Ask open-ended questions “What questions do you have for me?”
“What can I do that is most helpful for you?”
Clarify the facts “Knowing how far along you are will let you know how much time you have to decide.”
Reflect/Normalize “You seem…”
“It is okay to cry here.”
“Many people feel confused/scared/ambivalent…”
Seek to understand “Can you say more about that?”
Validate; don’t fix “That sounds really challenging.
I’m sorry you’re going through that.”
Frame the situation “It sounds like you are being thoughtful and making the best possible decision for your current life circumstances…”
“Deciding what’s best for you can be hard – but that doesn’t make it wrong.”
Reassure the patient Encourage them to trust and respect their feelings and their decisions.
Check in about support people “It may be helpful to tell someone you trust and who will support your decision, no matter what it is. Do you have someone like that to talk to?” If not, “What might happen if your partner/family/friend found out about the abortion?”
Communicate acceptance with tone and body language Be mindful of your tone and facial expression. Use eye contact (if culturally appropriate). Sit at their level.
Use silence Give them time to finish their sentences and thoughts.
Give the patient control “Which would you prefer?”
Keep your patient informed about the next steps
Address Common Fears
Spiritual conflict
Impact on health
“Can you tell me more about your beliefs? Your fears or worries?”
Review options for pain control and relaxation.
Review safety and lack of impact on fertility, mental health and overall health.
Consider language and literacy level Approach counseling using culturally appropriate language and exercises based on literacy level. Always use a trained medical interpreter when available.
False reassurances “This won’t hurt.”
Instead, prepare them for some discomfort and reassure them that the procedure is fast and anesthesia will be individualized to their comfort.
Over-identification “I know exactly how you feel.”
Medical or stigmatizing jargon “Elective abortion” implies a chosen vs. indicated procedure. Instead, use “abortion” or “induced abortion.”
Try to mirror a patient’s terminology regarding an abortion.
Loaded statements “Your family supports your decision, right?”


EARLY ABORTION TRAINING CURRICULUM Copyright © 2020 by UCSF Bixby Center for Global Reproductive Health. All Rights Reserved.