Abortion and Clinical Practice

Abortion is a common experience for women around the world; yet it is often excluded from the curricula of health professionals. Our aim is to fill in the gaps left by the exclusion of abortion from mainstream curricula.

This section contains all video lectures and slides relating to clinical practice.

Learning Objectives

After watching these video lectures, learner will:

Provide objective and compassionate pregnancy options counseling
Practice patient communication skills
Describe principles of patient-centered care for first-trimester abortion
Review the provision of abortion available in the first trimester and methods for pain management
Discuss complications associated with abortion and common abortion myths
Recognize common reasons why women have abortions after the first trimester
Discuss unique challenges for women seeking abortion after the first trimester

Assessments

Abortion and Clinical Practice Questions

Abortion and Clinical Practice Answers

Video Lectures and Companion Materials

Decision Counseling for Positive Pregnancy Test Results

Video Lecture Presented by:
Alissa Perrucci, PhD, MPH
San Francisco General Hospital, Women’s Options Center
Click here to download this video lecture

Lecture can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles.

_{Backline. 2015 [cited; Available from: http://yourbackline.org/}

_{Rachel Herndon, MSW, Adoption Connection}

Decision Counseling for Positive Pregnancy Test Results

Slide Set from Video Lecture Presented by:

Alissa Perrucci, PhD
University of California, San Francisco

Click to download Decision Counseling for Positive Pregnancy Test Results (pdf)

Decision Counseling for Positive Pregnancy Test Results

Slide Set from Video Lecture Presented by:

Alissa Perrucci, PhD
University of California, San Francisco

Click to download Decision Counseling for Positive Pregnancy Test Results (pdf)

Informed Consent, Decision Assessment, and Counseling in Abortion Care

Video Lecture Presented by:
Alissa Perrucci, PhD, MPH
San Francisco General Hospital, Women’s Options Center
Click here to download this video lecture

Citations:

_{Cozzarelli C, Sumer N, Major B. Mental models of attachment and coping with abortion. J Pers Soc Psychol 1998 Feb;74(2):453-67.}

_{Major B, Appelbaum M, Beckman L, Dutton MA, Russo NF, West C. Abortion and mental health: Evaluating the evidence. Am Psychol 2009 Dec;64(9):863-90.}

_{Major B, Richards C, Cooper ML, Cozzarelli C, Zubek J. Personal resilience, cognitive appraisals, and coping: an integrative model of adjustment to abortion. J Pers Soc Psychol 1998 Mar;74(3):735-52.}

_{Trybulski J. Women and abortion: the past reaches into the present. J Adv Nurs 2006 Jun;54(6):683- 90.}

Informed Consent, Decision Assessment, and Counseling in Abortion Care Slide Set

Slide Set from Video Lecture Presented by:

Alissa Perrucci, PhD
University of California, San Francisco

Click to download Informed Consent, Decision Assessment, and Counseling in Abortion Care (pdf)

Informed Consent, Decision Assessment, and Counseling in Abortion Care Slide Set

Slide Set from Video Lecture Presented by:

Alissa Perrucci, PhD
University of California, San Francisco

Click to download Informed Consent, Decision Assessment, and Counseling in Abortion Care (pdf)

Global Contraception

Video Lecture Presented by:

Jody Steinauer, MD, MAS

University of California, San Francisco

Click here to download this video lecture

Contraception Slide Set

Slide Set from Video Lecture Presented by:

Jody Steinauer, MD, MAS

University of California, San Francisco

Click to download Contraception (pdf)

Contraception Slide Set

Slide Set from Video Lecture Presented by:

Jody Steinauer, MD, MAS

University of California, San Francisco

Click to download Contraception (pdf)

Medical Abortion

Video Lecture Presented by:

Karen Meckstroth, MD, MPH

University of California San Francisco

Click here to download this video lecture

Medical Abortion Slide Set

Slide Set from Video Lecture Presented by:

Karen Meckstroth, MD, MPH

University of California, San Francisco

Click to download Medical Abortion (pdf)

Medical Abortion Slide Set

Slide Set from Video Lecture Presented by:

Karen Meckstroth, MD, MPH

University of California, San Francisco

Click to download Medical Abortion (pdf)

First-Trimester Aspiration Abortion

Video Lecture Presented by:

Andrea Jackson, MD, MAS

University of California, San Francisco
Click here to download this video lecture

First-trimester Aspiration Abortion Slide Set

Slide Set from Video Lecture Presented by:

Andrea Jackson, MD, MAS

University of California, San Francisco

Click to download First-trimester Aspiration Abortion (pdf)

First-trimester Aspiration Abortion Slide Set

Slide Set from Video Lecture Presented by:

Andrea Jackson, MD, MAS

University of California, San Francisco

Click to download First-trimester Aspiration Abortion (pdf)

Pain with Uterine Aspiration Abortion Slide Set

Slide Set from Video Lecture Presented by:

