The 130th Annual Meeting of APHA

5062.0: Wednesday, November 13, 2002 - 8:45 AM

Abstract #49919

A counseling model to improve the quality of postabortion care (PAC)

Jhony Juarez, MD, Miguel Gutiérrez, MD, and Elizabeth Aliaga, PSIC. Pathfinder International, 9 Galen Street, Suite 217, Watertown, MA 02472

Experience from Pathfinder International's “Integral Care Project for Incomplete Abortion in Peru” led to the institutionalization of a comprehensive counseling model for PAC. One of the main purposes of this model was to provide quality treatment to women throughout the process of postabortion care.

Early assessments of PAC services in the project's hospitals showed that the services offered were deficient in the areas of counseling and postabortion contraception. Based on this evidence, Pathfinder designed and institutionalized a counseling model that emphasizes quality of care and considers the social-cultural background and psychological state of a woman who has undergone an unsafe abortion.

The model has three distinct phases: before the procedure (usually MVA), during the procedure, and after the procedure. The first phase includes assessment of the woman's emotional state and assistance in managing her fears or anguish, provision of information on her condition, discussion on pain management, and identification of her reproductive intentions. The second phase consists of active communication with the client on the procedure and "verbal anesthesia". The third phase includes information on postabortion care, symptoms of complications, and other RH issues as well as postabortion contraceptive counseling and method provision.

During the project evaluation, providers stated “they have changed and improved their care for patients with incomplete abortion.” By counseling a woman at every stage in the PAC process, the quality of PAC services was greatly improved and there was an increase in the adoption of postabortion contraception (from 27% in 1997 to 54% in 2001 in 43 hospitals).

Learning Objectives: By the end of the session, the participant will be able to

Keywords: Quality of Care, Post-Abortion Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Improving Postabortion Care Services

The 130th Annual Meeting of APHA