_____ I dread going to the doctor. I always get very anxious. _____ Pelvic exams are very difficult for me. I can never relax. _____ I would like to include my partner or other person in the whole process. _____ I like the idea that a miscarriage is more ‘natural.’ _____ I have had a miscarriage with a lot of bleeding before so I know what that’s like. _____ I live close by and coming back for a follow-up exam would be no problem. _____ I am under 18 and my parents know all about what I am doing. _____ I would really like to take my time with this process and experience it. _____ I don’t panic or freak out with pain or bleeding. _____ I am usually very good at following directions about my health. _____ I know it’s hard to predict how this experience will be for me and I’m OK with that uncertainty. _____ My regular period bleeding is heavy. I am OK with lots of clots and bleeding. _____ I have easy access to a phone, transportation and I live pretty close to medical help if I need it. _____ I don’t have responsibilities for others and can clear my calendar the day after my appointment, and if need be, the following day too. _____I would do anything to avoid needles or shots.
_____ TOTAL POINTS
People who have these concerns are often more comfortable with the medication, or abortion pill.
____ I really want to get this over with. ____ I want the method that is more of a sure thing. ____ My schedule is really busy. I can’t afford much downtime for this. ____ I am trying to hide this from my partner/parents or housemates ____ I am leaving town in the next week or so. ____ I live far away, or have a crazy schedule, so it would be hard to get back here for a follow-up exam. ____ I’m under 18 and my parents don’t know I’m pregnant or that I am having an abortion. ____ I have difficulty speaking English, especially over the phone. ____ My partner (or someone else) is upset and is trying to stop me from having an abortion. ____ I have a bleeding disorder/I am on corticosteroids (ex: prednisone) ____ I get very nervous about medical stuff. I worry that something dangerous might be happening. ____ Uncertainty drives me crazy; I really need to know what’s going on and whether it will work. ____ I am responsible for children or others and I don’t have anyone to help me with that. ____ I live out in the country and/or don’t have easy access to transportation. ____ I feel safer in a medical facility with a doctor and nurses around.
_____ TOTAL POINTS
People who have these concerns are often more comfortable with the in-office procedure.