Couples counseling at an abortion clinic: a pilot study

Abstract

Background Nearly half of all pregnancies in the United States (US) are unintended. Nonuse, incorrect or inconsistent use of contraception may be related to limited support of male partners. Partners often accompany women seeking abortions to the clinic, representing an opportunity for health providers to engage them. This pilot study estimates the proportion of abortion patients accompanied by a male partner, the proportion agreeing to couples counseling and describes couples' experiences with the counseling. Study Design At a Baltimore clinic providing abortion, after preliminary qualitative research we recorded the number of patients who came with partners and accepted couples counseling in a 3-month period and sought feedback on the couples counseling in questionnaires from women, partners and the counselor. The counseling session consisted of giving information about the procedure and counseling regarding choices of a post-abortion contraceptive method and related topics that the woman and/or partner might raise. Results Overall, 27% of 774 patients came with their male partner, 28% with someone else and 45% alone. Fewer African-Americans (23%) came with a male partner, compared to 35% each among Whites and Hispanics (p<.001). Among all couples, 42% ( n=88) accepted couple counseling. Many women (77%) and partners (59%) completing questionnaires ( n=66) had expected the partner to be involved in the clinic visit. The patients appreciated having the partner's support, having an informed partner with whom to communicate and being able to share decision making. Conclusion Over a quarter of patients to an abortion clinic came with a partner without any advance notice of the availability of couple counseling, and a sizable minority of these couples accepted couple counseling. Those who had the counseling evaluated it favorably.