Individualized, evidence-based counseling for abortion

There is little scientific evidence about best practices in patient education and counseling related to abortion care. Yet many recently enacted state laws mandate specific counseling and education practices for abortion patients. A new study from UCSF Bixby Center researchers sheds light on the counseling practices and patient needs at one U.S. clinic providing abortion care. The study used data drawn from patient medical records and a counseling needs assessment form, which patients complete when they arrive at the clinic.

The study found that nearly nine out of ten women seeking abortion care had high confidence in their decision to terminate the pregnancy. Nearly all patients in the study had told someone about their decision, and the large majority of people they had told were supportive of the decision—whether it was a male partner, mother, or friend. Taking into account women’s demographics, social support, and decision-making characteristics, women were less likely to feel highly confident of their decision if they were under 20 years old, had not completed high school, were Black, had a history of depression, or had spiritual concerns about abortion.

The study concludes women’s attitudes and decisions about abortion are complex and require “individualized approaches to patient education and counseling.” Patient-centered care in the context of abortion can be a challenge due to constantly changing laws and mandated counseling that is not based on evidence. Future research should address how different counseling approaches affect women’s well-being following an abortion so that all health care providers offering this basic service can meet their patient’s needs.