Jennifer L Kerns1, Biftu Mengesha2, Blair C McNamara3, Arianna Cassidy2, Geffan Pearlson4, Miriam Kuppermann2. 1. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA. Electronic address: Jennifer.kerns@ucsf.edu. 2. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA. 3. Yale University School of Medicine, New Haven, CT. 4. University of California San Francisco School of Medicine, San Francisco, CA.
Abstract
OBJECTIVE: We sought to explore the relationship between counseling quality, measured by shared decision making and decision satisfaction, and psychological outcomes (anxiety, grief, and posttraumatic stress) after second-trimester abortion for pregnancy complications. STUDY DESIGN: We conducted a cross-sectional study of women who underwent second-trimester abortion for complications. We recruited participants from Facebook and online support groups and surveyed them about counseling experiences and psychosocial issues. We used multivariate linear regression to evaluate relationships between counseling quality and psychological outcomes. RESULTS: We analyzed data from 145 respondents. Shared decision making and decision satisfaction scores were positively and strongly correlated in bivariate analysis (r=0.7, p<.0001), as were posttraumatic stress and grief scores (r=0.7, p<.0001). In the adjusted analysis, higher decision satisfaction was associated with lower grief and posttraumatic stress scores (p=.02 and p=.01, respectively) and higher shared decision making was associated with lower posttraumatic stress scores (p=.01). CONCLUSIONS: Decision satisfaction and shared decision making have a positive effect on psychological outcomes after second-trimester abortion for pregnancy complications. Counseling quality may be especially important in this setting given the sensitive nature of decisions regarding pregnancy termination for complications. IMPLICATION: These results highlight the importance of patient-centered counseling for women seeking pregnancy termination.
OBJECTIVE: We sought to explore the relationship between counseling quality, measured by shared decision making and decision satisfaction, and psychological outcomes (anxiety, grief, and posttraumatic stress) after second-trimester abortion for pregnancy complications. STUDY DESIGN: We conducted a cross-sectional study of women who underwent second-trimester abortion for complications. We recruited participants from Facebook and online support groups and surveyed them about counseling experiences and psychosocial issues. We used multivariate linear regression to evaluate relationships between counseling quality and psychological outcomes. RESULTS: We analyzed data from 145 respondents. Shared decision making and decision satisfaction scores were positively and strongly correlated in bivariate analysis (r=0.7, p<.0001), as were posttraumatic stress and grief scores (r=0.7, p<.0001). In the adjusted analysis, higher decision satisfaction was associated with lower grief and posttraumatic stress scores (p=.02 and p=.01, respectively) and higher shared decision making was associated with lower posttraumatic stress scores (p=.01). CONCLUSIONS: Decision satisfaction and shared decision making have a positive effect on psychological outcomes after second-trimester abortion for pregnancy complications. Counseling quality may be especially important in this setting given the sensitive nature of decisions regarding pregnancy termination for complications. IMPLICATION: These results highlight the importance of patient-centered counseling for women seeking pregnancy termination.
Authors: Marleen M H J van Gelder; Tom H van de Belt; Lucien J L P G Engelen; Robin Hooijer; Sebastian J H Bredie; Nel Roeleveld Journal: Matern Child Health J Date: 2019-10
Authors: J L Kerns; J K Turk; C M Corbetta-Rastelli; M G Rosenstein; A B Caughey; J E Steinauer Journal: BMC Womens Health Date: 2020-02-03 Impact factor: 2.809
Authors: Catherine Sanchez; Adrienne Grzenda; Andrea Varias; Alik S Widge; Linda L Carpenter; William M McDonald; Charles B Nemeroff; Ned H Kalin; Glenn Martin; Mauricio Tohen; Maria Filippou-Frye; Drew Ramsey; Eleni Linos; Christina Mangurian; Carolyn I Rodriguez Journal: Compr Psychiatry Date: 2020-08-12 Impact factor: 3.735