Author Affiliation: Dr Grimes is Clinical Professor, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill.
Clinical Crossroads at Beth Israel Deaconess Medical
Center is produced and edited by Thomas L. Delbanco, MD, Jennifer Daley,
MD, and Richard A. Parker, MD; Erin E. Hartman, MS, is managing editor. Clinical
Crossroads section editor: Margaret A. Winker, MD, Deputy Editor, JAMA.
DR Daley: Ms B is a 26-year-old student and
part-time worker seeking to terminate a pregnancy. She lives near Boston with
her parents. Her health insurance is through public assistance in Massachusetts.
She receives her primary care from Dr K, a house officer at Beth Israel Deaconess
The patient is a primigravida who has been sexually active in a monogamous
relationship for the past 6 years. After she and her partner received counseling
about the use and efficacy of various forms of contraception, they chose to
use the rhythm method. Her last menstrual period was March 24, 1999. On May
6, she sought medical attention after her period was late and a home pregnancy
test result was positive. She noted breast tenderness and generalized fatigue.
Grimes DA. A 26-Year-Old Woman Seeking an Abortion. JAMA. 1999;282(12):1169-1175. doi:10.1001/jama.282.12.1169