Archive for April, 2017

Helping Your Patients Through Unplanned Pregnancy Emotions

Adoption is a sensitive subject and emotional experience. Certainly, the same can be said about unplanned pregnancy. When a woman first discovers she is pregnant, she experiences a rush of different, often competing, emotions – shock or disbelief, excitement or joy, disappointment or fear. Especially when a pregnancy is unplanned, these feelings can vary and be unpredictable.

As a clinical professional, you have likely helped patients through an unintended pregnancy before. If you have not encountered this situation, you should expect to down the road in your career. Today, nearly half of all pregnancies are unplanned. Among single women in their 20s, about 70 percent of pregnancies are unintended.

The common crisis of an unintended pregnancy can stir an array of challenging emotions for young women. Most often, the first reaction to surface is denial. If you have a patient facing an unplanned pregnancy now, you may have noticed that she is trying to avoid the situation. She may not want to talk about the news or know how to process it at the time. Denial is completely normal, and often occurs in patients who are not yet ready to face their situation or the emotions that it will bring.

As a clinician, you know firsthand that denial in patients can be particularly challenging. You want your patient to open up, to talk about her thoughts, and to make a sound decision regarding her pregnancy. Fortunately, there are things you can do to help her get through this stage. As a first step, set up a safe, supportive, and private environment for your patient. Remind her that your conversation is completely confidential. Give her space to reflect on her feelings and welcome her to work through them with you. By doing so, she can start to move past any hesitations and begin exploring her options.

A woman must feel safe and supported in order to let herself open up – not only to you, but also to herself. Opening up will allow her to feel any conflicting tensions, stresses, or other ambivalent feelings regarding her pregnancy. Ambivalence, experts say, is the key to making major life decisions.

Ambivalence means having mixed or contradictory feelings about something. For example, your patient may feel ambivalent because she wants to parent her child, but is not financially stable or ready to at this time. On the other hand, she may believe that terminating the pregnancy is the best option, but abortion has long-been against her beliefs or values. Your patient may also be considering adoption, but dreads the thought of never seeing her child again. These ambivalent feelings are a normal stage of the decision-making process, and are very important to work through together with your patient. As a clinician, it is your responsibility to ensure that your patients are educated and have time to think about their options reasonably.

Other ambivalent feelings your patient may experience when facing an unplanned pregnancy:

  • Confusion
  • Worry
  • Panic or anxiety
  • Anger or resentment
  • Embarrassment
  • Sadness or grief
  • Guilt
  • Eagerness
  • Love

It is okay for your patient to feel all of these unplanned pregnancy emotions, as she may be grieving a baby she is not yet ready to have or mourning a life she is letting go of for parenthood. Give her time to feel those emotions fully. Only then will she calm down and begin to think about her options. If she says she is ready to make a decision, be sure to ask her about the reasons behind her choice. Her decision should be informed, not made with anger or fear.

To better help you help your patients through this emotional journey, Adoptions With Love has compiled some additional tips for clinicians below.

  • Use active listening

When facing an unplanned pregnancy, most women will desire a compassionate and listening ear as they work through their many feelings. This sort of active listening will help ease any difficult emotions your patient may be feeling. It will also make your patient feel that she is being heard, no matter her age or background. Your patient will want to discuss life factors that may be influencing her decision. She may want to talk about the reality of her situation, her concerns or worries, and the potential outcomes of her options. Your patient is responsible for her own self-exploration. It is your responsibility to listen actively as your patient explores and assesses her options and to provide information and support where it is needed. This will empower your patient to make the right decision.

  • Remain positive

At this time, you may be your patient’s greatest support. Just as you are listening to her, she will be listening to you. She may be taking everything you say and do to heart. With that in mind, it is important that you maintain a positive tone and attitude as you help her through this emotional time. Use positive language as you talk about her options. For example, you may say “make an adoption plan” instead of “put up for adoption.”

  • If your patient chooses adoption, refer her to someone who will provide ongoing counseling and support

Like unplanned pregnancy, adoption is an emotional journey that often brings feelings of grief and loss.  If your patient chooses adoption, these feelings may not end upon the placement of her child. As a clinician, you should refer her to someone who will provide ongoing counseling and post-adoption support – an agency that will be there during her pregnancy and long after the adoption takes place.

Adoption will affect your patient’s life in many ways, but it is possible for her to prepare for these changes and emotions before they occur. It is possible for your patient to have a positive adoption experience. The first step will be for her to accept and understand that these feelings are normal. Only then can she begin the healing process.

Adoption may be a difficult choice, but it is also one filled with love and hope. By choosing adoption, your patient will have the comfort of knowing she was in control of her plan. She will find peace of mind in knowing that she gave her baby the best possible life she could.

If you are looking for ongoing adoption support for your patient, please reach out to Adoptions With Love. If you would like to schedule an in-service training in your Massachusetts practice, and learn about the emotional and complicated decision of adoption, please contact us at 617-964-4357. For more advice on helping patients with an unplanned pregnancy, please download our “Clinician’s Guide to Adoption” below.

