Abortion & Pregnancy

A 22-year-old G1P0 patient comes in after a positive home urine pregnancy test two weeks ago. While waiting for their visit with you, they went to a local crisis pregnancy center (CPC) for a free ultrasound. The CPC estimated they were 7 weeks. During the visit, they were told that abortion significantly increases the risk of breast cancer. They are feeling ambivalent about continuing this pregnancy or having an abortion and not sure what to believe. 

A 26-year-old (she/her) presents to your health center four weeks after a medication abortion at eight weeks of gestation. She reports bleeding was initially heavy with blood clots, and is now lighter, but she continues to have intermittent light bleeding and mild cramping. She reports she believes she is not pregnant anymore, as pregnancy symptoms have resolved, but is not sure if things are "done."  A transvaginal ultrasound shows a heterogeneous collection and thickened endometrial stripe, without a persistent gestational sac or evidence of an ongoing pregnancy.

We can only listen when we create a space for the patient to speak. Listening can be augmented through open-ended questions. During a period of listening, consider opting for one open-ended question in lieu of a series of closed-ended questions.

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