Counselling of complications of termination of pregnancy within a single Trust setting

National guidelines on the care of women requesting induced abortion recommend that counselling prior to termination of pregnancy (TOP) includes information about potential complications and sequelae. Case notes of women requesting TOP in a single hospital Trust were audited for documentation of counselling about complications. As a result of this audit the integrated care pathway (ICP) was altered to include a list of the potential complications and sequelae. We repeated the audit to evaluate the effect of this intervention on counselling.

To re-audit the counselling of women undergoing TOP with regard to the potential complications and sequelae of TOP and to compare counselling in consultant-led and nurse-led clinics.

The study population comprised women requesting TOP within south Glasgow, UK who were seen in a consultant-led gynaecology clinic or nurse-led clinic. A retrospective audit was carried out in 2004 and a prospective audit in 2005. Case notes and correspondence to primary care referrers were reviewed for documented evidence of counselling.

We reviewed 98% of case notes in the first audit and 85% in the second audit. Results from both nurse-led and consultant-led clinics indicated that evidence of adequate counselling had improved, with an increase from 98% to 100% in the nurse-led clinics and from 43% to 64% in the consultant-led clinics.

Comparison of results from 2004 and 2005 suggests improvement in counselling since introduction of an ICP listing complications and sequelae of TOP.