The objectives of Decision Counseling should be fulfilled in response to the needs of individual patient. The opportunity for individual counseling should be offered to every woman:
- To assist the patient in exploring her feelings about pregnancy, her circumstances, and her options
- To assist the patient to face the task of choosing, encourage careful examination of all options, provide accurate information and support her right to choose for herself
- To assist the patient by referral for further counseling or additional medical services if needed
The second process is the State of Alabama Mandatory 48 hour counseling session where a qualified person must provide the following:
1. The name of the physician who will perform the abortion in writing or by business card
2. Development of the fetus and probable anatomical and physiological characteristics of the embryo or fetus at the time the abortion will be performed that is explained in the state required literature.
3. The risks and complications associated with the abortion procedure.
4. Risks and complications associated with full term childbirth.
5. Alternatives to abortion that include continuation of the pregnancy and keeping the child, or placing the child for adoption.
6. List of agencies that offer assistance and a brief summary of services offered including adoption agencies. State of Alabama provides a Resource Directory that lists all this information.
7. Methods of birth control.
8. The father’s obligation to assist in the support of the child.
9. Patient must not be forced or required by anyone to have an abortion. The patient is free to withhold or withdraw consent to the abortion at any time before or during the abortion unless stopping the procedure jeopardizes the patient’s health. Exercising this right will not affect the right to future care or treatment and without loss of state or federal funded benefits which the patient might otherwise be entitled.
Special care will be exercised to insure that the patient considering the abortion is not subjected to duress or coercion, expressed or implied, of any kind, and that such decisions are reached on the basis of full information and free discussion.
Informed consent is an expression of respect for the patient as a person. It respects a patient’s moral right to bodily integrity, to self determination regarding sexuality and reproductive capacities, and to the support of the patient’s freedom with caring relationships.
Informed consent ensures the protection of the patient against unwanted medical treatment.
The patient must receive this information at least 48 hours in advance in person or by return receipt certified mail with restricted delivery. Mailing of the printed materials may be arranged by telephone. Patients requesting mail must also receive the materials again in person at her appointment time. The clinic must receive the signed green return receipt card of the certified mail dated 48 hours before the abortion. The process of mailing the required literature takes several days to complete the process to meet state requirements.
The third type of counseling is an INFORMATION AND EDUCATIONAL PROCESS, in which the specifics of the procedure and aftercare instructions are given and an informed consent is obtained.
Standards for Procedural Counseling
Informing the patient who chooses elective abortion of the procedure to be performed, its risks and benefits, and the aftercare involved is an important and effective means of reducing patient anxiety, increasing patient compliance, and promoting recovery.
In addition to the 48 hour Counseling and Decision Making Counseling, the educational process must include the following:
- The physician who will perform the abortion is required to perform an ultrasound before the abortion.
- The patient has the right to view the ultrasound and must complete a required form to acknowledge that she either saw the ultrasound image or that she was offered the opportunity and rejected it.
- The patient has the right to view a videotape prepared by the Department of Public Health.
Patients are provided with written descriptions of the abortion procedure, and risks and complications for the procedure. Patients must be supplied with materials that accurately pertain to their circumstances and are appropriate to the patient’s gestational age.
This may be accomplished in group sessions if voluntary, however individual counseling must be offered. The following objectives must be fulfilled with each patient who chooses abortion.
- Insure informed consent by establishing that the patient is mentally competent and appears to understand the nature and consequences of the procedure.
- Prepare the patient for surgery in a manner that facilitates her safety and comfort.
- Assist her in reaching a decision about the method of contraception she will use and then respect her choice.
- Provide the patient with accurate information, directly applicable to her procedure, about the risks of surgery and benefits as well.
- Provide patients the opportunity to ask questions about the procedure.
- Describe the abortion procedure in terms she can readily understand.
- Inform the patient that she is free to withdraw her request for abortion until a certain point in her care.
- Consent form must be obtained for a support person to be present for any part of the abortion process.
- Written documentation signed and dated by the patient and witnessed by a staff person, indicating all of the above steps has taken place.
Counseling notes are a part of the permanent medical record and function as such in both a medical and legal context.
