Quality counseling leads to better psychological outcomes for second-trimester abortion for pregnancy complications

Facing an unexpected diagnosis of a fetal anomaly in the second trimester of a wanted pregnancy can be devastating. Providers should have detailed discussions with patients, rooted in their values and needs, to determine how to move forward. Shared decision making incorporates these self-identified values and puts the patient at the center.

New research from UCSF and Yale University looks at the relationship between the quality of counseling and the anxiety, grief and post-traumatic stress women felt after having an abortion in the second trimester because of complications in a wanted pregnancy.

The study found that when the provider involved the woman in decision making, she was more likely to feel satisfied with her decision. Women who had shared decision making and those who felt satisfied with their decision showed less grief and post-traumatic stress. Researchers did not find any links with women’s levels of anxiety.

This builds on previous research showing that this type of high-quality counseling can lead to improved satisfaction and clinical outcomes. The counseling quality may be especially important given the range of emotions that can come with abortion and diagnosis of fetal anomalies when the patient planned to carry the pregnancy to term. Providers should strive to improve the quality of counseling for patients seeking abortion for fetal anomalies or complications to make sure they have the best possible psychological recovery.

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