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Counselling, information and referral

Supporting pregnant women

These principles have been developed by the Children by Choice counselling team, who are all tertiary-qualified and specialists in the area of pregnancy counselling and support from a pro-choice, woman-centred framework. The principles and micro skills below are covered in more depth in our professional development training; if you are regularly dealing with disclosure or requests for support in relation to unplanned pregnancy you may wish to consider covering these issues in more depth through our training

Overarching principles

Commitment to the principle of reproductive autonomy: we believe that women can freely make their own reproductive and sexual health choices. 

"The personal is political": women's experience is shaped by the dominant gendered discourse as well as by such issues as age, religious affiliation, culture and ethinicity, sexuality, economic status, and health. 

The woman is the expert in her own life: she knows best her own strengths and capacities, her experiences and the meanings she has drawn from them, her hopes and aspirations, as well as her values, beliefs and sentiments for living.

Micro skills 

Some specific questions are offered below as a way of bringing these principles into your practice.

Deal with your own beliefs and values and keep them separate from those of your patient or client. Refer on if needed.

Listen to her story without giving judgement, opinions or advice, and without blaming:

“How did you feel when you found out you were pregnant?”

“What are your needs, wants and concerns?”

Explore a broad range of factors that may impact on her decision, and clarify any statements that may seem straightforward but can be complex - like “giving a child the best start in life,” “I don’t believe in abortion,” or “dad will kill me”:

“What information do you need in order to reach your decision?’

“Tell me what you mean when you say...?”

Normalising unplanned pregnancy can be helpful for some women: 

"Estimates are that around half of all pregnancies in Australia are unplanned, so you're not alone in this experience."

Put yourself in her shoes: use empathy and understanding.

“Experiencing an unplanned pregnancy can be a stressful time. How are you coping? How do you normally go about making big decisions in your life?”

Explore her values and how they may impact on her options: discuss coping issues and strategies and identify factors present that may influence coping eg: no support, feeling pressured, relationship breakdown, past difficulties coping with major decisions:

“How do you think you will feel after an abortion?”

“Who is likely to provide you with support if you continue the pregnancy?”

Attend to her emotional and practical needs:  

"What are your plans or goals for the future?"

"How important to you are these plans?"

"How will your decision affect your plans?"

Challenge gently and purposefully, use self-disclosure carefully if at all, and use reality testing in a way that is practical and without judgement:

“What supports will you need to continue the pregnancy and parent? How will this work on a day to day basis?”

“Who is likely to provide you with support if you terminate the pregnancy?”

 

Assist where possible to give women referrals for financial assistance, liaise with clinic services where clients have difficulties with English and where consent issues may be present.

 

Things to be mindful of

Throughout your interaction with a patient or client, keep in mind your approach, your language, your environment, and your information. 

Language: 

Can your client understand your language/terms/jargon? Is it youth appropriate? Be careful not to speak in a condescending manner.

Most women ask “what does gestation mean?” Do they have basic reproductive knowledge?

Refrain from using terms such as “late” or “early” term pregnancy. Alternative questioning may be “how far into the pregnancy are you?”

Instead of saying “father of the child”, consider “man involved”, particularly if the pregnant woman herself has not told you of the relationship between the two of them. Be mindful that an ongoing relationship cannot be assumed, so "partner" or "boyfriend" isn't appropriate unless she refers to him that way. Additionally, don't assume a relationship at all - there may have been drugs or alcohol involved, or a sexual assault, or it may have been a one-night stand.

Environment:

How approachable are you and your organisation for a woman experiencing unplanned pregnancy?

Be mindful of your setting: do you have pictures on your desk of your family? 

Is there a quiet space available?

Is there a room available without baby/family themes?

Information: 

Ensure you have accurate and up to date information on all options, including referrals for abortion, adoption, and parenting organisations and services. Many women are repeatedly faced with a variety of health professionals providing them with inaccurate information. This can be especially important with ascertaining the gestation of a pregnancy and the availability of abortion services.

Keep updated, as contacts, procedures, costs and other essential information for clients can change rapidly.

Keep opportunistic testing in mind (eg sexual health check, pap smear etc). 

Last modified on: 04 July 2016
Supporting pregnant women: best practice principles
04 July 2016