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.