Pregnancy options counseling in the United States

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Pregnancy options counseling is a form of counseling aimed to help women come to a decision regarding a troubling or unintended pregnancy.

Contents

In the United States, approximately 51% of the six million annual pregnancies are unintended. A majority of the women affected by an unintended pregnancy are either 20–24 in age, poor or of low income, or are a member of a minority group. Unintended pregnancy rates are generally higher in the South and Southwest regions of the United States, in densely populated areas. A lack of family planning, limited access to birth control, or inconsistent use of birth control, are some of the contributing factors to unintended pregnancy. [1] Other factors that lead to unintended pregnancy are birth control or contraception failure, rape or incest, unprotected sex, or unsuccessful vasectomy or tubal ligation.

Counselors may provide information on what services are available to help women decide how to handle their pregnancy. By taking into consideration a patient's present life circumstances, they aid them in making a decision about which option is best: this may include getting an abortion, giving the child up for adoption, or choose to parent the child as a single parent. Counselors give information in a non-biased manner, neither encouraging nor discouraging a particular decision for a woman to make.

Abortion

Prevalence

Abortion is described as an intentional termination of a pregnancy. More than forty percent of women have an abortion during their reproductive cycle in their lives. In the United States, 3 out of 10 women have had an abortion by the time they are forty-five years old. Throughout the world, about 20-30 million legal abortions are performed each year, while another 10-20 million more are performed illegally. According to E Medicine Health, illegal abortions are unsafe and are responsible for 13% of deaths in women. [2]

Requirements and arguments

There are different requirements for women who wish to access abortion services. [3] [4] If someone is under eighteen, the person's state may require parental consent from one or both parents for the abortion to be carried out. In most states, it is possible to go to a judge and request to be excused from this requirement. The Supreme Court first legalized abortion in 1973 with the Roe vs. Wade decision.

When an abortion can be done depends on how far along an individual is in their pregnancy. Depending on that fact, [5] the mother may have a choice between a medical abortion, which uses drugs to induce the abortion, or a surgical abortion. In a surgical abortion, the mother undergoes an operation to have the fetus and placenta removed. After nine weeks, a surgical abortion is typically the only option.

There are many controversial questions that arise when the issues of abortion are discussed in the political and social arenas. Some questions that are considered are: "Should spouses be notified before a woman has an abortion?", "Should public funds be used for abortions?", "Should the rules be different in cases of sexual assault and rape?" The issue of parental consent also surfaces. There are many pro and con arguments that arise when discussing whether abortion should be legal. Many supporters of legal abortion argue that the Supreme Court has declared abortion to be "a fundamental right guaranteed by the constitution.” They also argue that allowing women to get abortions gives them control over their own bodies. In general, individuals who believe abortion should be illegal disagree. First and foremost, they believe that abortion is murder. They believe that life begins at conception. These are only a few of the many important arguments that both supporters and non-supporters voice regarding abortions.

Adoption

Types of adoption

There are two types of adoption to choose from: closed adoption and open adoption. Closed adoptions occur when the birthmother and the family adopting do not receive any information about one another, which typically happens when the birthmother wants to remain anonymous. Open adoptions occur when the birth mother and the adoptive parents do have some form of contact. In this situation, the birthmother usually selects the family based on their values, lifestyle, and religion. Sometimes the birthmother and adoptive parents will have some type of relationship, which might include visits with the child, phone calls, or pictures to update the birthmother. Birthmothers might choose this option when they want to be updated as the child grows up. [6]

Adoption laws

Whether open or closed adoption is chosen, adoption is legal and binding. Every adoption must be approved by a judge in a court of law. The adoption laws differ in each state, and adoption agencies, counselors, or lawyers can give information on the laws in each state. After the baby is born, the birth mother must sign papers to terminate her rights as the parent of the child. Laws about the birth father's consent also vary from state to state. [6]

