As an only child, Natalie was born in Ciudad Juarez, the most populous city in the Mexican state of Chihuahua, to a housekeeper and cook. Since birth, both Natalie’s parents sacrificed to create a better life for their daughter but often worked late hours, leaving younger Natalie in the hands of scrupulous family members.

At the age of 13, Natalie’s parents saw changes in her behaviors and appearance but were uncomfortable discussing sexually related topics with her. To her parents, Natalie needed a different life, one that was outside of Cuidad Juarez, known for being the most dangerous city in Mexico.

Two months before her 14th birthday, her parents and maternal grandmother attempted to surprise her with a visa into the United States of America but was unsuccessful. As a result, Natalie’s parents made an unconventional choice to safeguard her from trafficking, but once she arrived in the United States, Natalie became more defiant. She missed Ciudad Juarez so much that she socially isolated herself at El Paso High School until she met James.


On October 20, 2022, a 15-year-old sophomore at El Paso High School, Natalie Pena, walked into the girl’s restroom thinking she had escaped detention. Beside her were two other students on academic probation: one was a transgender female punished for being bullied, and the other, Alexa, was a cis-female in need of a sanitary napkin. Rummaging her backpack to find one, Natalie realizes she had missed her menstrual cycle months earlier, instantly questioning pregnancy.

In shock, she turns her head back to Alexa and reveals what happened at the party. They rushed to a nearby Dollar Tree and purchased two tests. Nervous but strengthened by her friend’s company, Natalie went into the store’s restroom, opened the tests, and followed the instructions. Both tests came out positive immediately; Natalie felt shaken. She opened the bathroom door and invited her friend inside. “What am I going to do?” Natalie asked Alexa, eyes brimming with tears.

The only adult she could turn to is her school’s social worker, Mr. Roberts. When she first approached him about her pregnancy, Natalie wanted support in telling her Catholic grandparents. But little did Nathalie know Mr. Roberts also faced an equally challenging dilemma when working with a pregnant minor, indecisive about reproductive options. She eventually calls James, but his response was not what she expected.

Learning Objectives

By the end of this case, students will be able to:

  • Identify the role of a social worker in educating or working with youth on reproductive health issues.

  • Discuss the impact of adolescent relationships on reproductive health behavior.

  • Discuss the impact of legislation affecting reproductive health.


James is an only child born to American Caucasian parents devoted to Catholicism. His parents, also pro-life, strongly believes teenagers should abstain from sexual activity until marriage. But they already knew that was the case with their son. Because James was tone-deaf to anyone who refused to let him use contraception, all they could do was take a blind-eye to his promiscuous behavior. But unlike his parents, James’ maternal grandmother, who also resides in their El Paso home, was the only family member who lectured against his actions, and he would listen, at least until he met Natalie.

Mr. Roberts

A ten-year veteran in El Paso High School, Mr. Roberts, was born in Boston, Massachusett, in a conservative Christian home. His father, an Army officer, landed an assignment in El Paso, Texas, when Mr. Roberts was young. Shortly after, his sister was born with an intellectual disability. Growing up, Mr. Roberts was so often frustrated by how unaccommodating the public school system was he later decided to pursue social work to eliminate that bias of children with disabilities.

Conversation with James


Natalie is afraid. With each ring, she feels more anxious about how James will respond. James is known to throw tempers when he does not get his way. He answers, “Hello; “What do you want?” he adds.

(Natalie pauses)

“I’m pregnant,” that was all she could say at the moment. Her English is not good; communicating such a life-altering matter was not easy, and knowing she and James were not together, she had no one.

“What!” he exclaimed. James immediately accuses her of cheating and demands a paternity test. “That’s not mine,” he kept yelling, causing them more anguish.

“Then take a paternity test,” he resolves, unknowing those tests are not possible until after delivery. Unfamiliar with pregnancies, she agreed, not realizing she will need to obtain parental consent.

As Natalie tells James she cannot afford a paternity test on her own James convinces her to get an abortion, threatening her that if she did not find a facility to perform the abortion, he would find a way to do it himself.

Conversation with the Social Workers and Grandparents

Feeling like she had no one to talk to, Natalie met with Mr. Roberts, her high school social worker, about the pregnancy. Mr. Roberts listened attentively and asked Natalie if she would like help informing her grandparents about her pregnancy, then scheduled a meeting with her grandparents.

The following day, Natalie could not help but feel anxious about the meeting. She and Mr. Roberts waited patiently for her grandparents to arrive. When they arrived, Mr. Roberts introduced himself and explained the situation to her grandparents, and they were all burst out into tears as Natalie explained how sorry she was. The more Natalie weeps, the more grandparents sympathize with her.

As the family calmed down, her maternal grandmother embraced Natalie, while her grandfather called her parents. Natalie understood why they needed to call her parents, but she grew fearful of abandonment. Her grandparents respond that even though they are distraught, they are a family, will not leave her alone in this situation, and will support her in everything.

Conversation with the Social Worker, Grandparents, and Parents


(Add conversation in Spanish)

Although her parents expressed sadness and disappointment, they acknowledged that it would be difficult for Natalie to become a single teen parent.

Discussion Questions

Competency #1: Demonstrate Professional and Ethical Behaviors

1. What is the presenting issue? What is the secondary issue?

2. What is the ethical dilemma of the social worker and the client?

3. If you were Natalie, what would you do?

4. If you were Mr. Roberts, what would be your school-based intervention?

Competency #2: Engage Diversity and Difference in Practice

5. To what extent do Natalie’s cultural and personal values, including social, economic, cultural exclusions, oppress, marginalize, alienate, or even create privilege or power?

6. To what extent do Mr. Roberts cultural and personal values, including social, economic, cultural exclusions, oppress, marginalize, alienate, or even create privilege or power?

Competency #3: Advance Human Rights and Social, Economic, and Environmental Justice

7. To what extent are Natalie’s fundamental human rights (safety, privacy, an adequate standard of living, healthcare, or education) violated?

Competency #5: Policy Practice

8. Is there a local, state, or federal policy that addresses this issue? Do you support or in opposition of this policy, and why?