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Options Counseling: How to Talk About Pregnancy Options with Your Patient

An unplanned pregnancy is often a considerable crisis in a woman’s life, one in which she may look to others for guidance and support.  With questions like What am I going to do? and How am I going to navigate this? running through her head, she may turn to you, a healthcare professional, for help.

Whether you are a primary care physician or gynecologist, hospital social worker or family therapist, there will likely come a time when you are faced with this situation. A patient of yours may discover a positive pregnancy test (perhaps right in your office) and request assistance from you in reviewing her different options: Should she parent her child, place her baby for adoption, or terminate the pregnancy?

This will be one of the most difficult decisions she will ever make in her lifetime. No matter which path she chooses, your patient will carry this decision for years to come. As a result, it is crucial that she is fully comfortable and confident in her choice. It is essential that she understands all her unplanned pregnancy options before she chooses the most positive one for herself and her child.

At Adoptions With Love, we believe that an informed decision is the best possible decision a woman can make. According to the American College of Nurse-Midwives, “every woman has the right to make reproductive health choices that meet her individual needs” as well as “the right to access factual, evidence-based, unbiased information about available reproductive choices, in order to make an informed decision.”

Often the initial medical contact for women facing an unintended pregnancy, clinicians should equip themselves with the knowledge and skills needed to counsel patients on their reproductive options. This is what “options counseling” is all about. Options counseling offers a patient, who is undecided about her pregnancy, the support and information needed to explore her alternatives as well as her feelings about each one. There are three components to effective options counseling:

  • Clinician provides medically accurate, unbiased information about each option and its potential outcomes
  • Clinician practices nondirective counseling, active listening, and asks questions to encourage open communication with the patient
  • Clinician helps patients work through and assess any feelings or values associated with her options

As a first step in counseling your patient about her options, it is important to examine your own values and biases. Unintended pregnancy can prompt both ethical and moral challenges, not only for patients, but also for the clinicians caring for them. Ask yourself if you have any personal experience with abortion, adoption, or single parenthood. Do you uphold certain values or beliefs regarding the morality of these options? If so, it is crucial to think about how your personal views may impact the quality of care and counseling you offer to patients. Your personal values should never disrupt or influence your patient’s decision. This is ultimately her choice to make. Maintaining a healthy detachment from your personal experiences with unplanned pregnancy will help you provide optimal, nondirective, nonjudgmental options counseling.

If at any point you feel conflicted or uncomfortable with your patient’s choice, be sure that you have a referral process in place in your practice. This way, your patients will still have rightful access to quality, neutral options counseling. Referrals should always be made to agencies or facilities that will provide immediate, affordable, convenient care and attention. In such an emotional time, your patient deserves this.

Adoptions With Love is a non-profit adoption agency offering free-of-pressure, free-of-cost services to expectant and birth parents considering adoption. We are available 24/7 to answer your call, speak with your patient, and help her through this decision. Our expert, compassionate attorneys and social workers can also meet your patient wherever is most convenient.

As a clinical professional, it is also your responsibility to have current and accurate information about adoption, abortion, and parenting on hand. Your patient must be fully aware of and educated on all her reproductive options before she can make a sound decision for her baby. If your patient is undecided about what to do, provide her with brochures and pamphlets that outline all three of her options, as well as their possible outcomes. If your patient has already made a decision, it is still imperative that you ensure that she is making an informed one. This means dismantling any myths or misconceptions about her different options, asking questions, and offering additional resources where they are needed.

If you feel your patient is making an unapprised decision, ask questions and probe her to talk about the reasons she is leaning towards this choice. As an example, your patient may say that terminating the pregnancy is her only option. She may not have considered adoption before. Or, she may say that adoption makes her sad because she will never see her child again. This is where current, factual adoption information can help.

Fact is, many young women today are not fully aware of the positive option of adoption. Some will associate it with secrecy or giving up. In reality, adoption is a selfless act of love, one that is largely about choice. Your patient can choose to have an open adoption, semi-open adoption, or closed adoption plan. As her healthcare provider, you can help dismantle any myths associated with adoption (or any other options), provide your patient with accurate information, and help her make a fully informed decision.

Options counseling also entails helping your patient sort through her feelings about adoption, abortion, and parenting. This is an emotional experience for her, and those emotions can create tension if they are not addressed. Open up the conversation by asking your patient about her feelings regarding the pregnancy, her goals, her values and beliefs, as well as her home life and influences. Listen to her as she reveals her answers. Respect her answers, make her feel comfortable, and provide support as she assesses her options. Remember, this is her choice, but you can help guide her in the right direction.

For more information about options counseling, or tips on how to help women facing an unintended pregnancy, please download our “Clinician’s Guide to Adoption” below. If you would like to refer a patient to Adoptions With Love, please contact us toll-free at 1-800-722-7731.

