Counselling after miscarriage

SAMHSA’s National Helpline | SAMHSA

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SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.
Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

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What Is Substance Abuse Treatment? A Booklet for Families
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Assures teens with parents who abuse alcohol or drugs that, "It's not your fault!" and that they are not alone. Encourages teens to seek emotional support from other adults, school counselors, and youth support groups such as Alateen, and provides a resource list.
After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
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For additional resources, please visit the SAMHSA Store.

Last Updated: 08/30/2022

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The Locator is authorized by the 21st Century Cures Act (Public Law 114-255, Section 9006; 42 U.S.C. 290bb-36d). SAMHSA endeavors to keep the Locator current. All information in the Locator is updated annually from facility responses to SAMHSA’s National Substance Use and Mental Health Services Survey (N-SUMHSS). New facilities that have completed an abbreviated survey and met all the qualifications are added monthly. Updates to facility names, addresses, telephone numbers, and services are made weekly for facilities informing SAMHSA of changes. Facilities may request additions or changes to their information by sending an e-mail to [email protected], by calling the BHSIS Project Office at 1-833-888-1553 (Mon-Fri 8-6 ET), or by electronic form submission using the Locator online application form (intended for additions of new facilities).

Termination of pregnancy from the point of view of a medical psychologist

A modern woman is very different from her great-grandmother. The main difference is the possibility of reproductive choice, which our ancestors did not have.

The priorities of contemporaries are arranged differently, career, desire for personal growth, travel. The whole world is open to a woman today, and the birth of a child does not always fit into her plans.

It often happens that pregnancy just happens at the wrong time. Lack of material base, education, work, loneliness often push a woman to terminate a pregnancy.

According to statistics, there are more than 55 million abortions worldwide. More than half a million is made in Russia. Despite the fact that with the development of medicine, mortality from abortions in clinical settings is minimized, such cases do occur. 30% of maternal deaths in Russia are associated with abortion.

Abortion is the only operation that does not cure diseases and is contrary to the very nature of a woman. This is an interruption of the natural process. No matter how long, and no matter what method it is produced, it never passes without a trace for the physical and psychological health of a woman. Often women do not think about the real dangers of abortion and consider it a means of contraception.

Abortion translated from Latin - abortus - "miscarriage".

Can only be performed in a specialized medical clinic with a license, exclusively by a specialist doctor. Every woman has the right to independently decide on the issue of motherhood, which is enshrined in federal law No. 323 "On the fundamentals of protecting the health of citizens in the Russian Federation"

Three methods of artificial termination of pregnancy are used. The most common of these is the "scraping" method, today WHO has recognized it as obsolete. In second place is the vacuum aspiration method or mini-abortion and medical abortion.

The most common method of abortion "curettage" can cause great complications already during the operation. Such an abortion is performed almost blindly, and artificial opening of the uterus can result in her injury. This abortion can cause severe bleeding, and the most serious consequence of such an abortion may be the removal of the uterus.

This termination of pregnancy is carried out under anesthesia, therefore, it is necessary to remember the possible consequences of the use of anesthesia. In addition to the risk of an allergic reaction, there may be a heart rhythm failure, respiratory failure, a violation of the functions of the liver and other internal organs.

Vacuum aspiration is a less traumatic way for a woman to terminate a pregnancy, but the risk of anesthesia remains.

Medical abortion is performed for up to 9 weeks, on an outpatient basis and up to 12 weeks in an inpatient setting, requires virtually no anesthesia. But it also deals a significant blow to the hormonal system of a woman. Uterine bleeding may also occur or the abortion will be incomplete. In this case, vacuum extraction and treatment will be required.

During and after an abortion, various complications are possible.

Early complications of abortion

- profuse bleeding,

- rupture of the uterine walls,

- filling of the uterine cavity with blood,

- the occurrence of painful contractions,

- incomplete removal of the dead fetus.

There are later consequences of abortion. They can appear in the first weeks after the abortion.

- sepsis,

- metroendometritis (inflammatory processes on the mucous membrane and muscles of the uterus),

- adnexitis (inflammation of the appendages).

Long-term complications of abortion may occur even several years after the abortion. Each abortion undermines the health of a woman and never goes completely without a trace.

