Pregnancy Options Counseling and Referral

Patients should be fully informed about all pregnancy options: parenting, adoption, and abortion.e

An All Options Model is defined as "creating space and using active listening to explore someone’s pregnancy decisions, feelings, and experiences, with curiosity and empathy, and without an agenda."140, 141 The goal of pregnancy options counseling is to equip people with information and resources.

Providers must offer nondirective counseling and be equipped to offer factual, neutral, nonjudgmental information about each option. Providers working in communities that are in states with restrictive abortion laws may consider using third-person language to share information. Options counseling should be provided in accordance with recommendations from professional medical associations, such as AAP.142

For persons desiring to continue the pregnancy, affirm their decision and offer prenatal care and/or referrals. Talk with the person to learn of any other referrals or resources that may be helpful to them.
For persons interested in pursuing adoption, affirm and offer resources to support this decision, including prenatal care and/or referrals. Providers may share appropriate community and/or national resources and referrals.
For persons desiring to end the pregnancy, affirm this decision, and offer resource information. Based on gestational age and setting, explain to the patient what options may be available (such as medication abortion or uterine aspiration). When considering providing abortion care on-site or referring for abortion care, providers should be aware of factors affecting abortion access—including proximity of abortion care facilities—and legal restrictions on abortion care, including state-based legal restrictions impacting individuals seeking abortion services.

A person receiving options counseling does not need to declare or come to a decision by the end of the counseling session. It is important to remember that patients have the right to receive, request, and refuse referrals and resources or information about all pregnancy options. They also have the right to defer making any decisions about their pregnancy during the visit. If a patient chooses to defer making a decision, discuss a timetable with the patient to help them understand their options at different gestational ages.

Resources for Providers

Exploring All Options: Pregnancy Counseling Without Bias Video Series

Source:

Reproductive Health National Training Center

Practice Guide for All Options Pregnancy Counseling

Source:

PROVIDE

140
Provide. Practice Guide for All-Options Pregnancy Counseling.
141
The Clinical Training Center for Sexual & Reproductive Health. Nondirective Counseling for Pregnancy Options in Title X Clinics
142
American Academy of Pediatrics, Committee on Adolescence. Options Counseling for the Pregnant Adolescent Patient. Pediatrics. 2022;150(3):e2022058781.
e
Federal conscience laws protect health care providers that refuse to participate in certain health care services on religious or moral grounds. These laws include the Church Amendments, codified at 42 U.S.C. § 300a-7; the Coats-Snowe Amendment, contained in 42 U.S.C. § 238n, et seq.; the Weldon Amendment, contained in Consolidated Appropriations Act, 2024, Public Law 118–47, div. H, tit. V, sec. 507(d)(1), 138 Stat. 460, 703 (Mar. 23, 2024); and others. The Department complies with all applicable federal conscience laws. More information about conscience laws is available here: Conscience Protections | HHS.gov. As noted in footnote b, the Title X statute (42 U.S.C. §300 et seq.), legislative mandates included in annual HHS appropriations, and the Title X implementing regulations at 42 CFR Part 59, Subpart A (86 Fed. Reg. 56144) prohibit providers from using Title X funds for abortion and certain related activities. For additional information about Title X restrictions, see OPA guidance at https://opa.hhs.gov/grant-programs/title-x-service-grants/about-title-x-service-grants/program-policy-notices.