Abortion Counseling: A Clinicians Guide to Psychology, Legislation, Politics, and Competency


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The majority of women who have had abortions report feeling happy, satisfied, and relieved following their abortion. Some few women who have had an abortion may experience some feelings of guilt and sadness; however, this rarely lasts longer than a few days. Those very few women who present with prolonged feelings of sadness and mental health problems are women who have either had these problems prior to their abortion, had other risk factors, or were influenced by frightening demonstrations and inaccurate biased information provided prior to the abortion. Through this book the authors hope to train general therapists and counselors in pre- and post-abortion counseling techniques--to avoid women experiencing unnecessary psychological problems created by those who insist that the non-existent "post-abortion syndrome" exists.

Finally, by reflecting on variations across all the preliminary themes, three final themes emerged that together constitute the essential meaning of the phenomenon of being pregnant and ambivalent in the first trimester. In this process, the four fundamental lifeworld themes, or existentials, recommended by van Manen, were helpful as guides for reflection.

The reflective questions were: How were the lived body, the lived time, the lived space, and the lived relations experienced by the woman when she was uncertain? Were these lived experiences different from the time before she became pregnant? In these processes of reflection, the art of writing and rewriting was of crucial significance van Manen, van Manen, M. The text was approached to capture the fundamental meaning or main significance of the interview as a whole. For the ten informants with whom we had a follow-up interview, the two analyzed interviews from each woman were synthesized.

Finally, by reflecting on similarities and differences across all the preliminary themes, three final themes emerged that together constitute the essential meaning of the phenomenon of being pregnant and ambivalent in the first trimester.

Missouri House Set To Approve Abortion Ban At 8 Weeks

World medical association declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA , 20 , — Participants were recruited from different areas to protect anonymity. The women received written information about the study and an invitation to participate. They gave written consent. The researcher met with the women in private meeting-rooms at the hospitals or at the university in the area where the women were recruited.

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A trained nurse was available after the interviews. The findings present the experiences described by the small subset of pregnant women who were unsure about whether or not to have an abortion.

By verification of the pregnancy, the women were confronted with their own readiness and faced a new reality. They experienced the decision-making process as a lonely journey toward a definite conclusion during which their values were challenged. They demonstrate the various aspects of the burden the women described when having to make an independent decision within a short timeline. The pregnancy meant that the women were thrown into a reality that challenged their life projects.

The women's reactions and attitudes depended upon their preparedness. When pregnant, the timing related to their age, partnerships, and awareness of support became prominent. Women's considerations and experiences might change during the limited time they had to decide whether to terminate the pregnancy and were influenced by bodily ailments and fluctuating feelings. Before the pregnancy, the women had thoughts about readiness — when and if they wanted more children. Some had talked about it with their partners, although they did not always agree. Only a few women had planned the pregnancy, while several described various challenges related to contraception.

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The expectation of controlled fertility and the shame they described when conceiving at the wrong time indicated that the women blamed themselves for having failed to protect themselves against an unwanted pregnancy. And it is clear that this may fail. So then, it was just simply an accident. I should really not have been here now. I do know how to protect myself.

Suspecting a pregnancy meant awareness of bodily signs like tender breasts, dizziness, nausea, or a missed period. Most women obtained a pregnancy test as soon as the suspicion arose. Those that had an expectation of being infertile or protected appeared to be less aware or tried to explain away the signs to themselves. Deferring the pregnancy confirmation gave a shorter time for decision-making.

Even if they had verified the pregnancy by a test and the bodily signs reminded them, this new reality might feel unreal and hard to take in. Some described how they tried to keep the thoughts away, even if they were there all the time.

They found thinking about the pregnancy was exhausting. Verification of the pregnancy set women's feelings in motion and raised questions about readiness for caring for a child. They expressed their feelings as combinations of happiness, surprise, shock, despair, and self-blame. From the moment I sat with a positive test in my hand, I was terrified. Suddenly my life was turned upside down — everything would change. Verification of the pregnancy might mean being thrown into a process of reorientation. Women transitioned from an idea that it might happen to considering whether they could or would go on with the pregnancy.