What to Expect From An Abortion Counseling Visit
Before arriving for your abortion counseling visit, you should have the following identification:
For a patient 18 years of age or older, some form of identification with her photograph on it such as driver’s license, or state non-driver identification card, high school annual photo with name printed, school ID, or military identification card.
For a patient under 18 years of age unless she is an emancipated minor or has a judicial waiver specific to abortion: a parent, legal guardian, or adult with durable power of attorney must accompany her. The adult must have a picture identification and proof of parenthood (such as a birth certificate) or the guardianship or power of attorney documents. The clinic is required to keep in their possession the original documents or a certified copy. The patient must bring some form of picture identification or proof of identity, such as a school identification card, military identification card, or a yearbook with her photo and name. A birth certificate alone is not a form of identification, but is proof of parenthood (Alabama residents can go to their county health department and get a copy of their birth certificate while they wait).
On your first visit to West Alabama Women’s Center you will receive 48 hour required counseling (including state literature and opportunity to view a video prepared by the state of Alabama) lab tests, an ultrasound to determine how many weeks you are pregnant. You will have the opportunity to view or to not view the ultrasound.
No smoking or food or drinks are allowed in the clinic.
When you arrive at the clinic, go to the receptionist’s window and sign in. Patient sign in sheets are HIPAA compliant protecting your privacy. You will be given a number for your privacy and will always be identified by that same number while you are at the clinic. Our receptionist will give you a packet of papers to fill out in the waiting room. You should fill out these documents fully; they give us your medical history so that we can tailor our services to your individual needs.
After you have completed your paperwork and verified your identify and age to the receptionist, you can relax and watch TV or read until called back for your lab work.
Next, a staff technician will call you back for your lab work. The lab includes vital signs check (pulse, blood pressure, temperature), and two tests which require a few drops of blood from your fingertip. The blood tests check for Rh-factor and hematocrit. These tests give us an understanding of your overall health and take only a few moments.
Your next step is the ultrasound examination. Ultrasound is the safest and surest way to confirm that you are pregnant, rule out ectopic pregnancy, and determine how long you have been pregnant. Ultrasound does not hurt. You lie back on a padded table and uncover your abdomen (tummy) below your navel (belly button). A cool gel will be applied to your skin, and then the ultrasound scanner will be moved around on your abdomen. A small video screen shows a black-and-white image of the inside of your uterus. State law requires that we offer you the opportunity to see the ultrasound but you are not required to look at the picture.
Sometimes, such as a very early pregnancy, we can’t see an image of the pregnancy with the abdominal probe. In this case you will have a second ultrasound exam called "trans-vaginal" ultrasound to give a better image of your uterus. In this case, you undress from the waist down and the probe used is a thin wand inserted into the vagina and gently moved to get a complete picture of the uterus. This is a painless exam.
After the ultrasound, you go to the counseling room for a counseling session and paperwork. You will learn more about the abortion options available so that you can make an informed decision about which method is best for you. If you decide not to have an abortion, you will learn about the many resources available to pregnant women for adoption or assistance with pre-natal care. There will be many papers to read and consent forms to sign.
If you are already certain that you want an abortion, we respect your decision; no one will try to talk you out of it. However, state law requires that we give you information about all options available to pregnant women and you will sign forms saying you have been given this information. You are not required to take this information.
You will also receive information about contraception (birth control) to help you decide which method will best help you to prevent future unwanted pregnancies after your abortion. At West Alabama Women’s Center we are very dedicated to preventing unwanted pregnancies before they happen; the Counselor can talk with you about all of the most modern and effective contraception methods available. Unwanted pregnancies can be prevented-we believe that giving a woman complete and up-to-date information is the first step. All prescription contraceptives are available through West Alabama Women’s Center; or you may decide which method is best for you and see your own doctor to receive it.
YOU CAN CHANGE YOUR MIND AT ANY TIME DURING THIS VISIT. THE ABORTION HAS NOT BEGUN. IF YOU DECIDE NOT TO HAVE AN ABORTION, YOU DO NOT HAVE TO RETURN TO THE CLINIC.
To Book An Appointment or for additional information please feel free to Contact us at anytime at 1-800-616-2383 or 205-556-2026.
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