SUMMARY POINTS

SKILLS

  • It is valuable to identify and understand the life experiences that have affected your opinions in order to promote a non-judgmental climate for patient care.
  • Patient-centered counseling uses a non-directive approach with active listening, open-ended questions, and accurate information about pregnancy options.
  • An understanding of abortion prevalence, safety, restrictions, and access is essential to understanding patients’ needs and providing high quality care.

SAFETY

  • Abortion is safe, and removing legal restrictions is associated with significant reductions in maternal morbidity and mortality globally. In fact, the only factors decreasing abortion safety are those decreasing access (NASEM 2018, Upadhyay 2015, White 2015).
  • Nearly half of all abortions worldwide are unsafe, and nearly all unsafe abortions (98%) occur in developing countries (Singh 2018, Sedgh 2016).
  • Patients who receive an abortion are not at risk for mental health problems, and are at no higher risk of PTSD than patients denied an abortion (Biggs 2016, Cohen 2013).
  • While self-managed abortion is not new, medication abortion has changed how we think about it, by offering methods proven to be safe and effective (Jones 2017).

ROLE

  • Abortion is among the most common procedures performed among women. One in 4 U.S. women will have an abortion in their lifetime. One in 4 pregnancies end in abortion globally (Jones 2017).
  • Given how common unintended pregnancy, abortion, and early pregnancy loss are, most primary health care providers will treat patients experiencing these issues.
  • Restrictive laws and regulations create harmful obstacles to care, increase the gestational age at which patients obtain abortions, and increase disparity in access.
  • Reproductive health access and training are limited by hospital mergers, religious restrictions at training sites, stigma, and lack of transparency for patients and trainees (Uttley 2013, Stulberg 2010). 
  • Abortion is provided by physicians and advanced practice clinicians, with similar safety, effectiveness, and patient acceptability in locations where abortion care is not restricted to physicians (NASEM 2018, Sjöström 2017, Barnard 2015).
  • If you do not provide abortion services directly, it is important to know how to refer patients and handle follow-up issues within the context of your practice setting.

License

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