the care usual for adult populations is supported for pregnant
adolescents at this time. (II-2A)
12. Practitioners should consult gestational diabetes mellitus (GDM)
guidelines. In theory, testing all patients is appropriate, although
rates of GDM are generally lower in adolescent populations.
Practitioners should be aware, however, that certain ethnic groups
including Aboriginal populations are at high risk of GDM. (II-2A)
13. An ultrasound anatomical assessment at 16 to 20 weeks
is recommended because of increased rates of congenital
anomalies in this population. (II-2A)
14. As in other populations at risk of intrauterine growth restriction
(IUGR) and low birth weight, an ultrasound to assess fetal wellbeing
and estimated fetal weight at 32 to 34 weeks gestational
age is suggested to screen for IUGR. (III-A)
15. Visits in the second or third trimester should be more frequent to
address the increased risk of preterm labour and preterm birth
and to assess fetal well-being. All caregivers should be aware of
the signs and symptoms of preterm labour and should educate
their patients to recognize them. (III-A)
16. It should be recognized that adolescents have improved vaginal
delivery rates and a concomitantly lower Caesarean section
rate than their adult counterparts. (II-2A) As with antenatal care,
peripartum care in hospital should be multidisciplinary, involving
social care, support for breastfeeding and lactation, and the
involvement of children’s aid services when warranted. (III-B)
17. Postpartum care should include a focus on contraceptive
methods, especially long-acting reversible contraception
methods, as a means to decrease the high rates of repeat
pregnancy in this population; discussion of contraception should
begin before delivery. (III-A)
18. Breastfeeding should be recommended and sufficient support
given to this population at high risk for discontinuation. (II-2A)
19. Postpartum care programs should be available to support
adolescent parents and their children, to improve the mothers’
knowledge of parenting, to increase breastfeeding rates, to screen
for and manage postpartum depression, to increase birth intervals,
and to decrease repeated unintended pregnancy rates. (III-B)