Supporting patients to choose appropriate contraception

Leanna is a 17 year old young woman who attends clinic to discuss contraception. She lives with her mother and siblings in a flat and is taking a further education course in childcare; she attends college regularly.

Leanna has been with her partner who is 18 years old for one year. She appears very concerned that she might be pregnant as, although she is on the combined oral contraceptive pill, she keeps forgetting to take it. She complains that she has been feeling very 'moody' since she has been taking the pill and has had some breakthrough bleeding.

A full history is taken from Leanna. This incorporates medical, family, sexual, obstetric and menstrual history as well as a discussion of other health issues such as smoking, drinking alcohol and drug taking.