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Crisis Pregnancy Unwanted Pregnancy
My Options Helpline Ph
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Pregnancy options A woman presenting with an unintended pregnancy has three options: 1. Continuing with the pregnancy with the intention to parent 2.Abortion, either medical or surgical 3.Continuing the pregnancy with the intention to place the child for adoption Note most women have already made up their mind by the time they seek care, and counselling rarely changes the outcome, but can be helpful to some Important that women should not rush their decision, but should be informed of the gestational age limit for abortion services.
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Decision-making support
No accepted standard for counselling or criteria that a woman must meet in order to be referred for abortion Consider the following: Provide opportunity to share circumstances of unplanned pregnancy Discuss pregnancy options if she is unsure. Non-directive guidance. Access to information. Confirm that decision is voluntary NB CAVE reproductive coercion. Try to speak with her alone (red dot etc) Address emotional needs and offer follow up Identify potential sources of positive support and possible need for additional counselling
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People who have unwanted pregnancy have higher rates of mental illness than the general population.
A review of 180- studies found that women who have an abortion do NOT have higher rates of mental illness than women who decide to carry their pregnancy to term.
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Risk factors for mental illness following abortion
Best predictor- positive history of mental illness prior to abortion Lack of social supports Perceived inability to cope Relationship difficulties
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Identify those who may benefit from additional support
Relationship issues when making the decision to have abortion Perceived need for secrecy Negative attitudes towards abortion generally Negative emotional reaction immediately after having termination
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ADDITIONAL SUPPORT MAY BE SOURCED FROM
HSE MYOPTIONS Helpline- phone or face-to-face counselling Mental Health Services Social supports- especially for this experiencing intimate partner violence, addiction issues, homelessness
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COUNSELLING BY GP Ensure woman has an opportunity for private discussion Remind women of confidentiality Listen, reflect back. Identify positive supports Reassure her that abortion is botH LEGAL AND SAFE
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AMBIVALANCE Common to experience simultaneous conflicting emotions.
Feeling ambivalent does not mean being ambivalent about the decision. Most women resolve ambivalence without assistance Active listening, reflect feelings back List of pros and cons, 1-10 scale on importance of factors. Abortion should be delayed if a woman is ambivalent about her decision.
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