Adolescent perceptions of adoption. Implications for resolving an unplanned pregnancy

This research examines the attitudes and perceptions that adolescents have of adoption. Of particular interest is how these attitudes might help to explain the decline in the choice of the adoption alternative as a way of resolving an unplanned pregnancy. Although participants appear to have generally favorable attitudes toward adoption, there were high levels of uncertainty about how parents and friends would feel about adoption. In relation to other pregnancy resolution alternatives, adoption is the least discussed option. Finally, many were uncertain about how to go about adoption and there were perceptions that making an adoption plan was complicated and of questionable legality.

Management strategies for promoting successful breastfeeding

Clinicians can promote a successful breastfeeding experience by providing support, anticipatory guidance and practical information. This article presents the components of early follow-up and guidelines for assessment. Management strategies for common problems are discussed, such as nipple soreness, cracked nipples, plugged ducts and mastitis, insufficient infant weight gain, perceived inadequacy of milk supply, breast-milk jaundice, sexual adjustment and failure at breastfeeding. Breastfeeding guidelines for employed mothers and adoptive mothers are indicated.

Health screening of international adoptees. Evaluation of a hospital based clinic

OBJECTIVE

To report the findings of health screening of 100 international adoptees.

DESIGN

Retrospective case review.

SETTING AND PATIENTS

The first 100 children to attend the Outpatient Inter-Country Adoption Clinic at the Royal Children's Hospital, Melbourne.

INTERVENTIONS

A medical history was taken and a thorough physical examination and series of screening investigations were performed on all children.

RESULTS

The children ranged in age from two months to 16 years (median, five months; mean, 2.8 years). The countries most represented were Korea, with 36 children, and India, with 21. Thirty children fell below the third Australian centile for both height and weight. Abnormalities on physical examination included hepatosplenomegaly (13 children), scabies (six) and severe dental caries (six). Parasitic infestation of the stools was found in 23 children, a positive Mantoux test result in nine (three had active tuberculosis), anaemia in 12, elevated hepatic transaminase levels in nine and positive hepatitis B surface antigen and e antigen in two. One child had acquired syphilis. Screening for human immunodeficiency virus antibody gave negative results in all children.

CONCLUSION

International adoptees constitute a special paediatric subgroup requiring assessment and screening investigations as soon as possible after arrival in their adoptive country.

The politics of reproduction in Ceausescu's Romania: a case study in political culture

The author analyzes "the politics of reproduction in Romania...[in order] to comprehend better the...legacy of the Ceausescu era.... This study also enables us to focus on the social implications and human costs of restrictive reproductive legislation and policies, especially as they impact on the lives of women and children.... In this report, I will explore the relationship between official rhetoric, policy, and everyday practice through an analysis of the politics of reproduction during Ceausescu's reign. I will discuss Ceausescu's pronatalist policies, and comment on the human dramas born of them: illegal abortion, child abandonment, infant AIDS, and international adoption."

Does family interaction prevent adolescent pregnancy?

This study uses data from the 1982 National Survey of Family Growth to ascertain whether family interaction can avert adolescent sexual activity, pregnancy, childbearing and parenthood. The results obtained from using logistic regression procedures indicate that the family may be effective in increasing adolescents' use of contraceptives and selection of abortion or adoption as alternatives to parenthood. Family interaction, however, was not associated with forestalling adolescent sexual activity or with providing for the well-being of the adolescent and her child and it is unlikely that a policy based solely on family interaction will be effective. Characteristics associated with effectiveness in preventing adolescent pregnancy included race, religion, residence, mother's education, the adolescent's age and family income.

Pregnancy testing and counseling

Pregnancy testing and counseling are increasingly accepted as necessary services for adolescents within the primary care setting. For teenagers in need of a pregnancy test, the easy-to-perform, highly sensitive and specific enzyme immunoassay analysis for measuring beta-human chorionic gonadotropin (beta-HCG) is ideal. However, no single beta-HCG analysis should be taken as absolute evidence for the presence or absence of pregnancy. Instead, an integrated approach using all of the health care professional's skills in adolescent health care should be taken. In some cases a careful history and physical examination will confirm the pregnancy. At other times serial quantitative serum HCG titers, pelvic ultrasonography, and culdocentesis may be necessary to rule out the possibility of ectopic pregnancy or threatened abortion. For more than three quarters of pregnant adolescents the pregnancy is unplanned and may represent a major conflict for themselves, their partner, and their families. When such an event occurs the health care professional will frequently be sought as a resource. Successful pregnancy counseling has many components. The adolescent will need to visualize the counselor as an available, sensitive, nonjudgmental individual who believes in the right of the pregnant teenager ultimately to progress to her own decision. The counseling process should be firmly based on an understanding of adolescent psychosocial and biologic development, crises intervention techniques, and family dynamics. The counselor needs to be a reliable information source. If the adolescent decides to go to term, programs offering comprehensive prenatal services to teenagers should be identified. Information concerning high-quality, low-cost abortion services also will need to be available for those who wish to terminate. It is important to monitor the quality of care given in prenatal and abortion service referrals. Few adolescents currently choose to place their babies for adoption. Counseling in this area is especially needed. Several types of adoption procedures are available and at appropriate times during a teenager's neonatal care adoption should be presented as a reasonable alternative to parenthood. Throughout this process, the health care professional will have opportunities to discuss a wide variety of health related topics with the adolescent and often her partner and their respective families. Ideally, whatever her final decision, it is the goal of the counselor to make the experience a positive and maturing influence on her life and the lives of other persons involved.