1. Crisis Pregnancy Unwanted Pregnancy
My Options Helpline Ph

2. 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.

3. 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

4. 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.

5. 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

6. 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

7. 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

8. 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

9. 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.