M., 15 years of age, is 6 months pregnant. She states that she does not know “for sure” who the father is. She comes to your clinic for her first prenatal visit. She says that she never uses condoms and has had two previous abortions. She acknowledges that she drinks alcohol (“only a few beers a day”) and “smokes weed once in a while.” Her weight is well below that expected for her height. She has a constant, hacking, and productive cough. She smokes two packs of cigarettes and drinks four to five cups of coffee each day. She has recently been living at the Salvation Army shelter in their “
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