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20 Questions to Ask a Patient Considering Adoption

Discovering an unplanned pregnancy can be a very emotional (and often confusing) experience for expectant parents. With the many unplanned pregnancy options available today, deciding what to do after this initial discovery can also be particularly overwhelming. You may be here now as you have a patient working through this very decision. She has confirmed her pregnancy – with you or another clinical professional – and is ready to talk about her options. She is considering adoption for her baby.

In order to help your patient make an informed decision regarding her pregnancy, it is important to first get to know her and her current situation. If you are her primary care physician or counselor, you may already know about your patient’s medical history and current state of health. However, you may not know about her feelings, her values, or her life beyond your practice? Does she have a support system or feel safe at home? This is all critical information to have as you guide this young woman on  her adoption journey.

As a clinician, the first way you can help your patient is by asking the right questions. This will help you better understand where she is and how she feels at this moment in time. Then, as she answers, offer a compassionate, listening ear as she works through this significant choice. Listening is often the best way to help a woman considering adoption. She will have many feelings, thoughts, and anxieties that will need sorting.  Because she trusts you, she may look to you to help ease her mind, to offer her accurate adoption information, and to guide her to the right resource.

As a first step, sit down with your patient in a comfortable and confidential environment. Use an empathetic, non-threatening tone as you talk to her about her pregnancy. Do not ask questions that infer certain feelings; rather, ask questions that are neutral in nature (such as, “How do you feel about this pregnancy?” rather than, “Congratulations!” or even, “Are you happy about the pregnancy?”). Ask questions that are also delicate in nature, to ensure your client feels at ease every step of the way. Questions should be open-ended, so that the conversation flows openly and honestly.

To help you start the dialog with your patient, Adoptions With Love has compiled twenty of the most important and advantageous questions to ask pregnant patients who may be considering adoption.

Questions to Ask Patients Facing an Unplanned Pregnancy

  1. How do you feel about this pregnancy? If you are delivering the news of this pregnancy, you do not know how your patient will react. She may be excited. She may be upset. Even if the pregnancy was unintended, that does not mean it is unwanted. Try not to assume how your patient feels; instead, ask how she feels.
  2. How will the father of the baby feel about your pregnancy? If your patient is unsure who the father is, you may be able to help her pinpoint when she became pregnant.
  3. Do you feel safe with him? Do you feel safe at home? Questions about intimate partner violence are standard and important in order to keep your patient safe.
  4. Does anyone else know about the pregnancy? How have they reacted so far? Again, these questions will let you know if your patient feels safe and supported at home. If your client is an adolescent, you should also ask if her parents have been informed.
  5. Do you know what your options are? Would you like to learn more about each one? No matter your personal experiences with adoption, abortion, and parenthood, it is important to remain unbiased as you discuss her options.
  6. Prior to discovering you were pregnant, what were your personal feelings about parenthood? How did you feel about adoption and abortion? Understanding how your patient felt about each of these options before getting pregnant may help clarify which choice is the right one.
  7. Was motherhood always a part of your long-term plan? Ask her if parenting was a part of her future, and if so, under what circumstances she wished to have children.
  8. Do you feel ready to raise a child now, for the next 18 years and beyond? Many young women will consider parenting their child. If this is likely of your patient, ensure that she understands that parenting is a lifelong responsibility.
  9. Do you feel abortion is an option? Depending on how far along she is, as well as her beliefs and values, your patient may or may not be considering terminating her pregnancy.
  10. Do you feel adoption is an option? Is adoption for you?
  11. Will the father of the baby be involved in making this decision? Depending on your patient’s choice, the father may need to be involved with any associated legal processes.
  12. Do you feel pressured to make a certain choice? Ultimately, this is your patient’s choice. She should never feel forced into a decision that she is not comfortable making.
  13. What are your goals for the future? Does your patient have educational or career goals she wants to achieve?
  14. How will adoption/abortion/parenthood impact your goals? Each of these options will affect your client’s life and her goals differently.

Questions to Ask Clients Considering Adoption

  1. Why do you believe adoption is the best choice for your child?
  2. Why do you feel adoption is the best choice for you?
  3. Do you want to choose a family for your child?
  4. Do you want to have contact with your child and his or her adoptive family in the future?
  5. Do you want the adoptive family to be at the hospital the day the baby is born? Or attend doctor appointments with you throughout the pregnancy?
  6. Do you want me to refer you to an adoption agency to learn more about this option?

By asking these questions, you can help your patient assess her feelings, values, and to begin exploring her different unplanned pregnancy options. At the same time, her answers can help you gain a better understanding of how she feels about her pregnancy and refer her to the resource that will best answer her questions, meet her needs, and respect her desires as an expectant mother considering adoption.

For more questions to ask patients and clients considering adoption, or to learn more about the adoption process as a clinical professional, please download our free eBook, “A Clinician’s Guide to Adoption” below. If you have a patient you would like to refer to Adoptions With Love, please call us toll-free at 1-800-722-7731 today.

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