Patient Education and Emotional Support Practices in Abortion Care Facilities in the United States

  • Heather Gould
    Correspondence
    Correspondence to: Heather Gould, MPH, 1330 Broadway, Ste. 1100, Oakland, CA 94612. Phone: (510) 986-8990.
    Affiliations
    Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California
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  • Alissa Perrucci
    Affiliations
    Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California
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  • Rana Barar
    Affiliations
    Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California
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  • Danielle Sinkford
    Affiliations
    Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California
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  • Diana Greene Foster
    Affiliations
    Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California
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      Abstract

      Purpose

      Little is known about how patient education and emotional support is provided at abortion facilities. This pilot study documents 27 facilities' practices in this aspect of abortion care.

      Methods

      We conducted confidential telephone interviews with staff from 27 abortion facilities about their practices.

      Main Findings

      The majority of facilities reported they rely primarily on trained nonclinician staff to educate patients and provide emotional support. As part of their informed consent and counseling processes, facilities reported that staff always provide patients with information about the procedure (96%), assess the certainty of their abortion decisions (92%), assess their feelings and provide emotional support (74%), and provide contraceptive health education (92%). Time spent providing these components of care varied across facilities and patients. When describing their facility's care philosophy, many respondents expressed support for “patient-centered,” “supportive,” “nonjudgmental” care. Eighty-two percent agreed that it is the facility's role to provide counseling for emotional issues related to abortion.

      Conclusions

      All facilities valued informed consent, patient education, and emotional support. Although the majority of facilities considered counseling for emotional issues to be a part of their role, some did not. Future research should examine patients' preferences regarding abortion care and counseling and how different approaches to care affect women's emotional well-being after having an abortion.

      Practice Implications

      This information is important in light of current, widespread legislative efforts that aim to regulate abortion counseling, which are being proposed without an understanding of patient needs or facility practices.
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      Biography

      Heather Gould, MPH, is a senior research analyst with the Advancing New Standards in Reproductive Health (ANSIRH) Program at the Bixby Center for Global Reproductive Health at the University of California, San Francisco (UCSF).

      Biography

      Alissa Perrucci, PhD, MPH, is a clinical psychologist and counseling and administrative manager at the Women's Options Center at San Francisco General Hospital and author of the book Decision Assessment and Counseling in Abortion Care: Philosophy and Practice.

      Biography

      Rana Barar, MPH, is project director and Danielle Sinkford is a research associate for the Turnaway Study at ANSIRH.

      Biography

      Diana Greene Foster, PhD, a demographer, is the principal investigator of the Turnaway Study, Director of Research at ANSIRH, and an associate professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at UCSF.