4. Preparation of the patient. The patient is asked to empty her bladder.

Preferably the patient is allowed to take a shower, for her own and for the doctor's wellbeing, especially if she has travelled a long time. Then she is requested to change into a night gown. The clinic should have some spare gowns and towels available for those who did not bring them.

Many patients want their husband or friend or mother to be present at the procedure. It is humane to allow this (provided the patient herself wants it). The fact that it is allowed gives the patient the comforting certainty that the procedure can not be so bad if relatives are allowed to be present. Generally the patient is much quieter in the present of her relative, but occasionally she is exaggerating her reactions to rub it in to the man what he has done to her. The man then looks hostile to the doctor who causes his wife so much pain and after treatment the couple might leave reconciliated and happy.

The doctor or his assistant should keep an eye on the man so that he can be advised to sit on the floor if he tends to faint. It is impossible to predict who will faint and who won't.

A burly policeman ascertained Schlebaum that he could see anything He had seen so many traffic accidents with rivers of blood on the street that he was fully immune for it. Now this man fainted in the same exaggerating way as he spoke about his experiences He had to be revived with an atropin injection for bradycardia and he had to stay in bed longer than his wife.

In another clinic the husband of the patient fainted and smacked his head on the floor. He had to be hospitalised because of brain concussion.

5. Anamnesis and Examination. The doctor who will do the termination should examine the patient himself.

In a number of cases a patient may be sent from reception or counselling for an preexamination to avoid a time consuming counselling procedure for a patient who will not be treated. This is done if there is doubt if she is pregnant or if the age of the pregnancy is uncertain. It is a good precaution to preexamine all patients over forty, since among them most cases of false pregnancy are found. Alternatively all patients may be examined after the reception and before counselling. It is also the counsellor's task to deal with patients who are not pregnant or those who can not be treated.

6. Performing the termination. This is described in detail in Chapter 9. Problems which may cause difficulties and complications which may arise are discussed in Chapters 11 and 12 respectively.

7. Bed rest. After the procedure the patient is allowed to rest in bed for some time, dependent on the type of anaesthesia and premedication. Patients waiting to be treated and patients resting after treatment can be put in the same room. This shows the waiting patients that the procedure is not so bad and that after treatment they recover rapidly.

8. Post abortum examination and counselling. About five minutes after the procedure a check on blood loss should be made. If there is blood loss the hygienic pad should be changed and another check done after some ten minutes. In case of continuous blood loss the patient must be seen by the doctor.

Blood loss after the procedure is discussed in Chapter 12. If the patient is considered fit to leave the clinic the final counselling is done. This includes measures to prevent infection and advise on contraception. The patient should be given written documentation on these subjects. The patient should be told what to do in case of complaints. These topics are discussed in Chapter 4.

Examples of forms are given in Appendix 9.

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