Choosing to parent

Prenatal care

When an unplanned pregnancy occurs, women are usually placed in a difficult position - as such, it is recommended they should write down thoughts, feelings, and fears about their pregnancy options to help with their decision. [7] If the woman decides to parent the child herself, her first step is to start prenatal care. This will ensure she and the baby stay in good health. [8] Prenatal care refers to the care that a woman receives from a health care provider, such as a doctor or midwife, during pregnancy. During the first prenatal care visit, the mother will have a full physical examination as well as a gynecological exam. Typically, for a healthy patient between the ages of 18 and 35, the expectant mother will see her doctor every four to six weeks for the first 32 weeks (8 months); from weeks 32 to 37, every two to three weeks; and from week 37 until delivery, every week. [9]

Lifestyle changes

If the mother chooses to parent, doctors often encourage mothers to make positive lifestyle choices in order to prevent health problems with the unborn baby. This often includes avoiding the consumption of caffeine, alcohol, cigarettes, marijuana, other recreational drugs, some prescribed medications, and some over-the-counter remedies. The mother is also usually encouraged to maintain a healthy diet and to exercise regularly. More than 97 to 98% of babies are born healthy. [10]

Monetary assistance

The U.S. Department of Health and Human Services has a program called Maternal and Child Health Bureau that coordinates medical care, support, and advice for pregnant women as well as information about health insurance. [11] The mission of the Maternal and Child Health Bureau is to provide leadership to improve the physical and mental health, safety, and well-being of the maternal and child health population, which includes all of the nation's women, infants, children, adolescents, and their families. [12] Medicaid and Children's Health Insurance Program are two assistance programs that aid with paying for prenatal care.

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<span class="mw-page-title-main">Gestation</span> Period during the carrying of an embryo

Gestation is the period of development during the carrying of an embryo, and later fetus, inside viviparous animals. It is typical for mammals, but also occurs for some non-mammals. Mammals during pregnancy can have one or more gestations at the same time, for example in a multiple birth.

<span class="mw-page-title-main">Prenatal care</span> Medical check-ups during pregnancy

Prenatal care, also known as antenatal care, is a type of preventive healthcare. It is provided in the form of medical checkups, consisting of recommendations on managing a healthy lifestyle and the provision of medical information such as maternal physiological changes in pregnancy, biological changes, and prenatal nutrition including prenatal vitamins, which prevents potential health problems throughout the course of the pregnancy and promotes the mother and child's health alike. The availability of routine prenatal care, including prenatal screening and diagnosis, has played a part in reducing the frequency of maternal death, miscarriages, birth defects, low birth weight, neonatal infections and other preventable health problems.

<span class="mw-page-title-main">Teenage pregnancy</span> Pregnancy in human females under the age of 20

Teenage pregnancy, also known as adolescent pregnancy, is pregnancy in a female adolescent under the age of 20. This includes those who are legally considered adults in their country. The WHO defines adolescence as the period between the ages of 10 and 19 years. Pregnancy can occur with sexual intercourse after the start of ovulation, which can be before the first menstrual period (menarche) but usually occurs after the onset of periods. In healthy, well-nourished girls, the first period usually takes place around the age of 12.

<span class="mw-page-title-main">Family planning</span> Planning when to have children

Family planning is the consideration of the number of children a person wishes to have, including the choice to have no children, and the age at which they wish to have them. Things that may play a role on family planning decisions include marital situation, career or work considerations, financial situations. If sexually active, family planning may involve the use of contraception and other techniques to control the timing of reproduction.

<span class="mw-page-title-main">Maternal death</span> Aspect of human reproduction and medicine

Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pregnancy, underlying conditions worsened by the pregnancy or management of these conditions. This can occur either while they are pregnant or within six weeks of resolution of the pregnancy. The CDC definition of pregnancy-related deaths extends the period of consideration to include one year from the resolution of the pregnancy. Pregnancy associated death, as defined by the American College of Obstetricians and Gynecologists (ACOG), are all deaths occurring within one year of a pregnancy resolution. Identification of pregnancy associated deaths is important for deciding whether or not the pregnancy was a direct or indirect contributing cause of the death.

