Case scenario

Shona, an Aboriginal girl who had just turned 13 years old, was brought in to see me by her aunt who said that the family had decided that Shona needed reliable contraception. Shona was already sexually active (consensually) and had recently run away from home for a few days with her 16-year-old boyfriend, who was in and out of remand centres. Shona was reluctant to talk about the issue, but giggled at questions about condoms and said that she would not use them. She was similarly rejecting of the aunt’s suggestion of injectable or implanted progestogen. She appeared to me to be unrealistic about contraceptive use and to behave and understand consequences only at about the level you would expect from an average 8-year-old. Shona’s mother was unable to be contacted, and her father had vanished years before.