Psychological Issues of the A... Video Transcript

Participants

, Richard Hausknecht MD, Michelle La Mothe MD, MPH, M, Beverly Winikoff MD, MPH

Summary

With the recent FDA approval of Mifepristone--the "abortion pill"--a new alternative is available to women with unwanted pregnancy. Abortion is always emotionally challenging, but the abortion pill brings with it its own particular issues. What are the emotional differences between medical and surgical abortion? How can women prepare themselves mentally? What kind of psychological counseling is available to women before and after? Join our panel of experts as they examine these and other psychological issues surrounding the abortion pill.

Webcast Transcript

MICHELLE LA MOTHE, MD: Hello and welcome to our webcast. I'm Dr. Michelle La Mothe. For many women, finding out they are pregnant is the happiest news in their lives. But for others, this news may be an unwanted surprise. For those women who decide to undergo an abortion, the psychological and emotional consequences can be distressing. Joining us to explain some of the psychological issues surrounding abortion are two experts. Let me introduce and welcome Dr. Richard Hausknecht, Medical Director of Danco Laboratories, and Associate Clinical Professor of Obstetrics and Gynecology, Mount Sinai School of Medicine. And with him joining us from the Population Council is the Director of Reproductive Health, Dr. Beverly Winikoff. Welcome and thank you both for joining us. I'd like to start with you, Richard, and ask, when a patient comes to you who is pregnant and has decided on an abortion, how do you counsel her?

RICHARD HAUSKNECHT, MD: The large majority of women who come to my office now seeking an early abortion have already made up their minds that they would like a nonsurgical or medical abortion. For those who don't know anything about it, the counseling process is very different because you have to explain the pros and cons of both. But in all cases when women come and have already made up their mind that they wish to proceed with a termination of their pregnancy, the counseling focuses primarily on the process; what to expect, what's going to happen, how to deal with it, what to do if there is a problem. Those are the kinds of issues that you raise. However, when you're faced by a patient who still can't make up her mind, the important issue is not to apply any pressure.

Yes, there are limitations imposed on how you can use the drugs to induce a medical abortion. In the case of mifepristone, or Mifeprex, we are limited to 49 days from the first day of the last period, but if a woman really can't make up her mind and wishes more time to think, the answer is she should take more time to think and consider really what she wants to do. Then of course, if it's too late to use the drug, she can always have an early surgical termination which is quite safe and, if it's properly done, with very, very few risks.

MICHELLE LA MOTHE, MD: Are there emotional differences, do you think Beverly, between a medical versus a surgical abortion?

BEVERLY WINIKOFF, MD: Well, I think different women may have different reactions, but on the whole, research on abortion shows that most women who undergo abortion feel a great sense of relief. A big problem has been solved. That's the most common emotional reaction to abortion. With medical abortion, we've done a lot of research on how women feel about it after having experienced it and most women are extremely pleased with the process. If you ask women what they like about it, interestingly, in this country and in other countries women refer to the fact that it's easier emotionally and it's more natural to them, and it feels like they have more control over the process. But these are the women who choose this method, so we can't generalize that to all women. Women who choose it seem to like it for a whole range of psychological reasons.

MICHELLE LA MOTHE, MD: You say that you also have a lot of information and data from other countries. Since RU-486 and this method has come from Europe and has been used in the Orient as well, some of the acceptability studies have come from other countries as well.

BEVERLY WINIKOFF, MD: Actually, our work has been done a lot overseas in countries that do not yet have this drug but as part of clinical trials in those countries.