Clients with Special Counseling Needs

Counseling Pregnant and Postpartum Women

Women who are pregnant and women in the postpartum stage have a special need for reproductive health counseling and may have many questions about pregnancy, labor and delivery, breastfeeding, and caring for the baby. They may also seek information about birth spacing and family planning.

Ideally, family planning counseling and services should be linked with maternity services so that pregnant and postpartum women can easily receive contraceptive information and services. Providers who have contact with pregnant and postpartum women must overcome any preconceptions and paternalistic attitudes that may limit a woman's decisions to use or forego postpartum contraception. Special care must be taken to ensure informed choice and consent when family planning services are provided in the perinatal period. Women who want to receive information about family planning should learn about breastfeeding and its contraceptive effects and about the availability of contraceptive methods that can be used safely immediately after delivery, as well as the range of methods that can be used safely at a later time. They should also be informed about where they can go to receive contraceptive services.

Return to the Informed Choice page.

Counseling Postabortion Women

Most women who have just undergone an induced abortion have a special need for family planning information. In fact, many women who obtain abortions do so because they did not have access to family planning information and services or to a particular contraceptive method. Women who have had abortions have special counseling needs, in part because they have just been through a stressful experience and because they often face disapproval from service providers and others within their community.

In addition to receiving information related to their treatment and recovery, women who have just been treated for an incomplete abortion or who have had an induced or spontaneous abortion need certain minimal information about fertility and contraception. Postabortion women should be informed that fertility may return within two weeks of abortion, and that several contraceptive methods can be used safely either immediately after abortion or at a later time.

Providers who have contact with postabortion clients must overcome any preconceptions and paternalistic attitudes that may limit a woman's decisions to use or forego postabortion contraception. If the woman chooses to obtain contraception, she needs to know where she can receive comprehensive contraceptive services.

Return to the Informed Choice page.

Counseling Adolescents

The family planning needs of adolescents are very different than the needs of adults. In many cultures, it is inappropriate and unacceptable for young unmarried women to go to family planning clinics. In some countries, many adolescents go to family planning clinics without parental knowledge or consent. However, in many countries, parental consent may be required.

In some locations, providers who disapprove of sexual activity among unmarried adolescents may even withhold information from young people. In addition, it is illegal in some countries to provide contraception to adolescents.

Concerns, reasoning, and behavior--especially regarding risk-taking--may be different among adolescents than among adults. Even more than for adult populations, adolescents' knowledge of family planning and sexually transmitted infections will not necessarily influence their behavior. Many sexually active adolescents do not understand the risks of pregnancy, and the primary challenge for providers in most countries is how to reach sexually active adolescents before their first pregnancy. It is important for providers to recognize and understand that adolescents may be strongly influenced by peer pressure, stigma, and lack of information. They may often take risks inconsistent with their knowledge, and they have special needs for privacy.

Return to the Informed Choice page.