Evaluation of a Training for Health and Social Service Providers on Abortion Referral-Making

Abstract

Purpose Engaging trusted care providers and empowering them with information and skills about abortion is a critical opportunity to improve coordination of care for women seeking abortion, if and when these services are needed. Description Provide, a nonprofit that works in partnership with health and social service providers to build a health system that is equipped to respond to women’s health care needs around abortion, launched a referrals training program in 2013. To assess the effectiveness of this training program, we conducted an evaluation of satisfaction with training and the impact of the intervention on provider knowledge of safety of abortion, self-efficacy to provide abortion referrals, and intention to provide pregnancy options counseling and referrals in the future. Assessment Approximately 90% of participants were “very satisfied” with their training experience. Results show significant increase in intention to provide non-judgmental pregnancy options counseling and referrals for abortion care after participants went through training. Post-training, significantly more reported that they would present all pregnancy options without judgment or bias (94 vs. 82%, p < .0001), provide a referral for abortion care if needed (80 vs. 50%, p < .0001), and follow-up with the client (71 vs. 39%, p < .0001). Further, more also reported they would refer a client for prenatal care if the client requested it (78 vs. 67%, p < .0001). Conclusion Our results suggest that abortion referrals training hold potential to build the capacity of health and social service providers’ ability to meet client needs related to pregnancy and could be implemented at a larger scale.

Future health providers’ willingness to provide abortion services following decriminalisation of abortion in Chile: a cross-sectional survey

“…However, there is a wide range of abortion-related information and skills that arguably should be offered as part of any medical or midwifery student curriculum, irrespective of their religious affiliation or prohibition on abortion provision. Medical and midwifery schools could train students to give accurate, informed and non-judgemental pregnancy options counselling and referrals for abortion care,33 to provide high-quality postabortion care, including managing complications and miscarriage management,34 to develop competencies on how to address specific-patient scenarios related to abortion care, and to offer offsite residency abortion training programmes. The extent to which medical and midwifery programmes in Chile currently or plan to offer abortion training, if at all, and whether they will require their students to participate at some level is still unclear.…”

Pregnancy Options Counseling and Abortion Referral Practices Among Colorado Nurse Practitioners, Nurse‐Midwives, and Physician Assistants

“…Second, because personal and religious objections were reported as reasons for not providing counseling or referrals, training should include values clarification and address professional responsibilities and ethics; specifically, how clinicians must respect patient autonomy and not delay access to care 28,29 . These trainings have been shown to improve clinician communication skills, empathy, respect of patient autonomy, and intentions to provide abortion counseling and referrals 35–37 . Finally, study data do not fully capture the complexity of attitudes and behaviors, including how clinicians may hold conflicting personal and professional beliefs 34,38 or how willingness to provide counseling or care may depend on a patient's reason for desiring abortion 34,38,39 .…”

“…28,29 These trainings have been shown to improve clinician communication skills, empathy, respect of patient autonomy, and intentions to provide abortion counseling and referrals. [35][36][37] Finally, study data do not fully capture the complexity of attitudes and behaviors, including how clinicians may hold conflicting personal and professional beliefs 34,38 or how willingness to provide counseling or care may depend on a patient's reason for desiring abortion. 34,38,39 This complexity, as well as barriers to providing abortion related care, such as abortion stigma or workplace culture, 38,39 must also be considered when identifying ways to change clinician practices and increase access to abortion care.…”

Society for Maternal-Fetal Medicine Consult Series #55: Counseling women at increased risk of maternal morbidity and mortality

“…56,58 When such practitioners do receive training in how to counsel patients regarding options for pregnancy termination, they report greater self-efficacy and intention in providing such counseling. 58,59 Expanding healthcare practitioner education on counseling for contraception and pregnancy options for high-risk women may be beneficial.…”