Post-Scripts: Positive Pregnancy Test
Recently, I posted the third in a new series of "Scripts," or example language to use in common clinical scenarios in midwifery and other professions who provide gynecologic, reproductive, and obstetric care. In the introduction to each post, I note that "With these example texts, I seek to provide a springboard for providers, care seekers, and reproductive health workers to discuss possible best practices for language and approach in different scenarios."
Similar to the response from the first two posts, I received lots insightful, critical, and reflective feedback! Below I summarize some of the key points. I will include this post-script in the original as well, to show the spectrum of difference in awesome care so many bring to their work. Thanks to everyone for contributing!
Note: Some have noticed that I am actively using gender-neutral language in my posts and online. Please consider doing the same when you leave comments!
Link to the original post: Feminist Midwife Scripts: Positive Pregnancy Test
Image of the flow chart that the blog post follows:
Feedback from the comments:
Important to be clear as a provider that medical abortion is abortion. "It is critical to me that all of my abortion patients understand that they have received an abortion. I think that this is especially important because these women are aborting without medical supervision. If they must go to the hospital, I want them to be able to say to their provider that they have elected to end their pregnancy rather than waste resources trying to save a pregnancy that isn't wanted. Not to mention, I want our patients to be able to reconcile their narrative as women who have had an abortion. Even if they aren't able to do that at the moment they are seen, I'm not interested in propping up any lies they tell themselves."
Assess pregnancy intention before knowing the test result: "Check in about their pregnancy intentions before you run the pregnancy test, if you can. It helps build rapport before you have a ton of power as the gatekeeper of all the options."
Acknowledge history of loss: "I would also add a bit about how to handle a patient who has a fear-based response due to previous pregnancy loss, stillbirth, or trauma associated with a previous pregnancy or birth. My current pregnancy was very much a wanted one, but my first response was hysterical crying and the thought that I didn't want to experience another miscarriage. It took a long time to ease my anxiety enough to feel positively about this pregnancy. Having a care provider that seems to dismiss a woman's concerns about viability doesn't help."
Managing different responses during abortions, from pain to pain-free: "I have to say that talking about pain and cramping with abortion is incorrect and could discourage someone from that route if they are wanting that. I say this because I had believed what you are saying to be the case. I personally was sedated and felt nothing nor remember anything. There was no pain whatsoever. I have seen multiple cases where other women had the same experience. By the time I was on my way home I already was beginning to feel better due to the fast hormonal changes (loss of all the nausea I had experienced constantly until that point, and constant unrelenting fatigue that completely disappeared that quickly). It wasn't at all the horrible experience I had chalked it up to be."
Looking forward to the next script, and to your feedback!
In solidarity,
Stephanie