All health care providers must provide accurate and unbiased information so that patients can make informed decisions. Conscientious refusals should be limited if they constitute an imposition of religious or moral beliefs on patients, negatively affect a person’s health, are based on scientific misinformation, or create or reinforce racial or socioeconomic inequalities (ACOG 2007).
Referral begins by providing information to your patient if they need services beyond what you can provide in your clinic. It is important to regularly vet referral resources for quality control (consider making “mystery shopper” calls to referral sites). While referral practices and motivations varied, one national study showed few clinicians facilitate referral for abortion beyond verbally naming a clinic if an abortion referral was made at all (Homaifar 2017).
In areas where access is limited, patients may face multiple obstacles to obtaining an abortion, and good care coordination is critical to ensure that people receive the services they need. Taking a more active role in referrals can help clear up misperceptions or misinformation about the legality and safety of abortion, and can assist with complex social or medical circumstances (Zurek 2015). Important steps to fully assist the patient may include:
- Scheduling an appointment
- Helping access supportive services such as funding (i.e. abortionfunds.org), travel support (i.e. brigidalliance.org), childcare, insurance coverage, or interpreter services.
- Following up on the patient’s satisfaction and outcomes with the care received
- Following up with patients that were referred out
In addition to referrals for services you don’t offer, making a referral may also involve:
- A pregnancy options talk line for people who are ambivalent or are needing more support after an abortion (e.g. All Options Talkline)
- Prenatal care or adoption facilitators (open and closed adoption)
- Intimate partner violence specialists
- Human trafficking specialists
- Referral for a judicial bypass for a minor
- Sexual abuse care
- Mental health services
- Substance use services
- Post-abortion counseling referrals
- Social support services