Counselling is to ensure patients understand different options, the risks and benefits of each and make informed decisions. Counselling also helps prescribers understand patients’ preferences and circumstances to advise the best course of actions.
Key counselling points include[4,6]:
- Review pregnancy options when indicated: abortion, becoming a parent or child adoption.
- Tailor the counselling to the needs of the patient (such as counteracting abortion stigma and / or providing emotional support).
- Communicate the risk of advancing gestational age without putting time pressure on the patient.
- Use non-judgmental and inclusive language.
(If choosing abortion:)
- Review abortion options, including risks, efficacy, process and length of time of medication versus procedural abortion.
- Discuss the patient’s eligibility for medication abortion, including gestational age and medical history.
- Discuss the patient’s access to pharmacies, telephone, transportation, emergency care, and labs and imaging facilities if needed.
- Discuss the patient’s preferences and circumstances, such as a safe place in their living situation to complete medication abortion. Share decision tools such as It’s My Choice to help the patient choose the type of abortion that fits them.
- Confirm that the decision is the patient’s own, reached without coercion.
- Confirm the patient’s understanding that medication abortion is irreversible and that the patients must take an additional dose of the second medication or undergo procedural abortion in case of ongoing pregnancy.
- Review the timing of examinations (ultrasound, blood tests, if needed), medications and follow-up appointments.
- Discuss post-abortion contraception options
