2. COUNSELING AND INFORMED CONSENT

^{Updated June 2020 by Razel Remen, MD and Nina Pine, MSc}

This chapter will provide guidance for patient-centered counseling and care, using a reproductive justice framework.  It will include issues related to identifying and addressing bias, and the use of patient-centered counseling to uphold patients’ autonomy in choosing abortion, parenting, or adoption when faced with a pregnancy. The chapter will also touch upon care of patients across the gender spectrum and provide exam, counseling, and procedure techniques that respect and support patients who have experienced reproductive coercion, or sexual trauma.

CHAPTER LEARNING OBJECTIVES

Following completion of this chapter, you should be able to:

• Give patients pregnancy test results in a non-judgmental manner
• Describe the full range of pregnancy options
• Support patients to choose options consistent with their needs, values, and preferences
• Address issues related to indecision, as needed, and help ensure that patients’ decisions are informed, voluntary, and free of coercion
• Provide information to compare medication and aspiration abortion
• Use language that is mindful, sensitive and unassuming – which supports patients through the reaffirmation of their choices during counseling and/or procedures

RESOURCES:

• Perrucci, A. “Your Patient Has the Answer” (https://providers.bedsider.org/articles/your-patient-has-the-answer)
• Perrucci A. Decision Assessment and Counseling in Abortion Care: Philosophy and Practice. Lanham, Maryland: Rowman and Littlefield, 2012.
• The Doula Project. DIY Doula: Self-Care for Before, During, and After your Abortion.
• Reproductive Health Access Project. Sam’s Medication Abortion
• Options Counseling Resources:
  • Ferre Institute Pregnancy Options Workbook
  • All-Options’ Pregnancy Options Workshop
  • RHAP Pregnancy Options Counseling Model
• Paul et al (eds). Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care (Wiley-Blackwell, 2009)
  • Chapter 5: Informed Consent, Counseling, and Patient Preparation
  • Chapter 16: Answering Questions About Long-Term Outcomes

VIDEOS