Counseling regarding pregnancy termination
- Uta Landy, PhD
Uta Landy, PhD
- National Director
- Ryan Residency Training Program
- Fellowship in Family Planning
- University of California, San Francisco
- Philip D Darney, MD, MSc
Philip D Darney, MD, MSc
- University of California, San Francisco
In the United States in 2011, approximately 1 million pregnancies were terminated . Approximately half of all pregnancies were unintended and 40 percent of these were terminated, meaning that 21 percent of all pregnancies were aborted. The number of induced abortions declined by 13 percent between 2008 and 2011, but the number of terminations of intended pregnancies has increased due to advances in prenatal testing for fetal abnormalities [1-3]. Women require appropriate counseling before and after pregnancy termination. It is important to note that the psychological context of pregnancy termination varies depending upon whether the reason is an unwanted pregnancy, multiple gestation, or fetal anomalies.
Counseling of women regarding pregnancy termination is reviewed here. Psychiatric illness associated with pregnancy termination and other issues regarding pregnancy termination are discussed separately. (See "Psychiatric aspects of pregnancy termination" and "Overview of pregnancy termination".)
Counseling before pregnancy termination includes education about the nature and purpose of the procedure, alternatives, and possible complications and ascertains that the patient is making the decision voluntarily. It also provides emotional support and helps identify those who require additional emotional support. Few patients are likely to fall into this latter category. Several approaches to counseling and resources for clinicians are available [4,5].
Some states in the United States have legal requirements regarding giving patients information about potential adverse emotional consequences of abortion. Clinicians should consult with their professional organization and local government authority about these requirements.
Source of counseling — Some women who consider pregnancy termination present directly to abortion clinics, while others seek the advice of their primary care clinician, gynecologist, midwife, or other clinicians, and are then referred to an abortion provider or clinic.
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