- menstrual disorders,

- amenorrhea,

- obstruction of the fallopian tubes,

- endometriosis,

- inflammation of the genital organs,

- difficulties in conception and pregnancy,

- ectopic pregnancy,

- miscarriage,

- premature birth and complications in them,

- infertility,

- increased risk of breast cancer,

- increased risk of developing uterine tumors.

In case of termination of the first pregnancy, the body can change the “carrying program” of the pregnancy to the “miscarriage program”. And the subsequent, already desired pregnancy will end in spontaneous abortion at an early stage. The body will launch a new program, and the pregnancy will not be saved.

A woman going for an abortion does not think about the fact that she may be forever deprived of the happy opportunity to become a mother. Termination of pregnancy cannot go unnoticed by the whole organism as a whole. First of all, it affects the menstrual cycle and the work of the ovaries. But, in addition to the ovaries, there is a violation in the work of such organs as the thyroid gland, adrenal glands, pituitary gland. There comes an imbalance of hormonal, immune, renal and hepatic functions, regulation of blood pressure, blood volume. The woman becomes irritable, sleep worsens, fatigue increases. That is, there is an "ideal state" for the penetration of any infection that provokes the development of infectious and inflammatory diseases.

Very often, when deciding to have an abortion, a woman is aware of the possible consequences for her body, but does not want to know about the consequences for her psyche.

Artificial termination of pregnancy is contrary to the very nature of man. The body does not know if it is carrying a wanted or unwanted pregnancy. The “program of childbearing” laid down in the woman strives to preserve the pregnancy. No matter how the pregnancy is terminated, it is unnatural for the woman's body.

Abortion causes not only physical but also psychological damage to a woman's body. After an abortion, a woman often experiences mental discomfort. 60% of women develop post-abortion syndrome - PAS. In addition, it is necessary to take into account the moral and ethical harm of abortion. Even those who do not believe in God consider this procedure a sin and experience pangs of conscience and guilt.

What is PAS - a set of mental consequences and illnesses that can result from an abortion.

PAS can occur immediately after an abortion and manifest itself in the form of such experiences as a feeling of emptiness, loss, grief. Often women feel guilty, become irritable, aggressive. Anxiety and depressive disorders can often develop.

Abortion is the strongest stress for a woman's psyche. In fact, this is the death of a child, even if not yet born. This feeling is reinforced by the fact that the woman herself made the choice in favor of an abortion.

Every woman who terminates a pregnancy feels guilty. Abortion is generally condemned by society, condemnation from the staff, misunderstanding of loved ones, articles and videos on the Internet only increase the feeling of guilt. After an abortion, a woman is left alone with herself. As a rule, she always understands that all the reasons why she refused to give birth (except for medical reasons) are better called excuses.

When pregnancy comes, a woman feels something inside herself, she feels that this is her child, she can imagine how he will grow and develop, what he would become when he was born. She subconsciously feels that he wanted to be born, but she did not give it to him.

Conditions such as panic and helplessness accompany PAS during the first time after an abortion. After a perfect abortion, there remains a deep feeling that everything, nothing can be returned, no one will help. Relatives often do not know how to behave, and the phrases “you will still give birth”, “now is not the best time for children”, “where would you live with him” and others cause only anger and irritation.

A woman has many questions to which there are no answers. How to be further? Do you speak to loved ones? How will your relationship with your husband develop? How will this affect children? Will I still be able to get pregnant and give birth? What “punishment” will I bear for my sin?

When you decide to have an abortion and sign your consent, no one gives you a list of answers to these questions.

Aggression, irritability, anger, "hardening", intolerance. These qualities can manifest themselves both in the first days after an abortion, and after a fairly long time. Sometimes women say that they cannot communicate with pregnant women and become irritated when they meet strangers on the street. Some say that even commercials showing small children have become unpleasant to them. All this often leads to the fact that a woman is fenced off from the environment, reduces communication with loved ones to a minimum.

Violation of relationships in a couple up to physical and psychological disgust. Abortion will forever stand in the relationship between a man and a woman. Guilt may be the third in such a pair for many years. The future of an aborted couple is often in question.

An unplanned pregnancy is not the fault of only the woman or only the man. Very often, partners begin to mutually blame each other for what happened. A woman often blames a man for pushing her to have an abortion. Many couples break up after an abortion. Many women say that after an abortion it is difficult to physically let a man near them. Libido decreases, it becomes more difficult for a woman to achieve orgasm, in rare cases anorgasmia, frigidity, vaginismus develop.

