Woman-Centered Postabortion Care

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Woman-Centered Postabortion Care
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Post-Procedure Care
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Purpose

• This module covers the knowledge needed to
  provide care for women immediately following a
  uterine evacuation procedure until discharge.

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Objectives

• At the end of this module, learners should be
  able to
• Describe the elements of post-procedure care
• Determine if PAC post-procedure symptoms require
  attention
• Provide patient instructions
• Arrange a follow-up appointment

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Post-Procedure Care

• Care provided after medical intervention
  completed
• Physical and emotional complications addressed
• Educate the woman about her condition and
  self-care
• Ends when she is discharged

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PAC Elements of Post-Procedure Care

• Physical monitoring
• Pain management
• Provision of antibiotics
• Other health issues
• Emotional monitoring and support

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PAC Elements of Post-Procedure Care (cont.)

• Contraceptive counseling
• Counseling about unsafe abortion
• Follow-up care arranged
• Discharge instructions given

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Physical Monitoring

• Ensure she is resting comfortably
• Take vital signs immediately
• Review chart for condition, history
• Monitor physiological status

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Physical Monitoring (cont.)

• Assess, manage complications
• Significant physical decline
• Dizziness, shortness of breath, fainting
• Severe vaginal bleeding
• Severe abdominal pain, cramping
• Support recovery
• Evaluate bleeding and cramping twice
• Continue existing therapy

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Physical Monitoring
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Pain Management

• Evaluate pain level, patterns
• Offer choices for pain relief
• Administer, monitor pain medications
• Offer support, including compresses,
  compassionate touch
• If a womans pain increases, she needs attention

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Provision of Antibiotics

• Prophylactic reduces risk of infection for all
  women
• Therapeutic for infection
• Monitor for allergic reaction

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Other Physical- and Reproductive-Health Issues

• Anemia counsel on diet, supplements
• Tetanus exposure administer vaccine or refer
• Rh-immunoglobulin administer according to
  protocol
• STI, HIV, violence, infertility, cancer
  screening counsel and refer

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Emotional Monitoring and Support

• Assess and monitor the womans emotions
• Provide consolation
• Offer appropriate touch
• Offer counseling or referral

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Post-Procedure Contraceptive Counseling

• Women may be able to focus on contraceptive needs
• Women may be motivated to prevent unwanted
  pregnancies
• Discuss reproductive plans
• Ensure she receives counseling and method, or
  refer her
• Some women may desire pregnancy

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Counseling About Unsafe Abortion

• Explain risks
• Describe risky behaviors
• Important to seek assistance early
• Describe legal options

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Follow-Up Care

• Make appointment
• Appointment tailored to condition, needs
• Obtain consent to send records to follow-up
  provider

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Woman is Ready for Discharge

• Vital signs are normal for her
• Bleeding and cramping diminished
• Awake, alert, walks unassisted
• She agrees she is ready to leave

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Normal Recovery

• A few days of menstrual-like bleeding, cramping
• Can use analgesics, baths, compresses for
  cramping
• Next menses four to eight weeks
• Can get pregnant almost immediately
• Intercourse, tampons when complications resolved

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Medications During Recovery
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Signs Needing Immediate Attention

• Fever, chills, fainting, vomiting
• Swollen, tender abdomen
• Foul discharge
• Cramping, bleeding more than normal menses
• Delay in resumption of menstruation (more than
  eight weeks)

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Before Discharge

• She received contraceptive counseling and a
  method
• She was counseled about unsafe abortion
• A follow-up appointment or referral was made

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Contraceptive Counseling Before Discharge
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Referrals for the Woman
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Educate Communities About PAC

• Signs of abortion complications
• Need for prompt attention
• Organize emergency transportation
• Follow-up in homes where needed

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Illustrations by Stephen C. Edgerton