Abortion counseling

Abortion counseling has 3 purposes: 1) to aid the applicant in making a decision about the unwanted pregnancy, 2) to help her implement the decision, and 3) to assist her in controlling her future fertility. To accomplish the 1st objective, the compulsory use of psychiatrists to prove emotional disorders has been unsatisfactory. Counseling needs to be supportive and nonjudgmental regardless of circumstances. Hostile feelings of the counselor must be suppressed. The applicant should be informed regarding the physical and emotional aspects of the abortion procedure. Also, good counseling should aim at future prevention by determining the reasons for failure that caused the unwanted pregnancy. Of importance in selecting abortion counselors are qualities described as personality traits. These include empathy, nonpossessive warmth, and genuineness. Also, maturity and flexibility are needed in allowing the woman to make the decision, particularly in cases of ambivalence and uncertainty. A program in New York City has used women counselors who themselves have had abortions. This experience alone is not sufficient, but may be significant. The counselor needs basic knowledge of sexual physiology, psychology, and contraceptive technology. Also, the counselor should be able to recognize prodromal psychiatric signs of an imminent crisis, and be able to initiate steps of prevention. Training programs vary widely. Flexibility is needed. Experience in counseling couples is important. Assistance by an experienced counselor is helpful on a continuing basis, particularly for the new counselor. Group sessions and didactic presentations are needed. To obtain acceptance of postabortal contraception may pose special problems. A history of previous psychiatric disturbance may require referral to a trained consultant. Strong religious or ethical feelings modify attitudes. The woman must not feel coerced. She should be able to integrate the experience in such a way as to prevent a recurrence.