Karen Meckstroth, MD, MPH

University of California, San Francisco

Click to download Pain with Uterine Aspiration Abortion (pdf)

Abortion After the First Trimester

Video Lecture Presented by:

Eleanor Drey, MD, EdM

University of California, San Francisco

Click here to download this video lecture

Abortion After the First Trimester Slide Set

Slide Set from Video Lecture Presented by:

Eleanor Drey, MD, EdM

University of California, San Francisco

Click to download Abortion After the First Trimester (pdf)

Abortion After the First Trimester Slide Set

Slide Set from Video Lecture Presented by:

Eleanor Drey, MD, EdM

University of California, San Francisco

Click to download Abortion After the First Trimester (pdf)

Patient Decision Making about Abortion after the First Trimester

Video Lecture Presented by:

Jen Kerns, MD, MPH

University of California San Francisco
Click here to download this video lecture

Citations:

_{Newmann S, Dalve-Endres A, Drey EA, Planning SoF. Clinical guidelines. Cervical preparation for surgical abortion from 20 to 24 weeks’ gestation. Contraception 2008 Apr;77(4):308-14}

_{Jones RK, Kooistra K. Abortion Incidence and Access to Services In the United States. Perspectives on Sexual and Reproductive Health: Guttmacher Institute; 2008}

_{Cowett AA, Golub RM, Grobman WA. Cost-effectiveness of dilation and evacuation versus the induction of labor for second-trimester pregnancy termination. Am J Obstet Gynecol 2006 Mar;194(3):768-73.}

_{Schechtman KBP, Gray DLM, Baty JD, Rothman SMM. Decision-Making for Termination of Pregnancies With Fetal An… : Obstetrics & Gynecology. 2015.}

_{Drey EA, Foster DG, Jackson RA, Lee SJ, Cardenas LH, Darney PD. Risk factors associated with presenting for abortion in the second trimester. Obstet Gynecol 2006 Jan;107(1):128-35.}

_{Foster DG, Jackson RA, Cosby K, Weitz TA, Darney PD, Drey EA. Predictors of delay in each step leading to an abortion. Contraception 2008 Apr;77(4):289-93.}

_{Wyldes MP, Tonks AM. Termination of pregnancy for fetal anomaly: a population-based study 1995 to 2004. Bjog 2007 May;114(5):639-42.}

_{Vargas J, Diedrich J. Second-trimester induction of labor. Clin Obstet Gynecol 2009 Jun;52(2):188-97.}

_{Liu S, Joseph KS, Kramer MS, Allen AC, Sauve R, Rusen ID, et al. Relationship of prenatal diagnosis and pregnancy termination to overall infant mortality in Canada. Jama 2002 Mar 27;287(12):1561-7.}

_{Henshaw RC, Naji SA, Russell IT, Templeton AA. Comparison of medical abortion with surgical vacuum aspiration: women’s preferences and acceptability of treatment. Bmj 1993 Sep 18;307(6906):714-7.}

_{Harwood B, Nansel T. Quality of life and acceptability of medical versus surgical management of early pregnancy failure. Bjog 2008 Mar;115(4):501-8.}

_{Creinin MD. Randomized comparison of efficacy, acceptability and cost of medical versus surgical abortion. Contraception 2000 Sep;62(3):117-24.}

_{Bryant AG, Grimes DA, Garrett JM, Stuart GS. Second-trimester abortion for fetal anomalies or fetal death: labor induction compared with dilation and evacuation. Obstet Gynecol 2011 Apr;117(4):788-92.}

_{Kelly T, Suddes J, Howel D, Hewison J, Robson S. Comparing medical versus surgical termination of pregnancy at 13-20 weeks of gestation: a randomised controlled trial. Bjog 2010 Nov;117(12):1512-20}

_{Kaltreider NB, Goldsmith S, Margolis AJ. The impact of midtrimester abortion techniques on patients and staff. Am J Obstet Gynecol 1979 Sep 15;135(2):235-8.}

_{Kerns J, Vanjani R, Freedman L, Meckstroth K, Drey EA, Steinauer J. Women’s decision making regarding choice of second trimester termination method for pregnancy complications. Int J Gynaecol Obstet 2012 Mar;116(3):244-8.}

_{Steinauer J, Landy U, Filippone H, Laube D, Darney PD, Jackson RA.Predictors of abortion provision among practicing obstetrician-gynecologists: a national survey. Am J Obstet Gynecol 2008 Jan;198(1):39.e1-6.}

_{Jones BS, Weitz TA. Legal barriers to second-trimester abortion provision and public health consequences. Am J Public Health 2009 Apr;99(4):623-30.}

_{Finer LB, Frohwirth LF, Dauphinee LA, Singh S, Moore AM. Timing of steps and reasons for delays in obtaining abortions in the United States. Contraception 2006 Oct;74(4):334-44.}

Patient Decision Making About Abortion After the First Trimester Slide Set

Slide Set from Video Lecture Presented by:

Jennifer Kerns, MD, MPH

University of California, San Francisco

Click to download Patient Decision Making About Abortion After the First Trimester (pdf)

Patient Decision Making About Abortion After the First Trimester Slide Set

Slide Set from Video Lecture Presented by:

Jennifer Kerns, MD, MPH

University of California, San Francisco

Click to download Patient Decision Making About Abortion After the First Trimester (pdf)

Myths about Abortion Complications

IERH acknowledges the importance of inclusive language as a component of patient-centered care and we are working to improve our content. Read more here.

