Pregnancy Testing and Results

Individuals present to a health care facility for urine pregnancy testing for many reasons, some of which are listed below:

• Some will have already taken home tests and are seeking confirmation of negative or positive results.
• For others, it may be the first evaluation for pregnancy after a missed menstrual period or with symptoms of early pregnancy, such as breast tenderness or nausea.
• Pre-procedural pregnancy tests may be done before procedures such as IUD placement or uterine or endometrial biopsies to prevent the pregnancy from inadvertent impacts caused by cervical or uterine manipulation.

In general, a history and physical exam are not required for patients who present for pregnancy testing. However, collecting a brief, focused history, including the first day of the last menstrual period (LMP), use of a contraceptive method, date(s) of unprotected penis-in-vagina sex or family-building attempts via MAR, and a brief review of systems, can be useful in the diagnosis and in assessing gestational duration, patient decision making, and clinical management, including the need for further care.

Pregnancy test results should be presented in a neutral tone that is simple and straightforward, for example: "Your pregnancy test today is positive. This means that you are pregnant." When conveying the test result, allow time for the person to reflect on the result and to ask any questions they may have. Exhibit 12 outlines detailed steps to provide person-centered delivery of prenancy test results.

All patients should be provided or referred for any additional health care needs, including STI screening; fertility/ infertility assessment; prenatal, abortion, or adoption care; and related social services, such as housing or nutritional support. Many of these additional services can be offered to the patient at the facility where the pregnancy test was performed to facilitate continuity of care.