Table 2.

Themes and Illustrative Quotations.

Theme	Quotation
Participants generally perceived options counseling before abortion as important and necessary but did not always feel they personally needed it.	“It felt weird that everybody makes such a big deal out of it [during counseling], but it was such a quick [procedure], so it’s certainly just a lot of buildup to something that is over with within, like, a half an hour.”—Lindsey (33 years old, 19 at time of abortion)
	“She did the standard of ‘There are these options. Here’s like adoption or taking care of the pregnancy to full-term and parenting.’ Because I was very clear from the start, I was like ‘There is no way.’ Like she didn’t push on that anymore as soon as I made it clear that I was not interested in being pregnant any longer. I was not interested in being a teenaged parent. […] And she was just like ‘Okay, cool’ and said ‘We’ll meet you where you’re at.’ And then just went into explaining the process itself… I do think that options counseling to some degree is important. I just don’t think it needs to be like shoved in their faces. Like, for me, it was a very brief like ‘Are you aware that these are options?’[…] and gauging my interest in that, and if I wasn’t, then not pushing any further. I think that’s the nice happy balance between them.”—Nina (27 years old, 16 at time of abortion)
Participants reported that clinicians including nurses, physicians, and other staff sometimes had poor bedside manner, which was not aligned with their perceived need for gentleness due to their adolescence.	“It felt like something that they had done thousands of times, and I was just a number.”—Alexis (34 years old, 18 at time of abortion)
	“I’ve met doctors who were nice, but they weren’t nice there. They were, like, the worst people you’ve ever met. It was horrible. Like, absolutely horrible.”—Stacy (34 years old, 19 at time of abortion)
	“I just didn’t feel like that connection… it more or less felt like I was just in and out, like, ‘Okay, on to the next.’” - Khalilah (30 years old, 18 at time of abortion)
Participants valued nonjudgmental communication including normalization of abortion care.	“I thought everyone was very nice, and super understanding and not judgmental which I liked which is obviously their job. So they’re used to people coming in and asking and doing that. But I just thought, they were very understanding and very kind. I don’t know what I was really expecting going in. But they were a lot more approachable about it than I was expecting”—Nadia (20 years old, 19 at time of abortion)
	“Just because I was young, I was so nervous and I was worried. They made me feel like, you know, I’m not the only young mother that has ever came through their door. I thought they were gonna be a little judgmental, but they weren’t. At the end of the day, it was a beautiful experience.” - Katie (31 years old, 17 at time of abortion)
	“The clinic was fantastic. I swear that my abortion counselor saved my life… The biggest thing, it’s like the normalization of it. I think it’s really, really significant when it comes to abortion for minors or anyone under the age of 20.”—Nina (27 years old, 16 at time of abortion)
Participants desired privacy and confidentiality throughout their clinic appointment, but clinic logistics led to concerns about limited privacy	“I was still pretty young at the time. I think I was just kind of concerned with the fact that my family wouldn’t find out. And that might have been all that I heard or all that I was listening for [during counseling].”—Alexis (34 years old, 18 at time of abortion)
	“I was alone in a room with other people that were in the same exact situation as me. There was a couple there that clearly wanted to have a baby. For whatever reason, they had to have an abortion and it was highly, highly emotional. I was a wreck. I think that couple should have had their own room. That was really a horrible situation. ‘Cause they clearly didn’t want that to be going on.” – Megan (32 years old, 16 at time of abortion)
Participants appreciated medically accurate information about abortion in plain language balancing safety and risk information for reducing fear before the procedure.	“She gave me a piece of paper. She was reading through it with me, and she just said, “Oh, you know, going through labor and delivery is—” I think she said it was, like, 8 to 10—I can’t remember the exact number, but she said it was like 10 times more dangerous than, like, having the procedure. It was just little stuff that she was saying throughout that put me at ease about the procedure.”—Megan (32 years old, 16 at time of abortion)
	“I know there was the myth out there that it’s gonna be harder to have children when you’re older. That made me feel better, knowing that it doesn’t really affect that and that I still, like, when I was older, could have the option. I guess, like, knowing that it’s not dangerous.”—Clara (35 years old, 19 years old at time of 2 abortions)