Pregnancy Options Counseling Points for the Ambivalent Patient
1. Clarify the facts – the actual timing of pregnancy and possibility that the patient may not need to decide today.
2. Normalize feelings of ambivalence.
3. Acknowledge common feelings such as shame, disappointment, guilt and regret.
4. Reframe the situation – she may be making the most responsible decision by NOT continuing the pregnancy.
5. Reassure and encourage her to trust and respect herself and her decision.
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Helpful Exercise for Ambivalent Patients
Day 1
Have the patient spend one day writing a list of all her positive and negative feelings about keeping the pregnancy.
Day 2
Encourage the patient to spend the day with her ambivalent feelings, not making any decisions.
Day 3
Have the patient spend one day writing a list of all her positive and negative feelings about not keeping the pregnancy.
Day 4
Make a follow-up appointment with the patient.
(Often, one recurrent theme or feeling will emerge to help her make a decision.)
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Other Tips
1. Be conscious of time – you do not need to know everything about the patient to help her make a decision.
2. Refer to the pregnancy, not the baby.
3. Elucidate that the patient’s choice not to be a mother now does not mean she is choosing not to be a mother in the future.
4. Ask about other supports in the patient’s life.
5. You may not have time for therapy but just talking is therapeutic.
6. Investigate the woman’s feelings. Don’t assume anything – she may not be experiencing shame or guilt.
7. You may not come to a resolution at the end of the first visit. You an always schedule a timely follow-up appointment.
