Sierra is an 18-year-old teen and the mother of a 1-year-old son. She has been in the foster care system for several years. Her parents were unable to maintain a functional family due to drugs and violence. Though she is in contact with her mother, her mother is not able to provide her with any emotional or financial support. This is not an unfamiliar scenario in an obstetrical and gynecological practice that provides care for teens. Medically, Sierra's care has been rather unremarkable. Her prenatal, childbirth, and postpar-tum experiences were without any untoward events. She has come consistently for gynecological care. Today's visit is for an IUD placement because she has sometimes forgotten her birth control pills and she does not want another pregnancy.
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