<span class="mw-page-title-main">Prenatal testing</span> Testing for diseases or conditions in a fetus

Prenatal testing consists of prenatal screening and prenatal diagnosis, which are aspects of prenatal care that focus on detecting problems with the pregnancy as early as possible. These may be anatomic and physiologic problems with the health of the zygote, embryo, or fetus, either before gestation even starts or as early in gestation as practicable. Screening can detect problems such as neural tube defects, chromosome abnormalities, and gene mutations that would lead to genetic disorders and birth defects, such as spina bifida, cleft palate, Down syndrome, Tay–Sachs disease, sickle cell anemia, thalassemia, cystic fibrosis, muscular dystrophy, and fragile X syndrome. Some tests are designed to discover problems which primarily affect the health of the mother, such as PAPP-A to detect pre-eclampsia or glucose tolerance tests to diagnose gestational diabetes. Screening can also detect anatomical defects such as hydrocephalus, anencephaly, heart defects, and amniotic band syndrome.

<span class="mw-page-title-main">Pregnancy</span> Time of offspring development in mothers body

Pregnancy is the time during which one or more offspring develops (gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins.

<span class="mw-page-title-main">Crisis pregnancy center</span> Organization that persuades pregnant women against having abortions

A crisis pregnancy center (CPC), sometimes called a pregnancy resource center (PRC) or a pro-life pregnancy center, is a type of nonprofit organization established by anti-abortion groups primarily to persuade pregnant women against having an abortion. In the United States, CPCs that qualify as medical clinics may also provide pregnancy testing, sonograms, and other services, while many others operate without medical licensing under varying degrees of regulation. CPCs have frequently been found to disseminate false medical information about the supposed physical and mental health risks of abortion, and sometimes promulgate misinformation about the effectiveness of condoms and prevention of sexually transmitted infections. CPCs are sometimes referred to as fake abortion clinics by scholars, the media, and supporters of abortion rights, due to deceptive advertising practices that obscure the anti-abortion agenda of CPCs from potential patients seeking abortions.

Pregnancy options counseling is a form of counseling that provides information and support regarding pregnancy. Women seeking pregnancy options counseling are typically doing so in the case of an unplanned or unintended pregnancy. Limited access to birth control and family planning resources, as well as misuse of birth control are some of the major contributing factors to unintended pregnancies around the world. In 2012, the global rate of unintended pregnancies was estimated to be 40 percent, or eighty-five million pregnancies.

Maternal health is the health of women during pregnancy, childbirth, and the postpartum period. In most cases, maternal health encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to ensure a positive and fulfilling experience. In other cases, maternal health can reduce maternal morbidity and mortality. Maternal health revolves around the health and wellness of pregnant women, particularly when they are pregnant, at the time they give birth, and during child-raising. WHO has indicated that even though motherhood has been considered as a fulfilling natural experience that is emotional to the mother, a high percentage of women develop health problems and sometimes even die. Because of this, there is a need to invest in the health of women. The investment can be achieved in different ways, among the main ones being subsidizing the healthcare cost, education on maternal health, encouraging effective family planning, and ensuring progressive check up on the health of women with children. Maternal morbidity and mortality particularly affects women of color and women living in low and lower-middle income countries.

The genetics and abortion issue is an extension of the abortion debate and the disability rights movement. Since the advent of forms of prenatal diagnosis, such as amniocentesis and ultrasound, it has become possible to detect the presence of congenital disorders in the fetus before birth. Specifically, disability-selective abortion is the abortion of fetuses that are found to have non-fatal mental or physical defects detected through prenatal testing. Many prenatal tests are now considered routine, such as testing for Down syndrome. Women who are discovered to be carrying fetuses with disabilities are often faced with the decision of whether to abort or to prepare to parent a child with disabilities.

<span class="mw-page-title-main">Faye Wattleton</span> American activist

Faye Wattleton is an American reproductive rights activist who was the first African American and the youngest president ever elected of Planned Parenthood Federation of America, and the first woman since Margaret Sanger to hold the position. She is currently Co-founder & Director at EeroQ, a quantum computing company. She is best known for her contributions to family planning and reproductive health, and the reproductive rights movement.

