Counselling in 2nd trimester: What do women need?
Mariet Lecoultre (The Netherlands)
Beahuis & Bloemenhove Kliniek, The Netherlands
From 7 weeks LMP onwards, the Dutch Pregnancy Termination Act (1984) provides for a mandatory five-day consideration period. The actual abortion can take place in at least 5 days after a first consultation with a doctor. During this initial doctor’s appointment the GP/MD must inform the woman of the alternatives available to her. The woman herself decides whether she continues her pregnancy or not.
In 2006 32,992 abortions were performed in the Netherlands. 13.7 percent of these interventions concern women who are non residents of the Netherlands. Due to the restrictive law in their respective countries, these women have to travel to another country for the intervention. As in the previous year, 15.2 percent involved second-trimester abortions from 14 weeks LMP onwards. 70% of these second trimester abortions concerned non Dutch residents. The great majority (94.3 percent) of the interventions in Holland takes place in one of the 16 specialized abortion clinics and is done by general practitioners.
The Centre where I work is specialized in second trimester abortions. We perform interventions till 22 weeks am. Many of the women we see have gone through various and sometimes difficult stages in their demand for a termination due to the fact that they have passed the legal delay for an abortion in their home country or have consulted a doctor who has ethical difficulties in dealing with second trimester abortion and refuses to refer her to a clinic where she could have the intervention.
Although there is not much difference in second and first trimester counseling it is our experience that all women have to be offered the possibility to discuss their demand. The true conviction of our entire staff is that it is only the woman who can decide and consequently counseling should be superfluous unless the woman indicates that she needs a consultation about her decision with a professional. However, as we are bound to a law which is not so liberal – contrary to what many may believe from the Netherlands – I will focus my presentation on the typical Dutch model we have developed to work within the framework of this law and at the same time leave the responsibility of the decision to the woman.