A 31-year-old nulligravida with a body mass index (BMI) of 42 kg/m2 is referred by her primary care provider to your high-risk obstetrics clinic for preconception counseling. Prior to the consultation, you highlight to your obstetric trainee that motivational interviewing with nonstigmatizing terminology avoids negative influences on mood and self-esteem, promoting patient uptake of weight management strategies and a healthy lifestyle.

A 30-year-old primigravida with schizophrenia is referred by her primary care provider to your high-risk obstetrics unit at a tertiary center. Her mental illness is controlled by clozapine, and she takes routine prenatal vitamins. The patient is at 12+2 weeks’ gestation by dating sonography; first-trimester fetal anatomy was normal with a low risk of aneuploidy. Results of routine prenatal investigations are unremarkable. The patient does not have any obstetric complaints.

A 16-year-old primigravida at 16+5 weeks’ gestation, confirmed two days earlier by dating sonography, is sent by her school nurse to your tertiary center’s teen-pregnancy clinic. She presents accompanied by her mother, whom she prefers to be present during your encounter. Early fetal anatomy appeared normal without sonographic markers suggestive of aneuploidy. Urine pregnancy testing was initiated by her school nurse, who was concerned when the patient recently complained of increasing bloating and nausea over the past two months. The nurse assures you she had addressed the possibility of pregnancy with the teenager prior to urine testing.