Negative attitudes towards people and life events in general can persist for a long time after an abortion. Even after a few years, a woman may feel guilty about having an abortion, for example, carrying a desired pregnancy. Because she saved this child, but did not allow the previous one to be born. Some admit that when they become pregnant and give birth to a child after an abortion, instead of warm feelings, they sometimes experience irritation and anger.

The hormonal system is the basis of the woman's psyche. When pregnancy occurs, it is rebuilt so that a woman can bear and give birth to a child. If the pregnancy is terminated, serious disturbances occur in the hormonal system, the woman loses the ability to control her own emotions and feelings.

Endless mood swings, depression, conflicts, insomnia, breaking consciousness and the existing model of perception of the world - all these are the mental consequences of abortion.

According to the law, every pregnant woman has the right to make her own decision: to give birth or not. But, before deciding to take such a step, every woman should weigh everything well and think it over, because the consequences of an abortion can appear even many years after the operation itself.

Abortion will not solve your financial or housing problems.

Abortion will not solve family problems.

Abortion will not make you happier.

Abortion is always a choice against life.

Think, maybe this child will become your joy and support in the future.

Contraception after abortion - selection, installation in St. Petersburg at the clinic "On Sennaya"

Barrier methods

Condoms, diaphragms (caps) and spermicides can be used to prevent unwanted pregnancy after an abortion.

Main advantages of barrier methods:

accessibility;
almost complete absence of contraindications;
no systemic effects on the body.

The main disadvantage of cervical caps and spermicides is their poor performance. Gynecologists recommend combining diaphragmatic contraception and the use of drugs in the form of vaginal tablets, creams or suppositories with other contraceptives.

The condom, on the other hand, is considered one of the most reliable contraceptives, providing additional protection against sexually transmitted infections. The disadvantages include the likelihood of damage to the latex product, a possible decrease in sensitivity for a man and a woman during intercourse.

IUDs

Insertion of an IUD is one of the most reliable ways to avoid unwanted pregnancy for women who have regular sex with a regular partner. Intrauterine devices can be non-hormonal and hormonal. The contraceptive effectiveness of both types is the same and is about 98-99%.

The principle of operation of copper-containing intrauterine devices, the so-called second-generation IUDs, is based on the release of copper ions, which inhibit the activity of sperm and eggs. The main advantage of installing a non-hormonal spiral is the absence of an additional load on the hormonal background. There are also disadvantages: the risk of rejection and prolapse, especially in young nulliparous girls, the likelihood of intermenstrual bleeding, the development of inflammatory diseases.

Hormonal IUDs are third generation contraceptives. Under the influence of the hormone, cervical mucus thickens and ovulation is suppressed, implantation is prevented if the egg is still fertilized. The installation of a hormonal coil can help to avoid not only unwanted pregnancy, but also painful and heavy menstruation - many women with a hormonal IUD have a decrease in pain and discharge during menstrual bleeding.

The coil can be inserted almost immediately after a surgical or medical abortion, after only 4 weeks. Before the procedure, it is necessary to consult with a gynecologist, undergo an examination, in particular, do an ultrasound scan. The insertion of an IUD must be performed by a qualified gynecologist.

Hormonal contraception

The effectiveness of OCs and other methods of hormonal contraception, when used correctly, is close to 100%. One of the most popular methods of preventing unwanted pregnancy is modern combined oral contraceptives. The tablets contain estrogens and progestins. Hormones affect the function of folliculogenesis, preventing the development and release of the egg. It is important to select COCs together with a specialist, based on the results of tests and examinations. With the wrong choice of hormonal contraceptives, side effects may occur:

headaches up to severe migraines;
weight gain due to improved appetite and water retention;
decreased libido;
change in vaginal secretion and thrush;
development of venous thrombosis.

With the correct choice of the drug suitable for the woman and the correct use (taking pills without gaps, at the same time), undesirable effects are usually not observed.

A less common method of hormonal contraception is the patch. It contains a combination of progesterone and estrogen and works in a similar way to COCs. It is glued to any part of the body except for the chest and is replaced once a week.

Contraceptive injection - a method of protection that allows you to forget about contraceptives for three months. The progestogen injection is valid for 3 months, after which, if you wish to continue using this method of contraception, you can give a new injection.