Narrative Therapy

For those who had planned the pregnancy, it might have been a vague decision or a deeply felt desire, but when it became real, they were unsure about their readiness. Some felt happiness and anticipation despite the fact that the pregnancy was not planned. These feelings contradicted an expectation that they would be happy for a child and be in love with the partner.

The absence of good feelings might be interpreted by the women as a sign in favor of terminating the pregnancy. Considerations related to whether the women were ready to give birth now, later, or never were affected in varying degrees by bodily changes. Bodily symptoms occurred gradually during the first weeks and were interpreted as hormones influencing feelings and the health condition. Awareness of timing and age suddenly appeared obvious and influenced what leeway they had.

Some adult women referred to a personal upper age limit for being pregnant and regarded this pregnancy as their last chance. The younger women did not want to have a child before they had completed their education and had a stable relationship with a partner. This comported with their mothers' warnings. Being pregnant made the women increasingly aware of their plans and living conditions. They considered whether their economy and living facilities were suitable and in some cases had to check if it would be possible to complete their education, keep their jobs or realize their plans if they went on with the pregnancy.

Thoughts about when fertilization had happened became prominent when calculating how far into the pregnancy they might be, and thus how much time they had to make the decision. The pregnancy test could give an indication, but for some it was not trustworthy. Some did not know the timing of their last menstrual period, which was needed to calculate weeks of gestation in their pregnancy and needed an ultrasound examination. This could take time, since several women were not aware that they could contact the gynecological outpatient clinic directly. Some were shocked when the gestational age based on the ultrasound turned out to be older than expected and felt the pressure of the decision even more.

I was totally shocked that I had gone so far. That the baby had developed so fast. Because I thought the test I took was exact, but it was not.

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The legal limit for terminating the pregnancy was described as stressful. However, despite the pregnancy ailments, most women used several weeks to decide. Some were close to the limit when they arrived at the clinic. The women described several factors that increased the stress of their experience: the time passing, the continuing uncertainty, and finally, the increasing bodily symptoms.

In addition, thoughts appeared about the fetus growing. They described this as the feeling of a ticking clock or an emotional roller coaster: Up and down all the time.

Bandura Self-Efficacy References

It's been so intense and tiring. Tiring to be pulled one way and then the other and the same thoughts just spinning round and round.


  • Ethics & American Psychological Association;
  • Women's experiences when unsure about whether or not to have an abortion in the first trimester.
  • Any choice can bring upheavals in our lives, strong feelings, and difficulty coping..

Having to think about it all the time. So tiring. For some, the nausea increased during the first weeks. For one it reminded her of her preceding horrible pregnancies and she described not being able to stand the suffering.

Abortion Counseling: A Clinicians Guide to Psychology, Legislation, Politics, and Competency Abortion Counseling: A Clinicians Guide to Psychology, Legislation, Politics, and Competency
Abortion Counseling: A Clinicians Guide to Psychology, Legislation, Politics, and Competency Abortion Counseling: A Clinicians Guide to Psychology, Legislation, Politics, and Competency
Abortion Counseling: A Clinicians Guide to Psychology, Legislation, Politics, and Competency Abortion Counseling: A Clinicians Guide to Psychology, Legislation, Politics, and Competency
Abortion Counseling: A Clinicians Guide to Psychology, Legislation, Politics, and Competency Abortion Counseling: A Clinicians Guide to Psychology, Legislation, Politics, and Competency
Abortion Counseling: A Clinicians Guide to Psychology, Legislation, Politics, and Competency Abortion Counseling: A Clinicians Guide to Psychology, Legislation, Politics, and Competency
Abortion Counseling: A Clinicians Guide to Psychology, Legislation, Politics, and Competency Abortion Counseling: A Clinicians Guide to Psychology, Legislation, Politics, and Competency

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