Initially you need to take a good history that includes gynaecological basics such as details of her cycle. You also need to consider the reasons behind her request. Before launching into a lecture about contraception, make sure you have elicited all her ideas, concerns and expectations.

Further questions would include: is she in a sexual relationship? If so what method of contraception, if any, is she using? Has she had any casual sexual relationships? Is she being put under unwelcome pressure to sleep with her boyfriend? After that you are in a strong position to move on to counselling her about her various options.

In medicine today there is a strong culture of ensuring that patients are fully informed about their decisions. Unfortunately in the areas of abortion and contraception this is generally not the case. Side effects of abortions, especially psychological, are glossed over, and there are many women who have no idea how their contraception works. It is our responsibility as Christian doctors to ensure that our patients can make fully informed choices about any medication they take or procedure they undergo. We should not use tactics of scaremongering, but we should speak the truth in love so that they understand the consequences of their chosen course of action. This has already been covered in detail by Nucleus [1] but here I have provided a quick summary of the mechanisms of action of the most common oral contraceptives (see box).[2]

Once you have explained the options clearly you may want to offer your patient the chance to ask questions or to go away and consider her options. More than likely a girl of her age will choose the COCP. You do need, however, to be prepared for her to choose the POP or another method that largely relies on preventing implantation. What will you do? Will you prescribe it?

I strongly believe that each human life begins at fertilisation. This is the point at which the DNA blueprint of a new individual is formed; all later milestones in development are far less significant. For me, therefore, prescriptions of the POP and emergency pill are out. When I've been asked for the POP I have taken the history and asked another doctor to issue the prescription. With the emergency 'contraceptive' I take a history and find out whether the treatment is indicated by the time in her cycle. If it is I explain gently why I don't feel able to prescribe it and then ask another doctor to see her. You may feel this is a lot of pratting about for the same ends (ie she still gets the pills) but the difference is that I can go home with a clear conscience, and the conversation may make the patient think further about her actions.

Finally, at some point you should look for the opportunity to share some of God's wisdom with your patient: 'Why not wait until you are sure that the person you are going to have sex with is committed to you long term?' Genesis 2:24 is God's plan for us and we would do well to remind others of it. The teenage pregnancy rate in the UK remains the highest in Europe but the government is only just realising that sex education is not the answer. In the USA schoolchildren are taught to wait until they are ready - it's cool to be a virgin. Challenge the status quo and prick some consciences on the way. In some cases it will open doors for further discussion about your faith.