FAM MED S5 OSCE - TOP

Question 1

Intro to ToP consult

Answer 1

• What would you like to talk about in regarding the decision on the outcome of the pregnancy?
• Listen and empathies

Question 2

Testing waters - pregnancy options

Answer 2

• Assure that outcome of pregnancy is patient’s choice
• Right to be informed, no judgement
• Any options you are currently considering?
• Would you like to receive information about adoption and government support?

Question 3

Adoptions basics

Answer 3

• Carry pregnancy through and considering adoption
• Someone you have in mind who could take care of the child until you have the capacity to

Question 4

Government/social assistance for parenting basics

Answer 4

• Social welfare available to assist with parenting, financially and otherwise
• Offer pamphlet
• Lead into ToP (would you life info about termination of pregnancy)

Question 5

ToP brief (testing waters)

Answer 5

• ToP is common and safe legal and medical procedure in SA
• It is your reproductive right
• Would you like to hear more about the laws surrounding ToP / procedure of ToP?

Question 6

ToP law (weeks)

Answer 6

<12 weeks - abortion on request

13-20 weeks - under certain circumstances, such as risk to maternal or foetal wellbeing, rape or incest

> 20 weeks - compelling reasons, such as danger to mother’s life, severe malformation of foetus

Question 7

ToP procedure (7 marks)

Answer 7

• Locale of service will be made known to you
• Misoprostol is a pill that can be taken to abort <10 weeks
• Once taking Misoprostol, there is no turning back
• Type of procedure (pill, surgical) depends on gestational age
• Pain management will be made available
• Support services will be made available before and after the procedure
• If after the procedure you encounter psychological or physical problems (bleeding), please ask for help

Question 8

Clarification about post-procedure fertility/cancer

Answer 8

Research evidence does not support an association between abortions performed in safe facilities and cancer/infertility

Question 9

Safety net and wrap up - ToP

Answer 9

• Follow up appointment to decide, or follow up after procedure
• Can discuss safe sex practice in a follow up
• Refer to abortion facility if requested
• Explore support structures
• Offer availability and support
• Pamphlet
• Any questions?