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REPORT OF INDUCED TERMINATION OF PREGNANCYInformation is PRIVATE and CONFIDENTIALCenter for Health Statistics 1. Patients ID number:2. Date termination performed://Facilityuse only(Patient ID/Facility
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How to fill out induced termination of pregnancy:

01
Consult with a healthcare provider: It is important to schedule an appointment with a healthcare provider who specializes in reproductive health. They will provide you with the necessary information, guidance, and support throughout the process.
02
Provide necessary medical history: During the initial consultation, you will be asked to provide your medical history, including any previous pregnancies, medical conditions, or medications you are currently taking. This information will help the healthcare provider assess your eligibility for induced termination of pregnancy and determine the most suitable method for you.
03
Understand the different methods: The healthcare provider will explain the various methods of induced termination of pregnancy, such as medication abortion and surgical abortion. They will discuss the benefits, risks, and potential side effects of each method, allowing you to make an informed decision.
04
Sign consent forms: Before proceeding with induced termination of pregnancy, you will need to sign consent forms, acknowledging that you understand the process, risks, and potential complications involved.
05
Follow pre-procedure instructions: Your healthcare provider will provide you with specific instructions to follow in the days leading up to the procedure. These may include avoiding certain medications, fasting before the procedure, or arranging for transportation to and from the clinic.
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Undergo the procedure: The procedure will be performed by a qualified healthcare professional in a medical facility. The method chosen for induced termination of pregnancy will determine the duration and specifics of the procedure. It is important to follow the healthcare provider's instructions during the procedure and ask any questions you may have.
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Post-procedure care: After the procedure, your healthcare provider will provide you with instructions for post-procedure care. This may include taking prescribed medications, monitoring any bleeding or pain, and scheduling a follow-up appointment to ensure your recovery is progressing well.

Who needs induced termination of pregnancy?

01
Women facing unplanned or unwanted pregnancies: Induced termination of pregnancy may be an option for women who find themselves in unplanned or unwanted pregnancies. It provides a legal and safe way for them to terminate the pregnancy if they decide it is the best choice for their circumstances.
02
Women with high-risk pregnancies: In cases where the pregnancy poses a significant risk to the mother's health or life, induced termination of pregnancy may be recommended by healthcare professionals. This decision is made after careful consideration of the potential risks and benefits for both the mother and the fetus.
03
Women with fetal abnormalities: If a woman receives a diagnosis of severe fetal abnormalities or genetic disorders that are incompatible with life or will significantly impact the quality of life, induced termination of pregnancy may be an option. This allows the parents to make a compassionate and informed decision for their unborn child.
04
Victims of sexual assault: Women who have been victims of sexual assault may choose induced termination of pregnancy as a way to regain control over their lives and reproductive choices. It offers them the opportunity to avoid reliving traumatic experiences and to move forward with their healing process.
05
Women whose contraceptive methods failed: Despite using contraceptives, there is always a small risk of unintended pregnancy. In cases where contraceptive methods have failed, induced termination of pregnancy may be considered as an option for women who do not wish to continue the pregnancy.
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Induced termination of pregnancy is the deliberate ending of a pregnancy through medical procedures.
The healthcare provider who performed the induced termination of pregnancy is required to file the necessary paperwork.
The healthcare provider must fill out the required forms with accurate and detailed information about the induced termination of pregnancy.
The purpose of induced termination of pregnancy is to safely end a pregnancy when necessary for medical, personal, or social reasons.
The information that must be reported on induced termination of pregnancy includes details about the procedure, patient, and any complications that may have arisen.
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