Aftercare following second trimester abortion procedures

The purpose of this review is to examine patient experiences following second-trimester abortion care to identify clinical interventions to improve aftercare.

Early validation of a five-question Reproductive Grief Screen suggests that this instrument may be useful for clinicians to identify patients with maladaptive grief responses following a second-trimester abortion. Patients want to talk with their healthcare providers about grief following abortion and desire frequent mental health check-ins. Most people will have breast symptoms following a second-trimester abortion; a one-time dose of cabergoline at time of abortion appears to be an effective intervention to prevent bothersome breast symptoms. As patient desires vary regarding disposition of fetal remains, clinicians should be prepared to discuss donation for research or cremation/ burial as alternatives to routine disposal. With significant variation in availability and cost of ceremonial disposition, clinicians and healthcare systems should identify local resources to facilitate this aspect of aftercare.

Clinical practices and healthcare systems should prioritize the aftercare experience including the management of breast symptoms, bereavement, disposition of fetal remains, and follow-up care.