Rachel Flink-Bochacki1, Megan E Hamm, Sonya Borrero, Beatrice A Chen, Sharon L Achilles, Judy C Chang. 1. University of Pittsburgh, Pittsburgh, Pennsylvania; the Department of Obstetrics and Gynecology, Albany Medical Center, Albany, New York; and the Center for Women's Health Research and Innovation (CWHRI), Qualitative, Evaluation And Stakeholder Engagement (Qual EASE) Research Services, the Clinical and Translational Science Institute, the Center for Health Equity and Promotion, VA Pittsburgh Healthcare System, and Magee-Womens Research Institute, Pittsburgh, Pennsylvania.
Abstract
OBJECTIVE: To explore initial pregnancy intentions and postmiscarriage family planning needs and counseling preferences of women experiencing spontaneous abortion. METHODS: We conducted semistructured qualitative interviews with women who recently experienced spontaneous abortion to explore their feelings about conception, pregnancy, and miscarriage; their future family planning goals; and contraceptive counseling preferences. Two trained coders utilized an inductive, iterative approach to code transcripts and identify themes using Atlas.ti software to organize the analysis. RESULTS: We interviewed 26 women reporting varied intentions in their recent pregnancies: 54% were trying to conceive, 27% were not trying but not preventing, and 19% were attempting to avoid pregnancy. Participants reported a range of feelings about the pregnancy diagnoses and eventual miscarriages with some relatively unemotional ("a little disappointed…suffering for two months for nothing") and others feeling devastated by their pregnancy losses ("in shock," "for it to be taken away was crushing"). Varying character and intensity of emotional reactions were seen across the range of initial pregnancy intentions. Some participants had consistent childbearing plans before and after miscarriage, whereas others experienced their pregnancies and losses as clarifying events leading to changed goals moving forward ("it was a wake-up call"). Although family planning needs were inconsistently addressed after spontaneous abortion, women were generally receptive to the idea of contraceptive counseling, though they had different preferences regarding timing, ranging from immediately to weeks later. CONCLUSION: Women's reproductive goals after spontaneous abortion cannot be inferred based on initial pregnancy intention or emotional reactions to pregnancy loss. Health care providers should offer family planning counseling to all women after spontaneous abortion, remaining responsive to individual patient needs.
OBJECTIVE: To explore initial pregnancy intentions and postmiscarriage family planning needs and counseling preferences of women experiencing spontaneous abortion. METHODS: We conducted semistructured qualitative interviews with women who recently experienced spontaneous abortion to explore their feelings about conception, pregnancy, and miscarriage; their future family planning goals; and contraceptive counseling preferences. Two trained coders utilized an inductive, iterative approach to code transcripts and identify themes using Atlas.ti software to organize the analysis. RESULTS: We interviewed 26 women reporting varied intentions in their recent pregnancies: 54% were trying to conceive, 27% were not trying but not preventing, and 19% were attempting to avoid pregnancy. Participants reported a range of feelings about the pregnancy diagnoses and eventual miscarriages with some relatively unemotional ("a little disappointed…suffering for two months for nothing") and others feeling devastated by their pregnancy losses ("in shock," "for it to be taken away was crushing"). Varying character and intensity of emotional reactions were seen across the range of initial pregnancy intentions. Some participants had consistent childbearing plans before and after miscarriage, whereas others experienced their pregnancies and losses as clarifying events leading to changed goals moving forward ("it was a wake-up call"). Although family planning needs were inconsistently addressed after spontaneous abortion, women were generally receptive to the idea of contraceptive counseling, though they had different preferences regarding timing, ranging from immediately to weeks later. CONCLUSION:Women's reproductive goals after spontaneous abortion cannot be inferred based on initial pregnancy intention or emotional reactions to pregnancy loss. Health care providers should offer family planning counseling to all women after spontaneous abortion, remaining responsive to individual patient needs.
Authors: Lisa S Callegari; Abigail R A Aiken; Christine Dehlendorf; Patty Cason; Sonya Borrero Journal: Am J Obstet Gynecol Date: 2016-10-21 Impact factor: 8.661
Authors: Sonya Borrero; Cara Nikolajski; Julia R Steinberg; Lori Freedman; Aletha Y Akers; Said Ibrahim; Eleanor Bimla Schwarz Journal: Contraception Date: 2014-10-22 Impact factor: 3.375