Counselling skills
User comes very overwhelmed, she's had a c-section 11 months ago. She is now 6 weeks pregnant. She wants to know how to recognize whether pills are fake. How do we counsel?
1. Address her anxiety. CR User's anxiety might help.
2. Explain she can use abortion pills after a c-section.
3. Edit and share CR how to identify pills
Direct providers vs national organisations. Where do we locate each one?
Nat organizations go under the box Refered to on-the-ground organizations.Direct providers go under the Referred to direct provider.
User indicates they have some medical conditions that could be serious, and you want the rest of the team to know about it. Where do you leave your comments?
Medical notes box
Is hyperthyroidism a contraindication to proceed with a medical abortion?
No, it isn't. Hypothyroidism: OK with pills (even if she is on thyroid medications). Anything you would add to reassure the treatment will go well?
What should we ask the user after sharing the map ID link?
We should ask if she could open the link properly and if she has further questions.
True or false:
With our update protocol, we do not recommend to use tampons or cups during an MA.
False.
We counsel as follow: Use pads at first to see how much you are bleeding. You can switch to a tampon or cup when you feel comfortable.
Is IUD listed as a medical contraindication?
Yes, it's under the "I have at least one" drop-down menu.
True or False:
We should delete all CR's headers which contain internal indications?
True.
Important reminder: Deleting CR titles is very important to tailor the email to user's needs. The user don't need to read counsellors internal indications.
True or false?
Users need to go for an ultrasound before and after the self-managed abortion.
False.
They do not need to have an ultrasound done before or after an abortion.
Exceptions?
What should we do in case we identify outdated information in the Database or country CR?
We should tag Rosa to let her know. What else do you think we could do?
What should we do if the user dropped in the chat and we have their email address?
Sending a follow up email, asking if they have any other questions and maybe sharing referrals if you consider that's appropriate.
What do you think is the most commonly empty PF box -even though the user provided the information?
Gestational age and LMP are the most common missing ones.Why do you think this is? How can we encourage filling in all blanks?
True or false:
It is forbidden to use emojis when chatting with a user?
FALSE. It’s 100% fine to tweak our replies to fit the user’s style. Think of it like wearing their favorite color instead of a simple uniform!
True or false?
User has been using long term oral steroids -Prednisone-. Using the combined treatment is not recommended. However, she can proceed with Miso only.
True. It is perfectly safe to have an abortion with Misoprostol Only in such a case.
How do we know a referral partner uses especific referral language? Where do we obtain that information from?
1. It's usually listed in the country CR.
2. It is especified in the bag you create in the Database under "code to use".
3. You can always ask Rosa or the team.
What do we do when a user did not take a pregnancy test? And is very nervous about it.
Appraise the situation: acknowledge the feelings behind not taking a pregnancy test: Is it anxiety because it's a missed period? Is it recent unprotected intercourse? Not sure about their menses?
Please guide how to complete Reason for contact box in this case:
The user is during the procedure and used a different protocol. She has used 2 doses of 2 pills, one dose was sublingual and the second one was vaginal. Bleeding was around one menstrual pad. She is 10 week pregnant.
PAC- Incomplete abortion / failed treatment.
True or false:
When highlighting some sentence or word in an email, you should keep in mind the brand colours.
True.
How do we know which are the colours and how to apply them in the text?
User from Nigeria, 8 weeks pregnant. She is currently not eating well due to Malaria. She is receiving treatment for it but she just found out she has an unwanted pregnancy. What should we advise?
If she currently has malaria, she is at risk for anemia, which could be complicated further with heavy bleeding from the pill abortion. It is important that she is under the care of a physician for the malaria treatment, and important that she has access to care during the pill abortion in case she needs it. If she is being treated for malaria, she should complete her treatment first before using the abortin pills.
A user has provided the following info:
test method to confirm pregnancy, medical conditions and medication and country.
Should we offer Referrals?
Depends on the situation:
If user has confirmed with an ultrasound, she may know her GA.
If she is uncertained, emphasize on the amount of weeks before referring. If you feel there's something off, avoid sharing direct providers. Use international organizations instead.
User with less than 5 weeks pregnant from Indonesia. She already tried with Miso only treatment, used the pills correctly, however there was no bleeding, just little cramping. She got a new set of pills, she is noticeably anxious and nervious. She has talked to several counsellors and three of them told her she could repeat right away. The fourth counsellor suggested treatment that early might fail. User was furious and felt frustrated. What would be your answer to her? What could the team have said to avoid user's confusion and frustration?
Let's brainstorm!
Name 3 reasons for NOT referring.
1. Hasn't confirmed pregnancy.
2. No referrals available.
3. Not enough information on the user.
4. User wants to keep control of SMA
5. Dropped conversation.
6. Talking to other than the abortion seeker.
We have been repeating that canned responses should be .... before sharing with users.
Customized
Fever can be both a side effect of misoprostol and a warning sign. Is it essential that fever as a side effect cannot last for more than 24 hours? How can one distinguish between a side effect and a warning sign with fever?
Misoprostol is rapidly eliminated from the body. It has an elimination half life of 20-40 minutes. This means that after 20-40 minutes the substance has lost half of its pharmacologic activity.
This is important because fever as a side effect of misoprostol would occur near the drugs peak activity level, thus risk of fever also diminishes rapidly as the medication disappears. This is why 24 hours is used as a cutoff, because it is unlikely to cause fever beyond 24 hours as it is essentially gone from the system.
Fever as a warning sign of infection may be accompanied by body aches, nausea, sharp abdominal pain, and foul/odorous vaginal discharge.
Which two referral partners are the best options for a user from the Philippines who is asking where to get the pills?
Women Help Women and Women on Web. These two are totally solid options - but heads up, their elegibility criteria is up to 10 weeks. There's also a request donation of €75.
Any other referral option we can suggest?