Women requiring post-abortion care (PAC) have both physical and emotional needs. Proper and effective counseling is a successful means through which the providers offer emotional care to women. Right to high-quality counseling is a fundamental right of women requiring PAC.
Counseling is a way of providing support to patient; helping her to assess her feeling, coping ability, managing her anxiety and understanding information in order to enable her make inform decision.
What is counseling?
Counseling is defined as structured interaction whereby an individual voluntarily receives emotional support and guidance from a trained person in conducive environment that promote sharing thoughts, feeling and perceptions.
- Exploring the person’s feelings and thoughts
- Accepting the person’s perceptions and feelings regardless of societal norms
- Respecting individuals’ privacy and confidentiality
- Focusing on the person
- Communicating effectively
- Providing information and helping the individual apply the information to meet their needs
Counseling is not:
- Only or mainly information
- Giving advice
- Trying to influence the person’s attitude beliefs and behaviours by persuading admonishing, threatening and compelling
Role of PAC Counselor
- Assess and affirm client’s feelings
- Help the woman clarify her thoughts and decision about her pregnancy, her need for PAC treatment and her future sexual and reproductive health
- Help her examine her feeling and circumstances that relates to her sexual and reproductive.
- Provide appropriate answers to questions about her medical condition, test results, treatment and pain management options and follow-up care.
- Address any other concerns that the woman has
- Refer her if necessary for addition services.
Benefits of Counseling in a PAC Setting
- Helps provider identify when client deserves a special care due to extreme emotional distress or personal needs to make informed decision.
- It provides more effective patient-provider relationships.
- It gives opportunity for more effective treatment that is less painful and distressing
- It provides greater patient satisfaction with care provider.
Counseling in PAC Setting
In order to provide effective counseling, the provider should give counseling before, during and after medical treatment whenever the woman’s health is not at risk of delay and she is in a state to make an informed decision.
Counseling in PAC helps the woman plan for her future to ensure her wellbeing. All elements of PAC must be employed for effective counseling.
Guiding Principles in PAC Counseling
The counselor must have these principles as a guide in counseling a woman with post abortion needs.
The counselor must assess her biases, beliefs, attitudes. She should separate her beliefs, personal values, attitudes and biases from her professional practices and empathy to all clients regardless of their reproductive behaviours and decision. Health providers’ attitude to patient has great impact. Self-reflection will help her not to oppose her beliefs, values and attitudes to client. She should recognize how their attitudes could negatively or positively affect counseling.
- Empathy and Respect
Empathy is the ability to understand another person’s feelings and opinion (view) and to communicate at same level with cent. It is putting oneself in another man’s shoes. Empathic provider will always have it in his/her mind to treat others how they would want to be treated. Patients respond most favourable to counselors who:
- Remain open, empathic and non-judgmental.
- Extend compassion and respect to every patent regardless of the PT’s reproductive behaviours and decisions
- Separate their own values and attitudes from those of patients
- Respect patient’s independent values and attitudes.
- Honour every PT’s feeling, perceptions and decisions.
- Interaction and Communication
Create a positive rapport between you and the woman which is the bedrock of quality health care. Effective communication skills are necessary in PAC setting because women’s physical and emotional distress may interfere with her ability to accurately explain their physical conditions respond to questions and understand information. She should adapt her behaviour and language to client’s cues especially at the beginning of clinical interactions. She should make patients active participants of their own care through sharing of information.
- Privacy and Confidentiality
She should provide privacy and treat information confidentially for counseling and that which is essential in promoting woman’s sense of dignity. If patient loose trust, it may be difficult to regain.
Therefore, health worker must maintain trust by posting the facility confidential policy in strategic places in PAC setting. Caring areas and sharing it verbally with all clients.
Patient’s right to privacy must be respected in PAC setting. It is essential that counseling should take place where nobody can hear and see her. Meeting privately, especially at the initial meet will help the client to be open and give out information.
- Counseling Skills
Effective woman-centered care is a two-way communication. When there is good rapport, patient opens up easily and from her history, proper diagnosis will be made and appropriate treatment would be provided.
Counseling should be devoid of discrimination, racism and favouritism. The counselor should provide safe and evidence-based facts to enable patients take decision in his or her care. When patients are involved in decision-making, they tend to show maximum cooperation and quick recovery from the ill-health.