Ask open-ended questions “What questions do you have for me?”
Clarify the facts “Knowing how far along you are will let you know how much time you have to decide.”
Reflect/Normalize “Many people feel …”
“I hear that is difficult for you.”
“It is okay to cry here.”
Seek to understand “Can you tell me more about that?”
Validate; don’t fix “That sounds really challenging. I’m sorry you’re feeling…”
Frame the situation “It sounds like you are being thoughtful and making the best possible decision for yourself.” “Deciding what’s best for you can be hard – but that doesn’t make it wrong.”
Reassure the patient “I trust and respect your feelings. You are the best person to make decisions for you and your family”
Check in about support people “It may be helpful to tell someone you trust and who will support your decision, no matter what it is. Do you have someone like that to talk to?” If not, “What might happen if your partner/family/friend found out about the abortion?”
Communicate acceptance with tone and body language Be mindful of your tone, facial expression, and body language. Use eye contact (if culturally appropriate). Sit at their level.
Use silence Give them time to finish their sentences and thoughts.
Give the patient control; keep them informed about next steps “Which would you prefer?”
“You are in control. Let me know when you’re ready to proceed.”
Address Common Fears
Impact on health
“Tell me more about your fears or worries.”
Review options for pain control and relaxation. Review safety and lack of impact on fertility, mental and overall health.
Consider language and literacy level Always use interpreting services when needed. Approach counseling using culturally appropriate language and exercises based on literacy level.
Over-identification I know exactly how you feel Many patients feel that way
Medical or stigmatizing jargon Elective abortion
It’s your choice
Are you planning to have a medical abortion or surgery?
Abortion (or mirror the patient’s terminology)
I support whatever decision you make about this pregnancy.
Are you planning to have a medication abortion (with pills) or in-clinic abortion?
Loaded statements Your family supports your decision, right? Who can support you through this, without judgment?


TEACH Abortion Training Curriculum Copyright © 2022 by UCSF Bixby Center for Global Reproductive Health. All Rights Reserved.