Unintended pregnancies are pregnancies that are mistimed, unplanned or unwanted at the time of conception.

Effects of adoption on the birth mother include stigma and other psychological effects a woman experiences when she places her child for adoption.

The following outline is provided as an overview of and topical guide to obstetrics:

Prenatal care in the United States is a health care preventive care protocol recommended to women with the goal to provide regular check-ups that allow obstetricians-gynecologists or midwives to detect, treat and prevent potential health problems throughout the course of pregnancy while promoting healthy lifestyles that benefit both mother and child. Patients are encouraged to attend monthly checkups during the first two trimesters and in the third trimester gradually increasing to weekly visits. Women who suspect they are pregnant can schedule pregnancy tests prior to 9 weeks gestation. Once pregnancy is confirmed an initial appointment is scheduled after 8 weeks gestation. Subsequent appointments consist of various tests ranging from blood pressure to glucose levels to check on the health of the mother and fetus. If not, appropriate treatment will then be provided to hinder any further complications.

Antenatal depression, also known as prenatal or perinatal depression, is a form of clinical depression that can affect a woman during pregnancy, and can be a precursor to postpartum depression if not properly treated. It is estimated that 7% to 20% of pregnant women are affected by this condition. Any form of prenatal stress felt by the mother can have negative effects on various aspects of fetal development, which can cause harm to the mother and child. Even after birth, a child born from a depressed or stressed mother feels the affects. The child is less active and can also experience emotional distress. Antenatal depression can be caused by the stress and worry that pregnancy can bring, but at a more severe level. Other triggers include unplanned pregnancy, difficulty becoming pregnant, history of abuse, and economic or family situations.

HIV in pregnancy is the presence of an HIV/AIDS infection in a woman while she is pregnant. There is a risk of HIV transmission from mother to child in three primary situations: pregnancy, childbirth, and while breastfeeding. This topic is important because the risk of viral transmission can be significantly reduced with appropriate medical intervention, and without treatment HIV/AIDS can cause significant illness and death in both the mother and child. This is exemplified by data from The Centers for Disease Control (CDC): In the United States and Puerto Rico between the years of 2014–2017, where prenatal care is generally accessible, there were 10,257 infants in the United States and Puerto Rico who were exposed to a maternal HIV infection in utero who did not become infected and 244 exposed infants who did become infected.

Paper abortion, also known as a financial abortion, male abortion or a statutory abort, is the proposed ability of the biological father, before the birth of the child, to opt out of any rights, privileges, and responsibilities toward the child, including financial support. By this means, before a child is born, a man would be able to absolve himself of both the privileges and demands of fatherhood.

<span class="mw-page-title-main">Maternal healthcare in Texas</span>

Maternal healthcare in Texas refers to the provision of family planning services, abortion options, pregnancy-related services, and physical and mental well-being care for women during the prenatal and postpartum periods. The provision of maternal health services in each state can prevent and reduce the incidence of maternal morbidity and mortality and fetal death.

References

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  5. "Abortion: Get Facts About the Procedure and Statistics". eMedicineHealth. Retrieved 2015-11-04.
  6. 1 2 "Thinking About Adoption". Planned Parenthood. Planned Parenthood Federation of American Inc. Retrieved 25 October 2015.
  7. "My Three Pregnancy Choices". American Pregnancy Association. Retrieved 25 October 2015.
  8. "Pregnancy Options". Planned Parenthood. Retrieved 25 October 2015.
  9. "Prenatal Care". Planned Parenthood. Retrieved 25 October 2015.
  10. "Lifestyle Changes During Pregnancy". Kid Spot. Retrieved 5 November 2015.
  11. "Help for Low-Income Pregnant Women and Families". Baby Center. Retrieved 25 October 2015.
  12. "About Us". Maternal and Child Health. U.S. Department of Health and Human Services. Retrieved 25 October 2015.