Catharina Zätterström


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    Counselling aspects
    Catharina Zätterström, Midwife, supervisor for Family Planning Clinics and Youth Clinics in
    SLSO South-West Stockholm, Sweden,
    Contraceptive counselling is usually given to the woman both before the abortion, by a
    physicians or a midwife and after, at the post-aborton visit by a midwife. Roughly 50–60%
    of the women will come back for a check-up 3-4 weeks after the abortion.
    Women applying for repeat abortions have experienced more psychological problems
    during their lifetime compared with women applying for their first abortion. Women who
    have had previous abortion/abortions seem to need for special attention, which should
    include not only efficient and acceptable contraception but also social and psychological
    support based on the individual woman’s need.
    In several studies the use of contraceptives amongst women applying for repeat abortion
    had been affected by family circumstances more than amongst women applying for their
    first abortion. This could indicate the need for including men in family planning programs.
    In Sweden immigrant status seems to be an independent risk factor for induced abortion.
    Immigrant women also have more early pregnancies and less knowledge and experience
    of contraceptives. Immigrant status is also an independent risk factor for repeat abortions.
    Although immigrant women after 10 years in Sweden are more socioeconomically equal to
    the Swedish-born women regarding education, employment and marital status but they still
    have more children and have experienced more induced abortions than Swedish-born
    Post-abortion check-up in Sweden is focused on the woman’s medical condition and on
    her need for efficient contraceptives. It is seldom designed to suit the individual woman.