Chapter XII-Pregnancy Services

V. Policies

A. Eligibility

Pregnancy Services are provided at county option. Need is defined by the target population, which is found in Section 6010, page 1.

B. Method of Service Provision

Pregnancy Services may be provided directly by county departments of social services or may be purchased under contract.

C. Scope of Services

Pregnancy Services include counseling to assist the expectant mother, the expectant father, involved relatives, and significant others in assessing their situations and looking at various possibilities for resolving the unplanned pregnancy (i.e., keeping the child of an existing marriage, rearing the child as a single parent, marriage adoption, or abortion). The probable consequences of each alternative are explored realistically and assistance in arranging for and utilizing other needed services is provided. Supportive counseling is provided to help the client in carrying out the chosen alternative. Personal counseling is provided to help the client deal with emotions and personal problems that are involved with and/or which led to this unplanned pregnancy. Pregnancy Services may also include residential care for up to six months when necessary for a concentrated regimen of services. In addition to room and board, residential care must include counseling and supportive services, medical supervision, and medications required for health maintenance in pregnancy as prescribed by a physician, and may include psychiatric counseling for coping with the pregnancy. Medical services received outside of the regimen of residential services; e.g., labor and delivery, are not provided for within this set of services.

A pregnancy becomes a problem when the prospect of a new child is detrimental to one's well-being and/or is unplanned for social, economic, emotional, medical or personal reasons. Initial counseling is focused on helping the client make a decision about resolution of the pregnancy by being accepting and understanding of the dilemma, through giving needed information about alternatives and resources, and by helping the client reach a decision that she can live with, both now and later. The second stage of counseling focuses on helping the client follow through with the alternative selected. An extended counseling role includes helping those involved in a problem pregnancy, when circumstances indicate the need, to establish a pattern of responsible sexual behavior. This includes counseling about or referral to family planning services.

D. Freedom of Choice

An individual who requests Pregnancy Services will have the opportunity to explore with the caseworker several alternatives for resolving problems accompanying the pregnancy.

Because of the nature of the services and the various options available to the client, it is important for the caseworker to recognize that the decision of how to resolve the problem is the choice of the client. Complete freedom of choice for the client should be protected. The caseworker must concentrate on objectively helping the client assess individual circumstances, explore feelings, realistically examine alternatives and available resources and reach a decision. Care should be taken to avoid persuasion or encouragement of one alternative over the other. Once the client has reached a decision, the caseworker should support the decision, offer assistance in locating additional services and resources and provide ongoing counseling as needed throughout the pregnancy.

E. Confidentiality

When a client requests Pregnancy Services she realizes that in order to receive the help she is seeking, she must reveal certain information about the pregnancy to the caseworker. To feel secure in sharing extremely personal information, the client needs assurance that the information will not go beyond the person engaged in helping. Confidentiality is the basic right of the client, is an ethical responsibility of the caseworker and is necessary for the effective delivery of Pregnancy Services.

All agency staff should be oriented to the confidential nature of Pregnancy Services. Access to records should be restricted to authorized staff. When resources outside the agency are to be utilized for the client and sharing of information seems appropriate, a statement of release of information should be signed by the client and placed in the record prior to release of any information.

An initial contact with the expectant father should be made only with the expectant mother's knowledge. Contacts should be initiated with the parents of the expectant mother or parents of the expectant father only with the consent of the expectant parent(s).