Abstract

PIP: Focus in this discussion of abortion counseling is on: the purpose of counseling -- informed consent, decision making, patient education and preparation, emotional support; the underlying assumptions of counseling; who provides the counseling; and issues in abortion counseling. It is essential to establish that the woman consents to the abortion with a full understanding of her choices and the medical risks. Unless a woman is retarded, emotionally severely disturbed, or very young, there usually is little question about her competence to provide informed consent. The abortion counselor must be capable of distinguishing between "normal" feelings of ambivalence and genuine confusion. Once the woman has decided to have an abortion, the counselor needs to describe the method of abortion, explaining instruments, logistics, choice of anesthesia, and the types of sensations and reactions she can expect during and after the abortion. The use of simple, nonmedical language is preferable. Emotional support can be provided by establishing rapport with the patient, being empathetic, listening actively, giving permission to express feelings, and being nonjudgmental. Some major themes which consistently appear in counseling sessions are conflicts with the partner; guilt; ambivalence; anger; fear of pain, the medical procedure, and future childbearing; and concern about suitable birth control. Education and discussion can help to alleviate fears. answer contraceptive concerns, and ease decision making. The profession of abortion counselor was created in the US after the legalization of abortion. The counselor, usually a woman, may have a background or training in social work, psychology, sociology, counseling, or nursing. Counselors are trained at the abortion facility and may on occasion attend training seminars. Common areas of concern for the abortion counselor include the setting of counseling, the length of counseling, counselor stress, professional burnout, 2nd trimester counseling, and coping with special patients. The remainder of the discussion covers 2nd trimester abortion counseling and those patients who can present special problems for the counselor.