bishon Frise gets better socialization, instruction, diet, affection and health care than these kids, who cease to matter at all the minute they slide out of a well worn vagina....Pattie, RN

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  13. No, not making the story up.

    You're right about the liberal take on this situation. The point of the post is to illustrate how health care deform will not solve any of these issues. These uninsured will not seek primary care. They expect everything to be paid for free and use their money for poor choices.

    Sure, there are responsible folks who need help, but we see folks like this all of the time.

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  14. 16 yr old G3??? Must be Ugly, I mean a Late Bloomer...
    Well, the World Needs Ditch Diggers too....

    Frank

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  15. Bwhahahaha@Frank, re: Ditch Diggers!

    Seriously, you think Baby Daddy will ever work?

    My grandaddy bought a used concrete mixer and my Dad and his older brother worked every day, after school and on weekends, mixing concrete, until they could find better jobs. OSHA being what it is (as, with the EPA, another monstrosity brought forth by "conservative" Richard Nixon), my Dad had my brothers and me toting wheelbarrows full of rocks for no pay, to fill potholes in roads, until we could find better work.

    The whole problem with Ditch Diggers is we have to import them, as you dang sure can't get most kids today to get past the stigma of manual labor. The "Millenials" in today's work force are, mostly, lazy and remedial projects (ask almost anybody that hires). But they sure do have self-esteem!

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  16. The Blackberry, just like the Denari, are temporary. It's difficult to hold on to these when there is no decent and steady income. Next time you see them - for their 4th child - they'll have maybe a temporary iPhone and Escalde.
    What's permanent is the food stamps card.
    So sad that no one seems to have the motivation to better oneself and break away from this lifestyle.

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  17. "So sad that no one seems to have the motivation to better oneself and break away from this lifestyle"

    This is a generalized comment. it should read that so few have the motivation....

    My parents were by no means irresponsible, but we were not rich and my mother was not the best role model. This spurred the opposite effect and I am an overeducated successful business owner who can easily support myself. I also provide pro bono biz services to small up and coming women owned businesses and volunteer as a child advocate to help these kids. So to say no one is far to broad. Not only did I get myself out of that life, I took my sister along with me. It is not an easy road, in fact it is long and often times dismal. The inner motivation is a gift very few have and even fewer help those who want to claw themselves out of the hole others created for them (the kids). So please dont say no one and it doesnt hurt to lend a hand.

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  18. frank,
    am i the only one who caught the 'caddyshack' reference. i believe that quoting caddyshack, fletch, animal house, and a few others is a new way to tell if you are old.

    to the point. without putting yourself in the ER or public health clinic as an employee or volunteer it is impossible to really beleive that this is the rule rather than the exception for a large portion of our population. i once diagnosed pregnancy in a very large woman who came in with abdominal pain and thought she was 'constipated'. the fully formed skeleton of a 36 week gestational babe was clearly seen on the one view plain film. not exactly the right way to diagnose pregnancy but it worked.

    and yes, these are the folks that will eat up obama care and make your wait to see a physician months long. if obama has any sense in terms of completing the switch to socialism he will outlaw private clinics because there will be quite a market for them. the result will be huge expense for taxpayers and a diminution of care for folks like me and you.

    as a matter of fact, the NHS in england has, within the past five years, allowed private hospitals back in the mix. on any given night the number of inpatients in the private hospitals is greater than the number in the NHS facilities. five years for this to happen in a system that has been up and running since just after WWII.

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  19. As a woman struggling with infertility, I love to hear about patients like these.

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  20. dear sn moxie,
    don't give up... please! it is a cruel joke that those couples seeking to get pregnant often have to wait and wait while those loading up on alcohol and cocaine seem to get pregnant 'just that one time'. best to you.

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  21. C,
    The key word was "seems". If you had not missed it, you would have spared yourself a long rant. As for your last comment about lending a hand, is it not a generalized comment too, because, after all, you do not know me? However, I will spare you my very own personal rant because I do not believe in inflicting lenghty commentaries about myself upon others on a blog which is not about me.
    What is your business, for which you claim to be overeducated? Rider of high horses? Perpetually offended ( in a professional manner, of couse)?

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  22. Yes, Amy, I am an overeducated rider of high horses. However, the rant was not directed specifically at you, but at the generalized nature of comments about a 16 yo child. And "seems" in your sentence does not take away the untruth to it. The girl is 16. She is a child. She didnt get to this place by herself and the responsibility does not lay solely with her. At 16 she doesnt have to tools to "break away from this lifestyle." So let's cut her some slack and place more blame on the parents...mhm.

    Youre right, I dont know you, but by your defensive response, and disbelief about personal rants but not those about 16yos, I suspect you may be part of the problem with your air of pretension that "no one seems to have the motivation...blah blah blah

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  23. Oooh, I see your type now. I should have ignored you at the first rant.

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  24. Amy, I have to agree with you in many respects. Doubt this young lady had any parenting at all. But I'd extend the issue beyond her particular parents and extend it to the culture that she comes from.

    She is from a culture that considers unwed teen pregnancy, and fatherless homes to be the norm. Amongst the people she "hangs with" personal gratification is more important than personal responsibility, and in the view of this social class of people, it is the Government's (thus society's) responsibility to care for them and their progeny. I'm making a class statement here, not a racial one.

    I applaud you for working with people to try and help, but I would ask if those who were successful did not first need to show a desire for help? A desire to better themselves? A desire to improve their lot in life?

    I see people like this young lady every day. She has no desire or ambition and that is heartbreaking. Through many years of contact with all ages of this type of individual, I have become convinced that we do them no favors by giving them things for free. There is NO appreciation, only an expectation for more.

    I'm not lecturing at you, but making a broader point here based on your comments.

    As you know through your own experiences, the path to a better life isn't through social programs that give and give in perpetuity. I believe it's through social programs that help where needed, but teach and expect responsibility.

    Sadly, I can't see that ever happening because politicians see that they can buy votes amongst the poor by promises and amongst the guilty by promising to help the poor.

    A "standard of living" supplied by the Federal Government sucks, and far too many people chose this route, and then demand more. Like idiots, our society seems to want to give more as if at some point we will have given enough and the problem will cease.

    Those who point out the fact that as the Government has thrown more and more money into giving people a free ride (and an abysmal ride it is), the worse the problem has become are labelled as "cruel and heartless".

    The only solution the Government can come up with is to throw more money at the problems. This hasn't worked yet, and it never will. Anyone who believes it will needs to come and meet a few of these folks face to face.

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  25. Who you callin old 9-11???
    I can quote "Napoleon Dynamite" too...

    "Do the Chickens have sharp talons"

    OK maybe I am getting old..

    Frank

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  26. She doesn't have three kids. She has three sex trophies...

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  27. Oooh, I see your type now. I should have ignored you at the first rant.


    Exactly.

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