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A Cry For Help

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When a teenage girl walks out of a health clinic with a negative pregnancy test, there's a good chance she'll be back. A new national study by Johns Hopkins University researchers found that one out of four girls who become pregnant by age 17 has had an earlier negative test result at a clinic.

At a time when targeting pregnancy-prevention efforts to the young women who need them most has become crucial as well as problematic, the findings suggest some prime candidates. For some teenage girls, a pregnancy test at a clinic may be "a cry for help," the authors say. If girls receive counseling at the time of their first pregnancy tests, some pregnancies later on might be avoided.

The researchers studied about 2,800 girls ages 17 or younger who sought pregnancy tests at 52 clinics in cities around the country between 1992 and 1994. The results were published in the Jan. 10 Journal of the American Medical Association.

In questioning the girls, the researchers found that almost one-third of those who had become pregnant had had at least one negative pregnancy test before they had a positive one. And for one-fourth of the girls, that negative test was at a clinic where they could have been reached by organized pregnancy-prevention programs.

Why so many negative test results? Irregular menstrual cycles among teenagers prompted many to seek out the test, the article says. Such a common symptom "may provide a valuable opportunity to intervene" with many young women, the authors write. Some teenagers in the study acknowledged they had little reason to believe they were pregnant but appeared at a clinic for a test anyway. "One can speculate that the visit may be a cry for help," the authors write.

Pam Johnson, director of client services at Planned Parenthood of Southeast Michigan, agrees. Often, she says, the first time a girl visits a clinic for gynecological services it is for a pregnancy test or a pregnancy. "For those who get a negative test," she argues, "it's imperative that some contraceptive-option counseling happen right then and there. Because once they're out the door and feeling very lucky, they will tend then to continue with risky behavior, and we'll see them again in six months for another test. And they may not be so fortunate."

--Millicent Lawton

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