Video Lecture Presented by:
Jen Kerns, MD, MPH
University of California San Francisco
Click here to download this video lecture

Citations:

_{Institute G. Induced Abortion in the United States. July 2014}

_{Institute G. Guttmacher Policy Review 16(2): Table of Contents. 2015}

_{Bazelon E. Is There a Post-Abortion Syndrome? – New York Times. Jan 2007 [cited; Available from:

http://www.nytimes.com/2007/01/21/magazine/21abortion.t.html?pagewanted=all&_r=0}

_{Jagannathan R. Relying on surveys to understand abortion behavior: some cautionary evidence. Am J Public Health 2001 Nov;91(11):1825-31.}

_{Parazzini F, Ricci E, Chiaffarino F, Cipriani S, Tozzi L, Fedele L. Does induced abortion increase the risk of preterm birth? Results from a case-control study. Gynecol Obstet Invest 2010;69(1):40-5.}

_{Henriet L, Kaminski M. Impact of induced abortions on subsequent pregnancy outcome: the 1995 French national perinatal survey. Bjog 2001 Oct;108(10):1036-42.}

_{Moreau C, Kaminski M, Ancel PY, Bouyer J, Escande B, Thiriez G, et al. Previous induced abortions and the risk of very preterm delivery: results of the EPIPAGE study. Bjog 2005 Apr;112(4):430-7.}

_{Martius JA, Steck T, Oehler MK, Wulf KH. Risk factors associated with preterm (<37+0 weeks) and early preterm birth (<32+0 weeks): univariate and multivariate analysis of 106 345 singleton births from the 1994 statewide perinatal survey of Bavaria. Eur J Obstet Gynecol Reprod Biol 1998 Oct;80(2):183-9.}

_{Raatikainen K, Heiskanen N, Heinonen S. Induced abortion: not an independent risk factor for pregnancy outcome, but a challenge for health counseling. Ann Epidemiol 2006 Aug;16(8):587-92.}

_{Kalish 2002}

_{Freak-Poli R, Chan A, Tucker G, Street J. Previous abortion and risk of pre-term birth: a populations study. J Matern Fetal Neonatal Med 2009 Jan;22(1):1-7.}

_{Jackson JE, Grobman WA, Haney E, Casele H. Mid-trimester dilation and evacuation with laminaria does not increase the risk for severe subsequent pregnancy complications. Int J Gynaecol Obstet 2007 Jan;96(1):12-5.}

_{Melbye M, Wohlfahrt J, Olsen JH, et al. Induced Abortion and the Risk of Breast Cancer. New England Journal of Medicine. 1997;336(2):81-85. doi:10.1056/NEJM199701093360201}

_{Lindefors-Harris BM, Eklund G, Adami HO, et al. Response bias in a case-control study: analysis utilizing comparative data concerning legal abortions from two independent Swedish studies. Am J Epidemiol 1991;134:1003-8.}

_{Steinberg JR, Russo NF. Evaluating research on abortion and mental health. Contraception. 2009;80(6):500-503. doi:10.1016/j.contraception.2009.06.003}

_{Santorum R. S.3 – 108th Congress (2003-2004): Partial-Birth Abortion Ban Act of 2003. Published November 5, 2003. Accessed December 9, 2021. https://www.congress.gov/bill/108th-congress/senate-bill/3}

_{Kelly K. The spread of ‘Post Abortion Syndrome’ as social diagnosis. Soc Sci Med 2014 Feb;102:18-25.}

_{Weitz TA, Moore K, Gordon R, Adler N. You say “regret” and I say “relief”: a need to break the polemic about abortion. Contraception. United States; 2008. p. 87-9.}

_{Reframing Regret | Humanities | JAMA | JAMA Network. Accessed December 9, 2021. https://jamanetwork.com/journals/jama/article-abstract/1810383}

_{Stotland NL. Psychosocial aspects of induced abortion. Clin Obstet Gynecol. 1997;40(3):673-686. doi:10.1097/00003081-199709000-00026}

_{Lee SJ, Ralston HJP, Drey EA, Partridge JC, Rosen MA. Fetal PainA Systematic Multidisciplinary Review of the Evidence. JAMA. 2005;294(8):947-954. doi:10.1001/jama.294.8.947}