Primary care providers fall short on pregnancy options counseling

One in three pregnant women have seen their family physician in the past year. At the same time, nearly half of all pregnancies in the US are unintended. Family physicians are therefore a critical source of information for women considering their pregnancy options. A recent survey of primary care physicians (PCPs) found that while most believe their colleagues should counsel women on all options for unintended pregnancy, they often fail to do so in their own practices.

Provider and patient
The gold standard for pregnancy options counseling entails providing newly diagnosed women non-directive, evidence-based information about all options for continuing or terminating their pregnancy, and referrals as necessary. In reality, only 26 percent of the PCPs surveyed routinely provide options counseling to women with unintended pregnancy. In contrast, 60 percent routinely discuss prenatal care with those same women.

Among PCPs who see women seeking abortions but do not provide the service, 62 percent routinely make referrals while 14 percent routinely attempt to dissuade women. The most common reason given for not providing referrals is having a personal objection to abortion.

Failing to receive timely and appropriate referrals or counseling can constrain, complicate or raise the costs of women’s choices. As a result, more must be done to ensure PCPs provide sufficient counseling and referrals to women with unintended pregnancy. The study authors suggest placing more emphasis on professional obligations during medical education, working with professional societies to draft and disseminate counseling guidelines, and targeting providers most likely to provide deficient counseling with training.