Decision satisfaction among women choosing a method of pregnancy termination in the setting of fetal anomalies and other pregnancy complications: A qualitative study

Kerns, Jennifer L.; Light, Alexis; Dalton, Vanessa K.; McNamara, Blair; Steinauer, Jody; Kuppermann, Miriam

doi:10.1016/j.pec.2018.06.012

Cited by 23 publications

(16 citation statements)

References 23 publications

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“…However, our results point to how such an arrangement might be problematic in situations where the gestational age is approaching the cut-off for surgical abortion. The women in the present study felt rushed but appreciated the opportunity to make their own decision which is in line with other studies showing higher satisfaction among women, who have the option of choosing the mode of TOP 37–40. The physician may address these issues in connection with the invasive procedure and let the couple choose how they prefer to receive the answer, including an early answer.…”

Section: Discussionsupporting

confidence: 83%

Receiving a prenatal diagnosis of Down syndrome by phone: a qualitative study of the experiences of pregnant couples

et al. 2019

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ObjectivesTo examine how pregnant couples experience receiving a prenatal diagnosis of Down syndrome (DS) by phone—a practice that has been routine care in the Central Denmark Region for years.DesignQualitative interview study.SettingParticipants were recruited from hospitals in Central Denmark Region, Denmark.ParticipantsCouples who had received a prenatal diagnosis of DS by phone and decided to terminate the pregnancy. They were recruited from the obstetric department where the termination was undertaken. During the study period (February 2016 to July 2017), 21 semistructured, audio-recorded interviews were conducted by an experienced anthropologist. Interviews were conducted 4–22 weeks after the diagnosis and analysed using thematic analysis.ResultsA prearranged phone call was considered an acceptable practice. However, the first theme’Expected but unexpected'shows how the call often came earlier than expected. Consequently, most women were not with their partner and were thus initially alone with their grief and furthermore responsible for informing their partner, which some considered difficult. The second theme’Now what?'shows how during the phone calls, physicians were quick to enquire about the couples’ agendas. As the majority had already decided to seek termination of pregnancy, the dialogue focused on related questions and arrangements. Only half of the couples received additional counselling.ConclusionA prearranged phone call was considered an acceptable and appropriate practice. However, some aspects of this practice (particularly related to the context of the call) showed to be less than optimal for the couples. To make sure that a diagnostic result is delivered in accordance with the couples' needs and requests, the context of the call could be addressed and agreed on in advance by physicians and couples.

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Section: Discussionsupporting

confidence: 83%

Receiving a prenatal diagnosis of Down syndrome by phone: a qualitative study of the experiences of pregnant couples

et al. 2019

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“…The benefits of deciding, and the resulting sense of control, is emphasized in an American study on the satisfaction with the possibility to choose the method of termination (surgical or pharmacological termination). Patients’ sense of control contributed not only to higher satisfaction with the decision but also to long-term coping and grief resolution [31].…”

Section: Discussionmentioning

confidence: 99%

“…Regardless of the evidence described above, a higher risk of emotional complications among the patients participating in the study may probably be found in case of introvert patients, who had not sought support from the attending physician or people in their surroundings. According to the latest study by Kerns et al (2018) conducted among online support groups higher decision satisfaction and shared decision making is associated with lower feeling of sadness and less frequent occurrence of post-traumatic stress disorder [31].…”

Section: Discussionmentioning

confidence: 99%

Role of Social and Informational Support while Deciding on Pregnancy Termination for Medical Reasons

Zaręba

Makara‐Studzińska

Ciebiera

et al. 2018

IJERPH

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Background: Poland is a country with restrictive laws concerning abortion, which is only allowed if the mother’s life and health are in danger, in case of rape, and severe defects in the fetus. This paper specifies the forms of support expected by women considering termination from their family, people in their surroundings and professional medical personnel. Methods: Between June 2014 and May 2016 patients eligible to terminate a pregnancy for medical reasons were asked to complete an anonymous survey consisting of sixty questions to determine patient profile and forms of support expected from the society, family and professional medical personnel as well as to assess informational support provided. Results: Women do not take into consideration society’s opinion on pregnancy termination (95%). The majority of the respondents think that financial support from the state is not sufficient to provide for sick children (81%). Despite claiming to have a medium standard of life (75%), nearly half of the respondents (45%) say that they do not have the financial resources to take care of a sick child. The women have informed their partner (97%) and closest family members (82%) and a low percentage have informed friends (32%). Nearly one third (31%) have not talked to the attending gynecologist about their decision. Conclusions: The decision to terminate a pregnancy is made by mature women with a stable life situation—supported by their partner and close family. They do not expect systemic support, as they believe it is marginal, and only seek emotional support from their closest family. They appreciate support provided by professional medical personnel if it is personal.

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“…In a patient-centered healthcare model, providers offer and fully inform patients about their options and engage in a shared-decision-making approach that respects patient preferences [29]. This approach can support patients to take ownership over and feel more satisfied with their decision, as evidenced by research on patient preferences for IUD removal, contraceptive counseling and other healthcare decision-making [30][31][32][33][34]. With regard to EC method choices, many women do not have access to the IUD as EC, given existing structural barriers [7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Exploring young women’s reasons for adopting intrauterine or oral emergency contraception in the United States: a qualitative study

et al. 2020

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Background: The recent focus on increasing access to long-acting reversible contraceptive methods has often overlooked the diverse reasons why women may choose less effective methods even when significant access barriers have been removed. While the copper intrauterine device (IUD) is considered an acceptable alternative to emergency contraception pills (ECPs), it is unclear to what extent low rates of provision and use are due to patient preferences versus structural access barriers. This study explores factors that influence patients' choice between ECPs and the copper IUD as EC, including prior experiences with contraception and attitudes toward EC methods, in settings where both options are available at no cost. Methods: We telephone-interviewed 17 patients seeking EC from three San Francisco Bay Area youth-serving clinics that offered the IUD as EC and ECPs as standard practice, regarding their experiences choosing an EC method. We thematically coded all interview transcripts, then summarized the themes related to reasons for choosing ECPs or the IUD as EC. Results: Ten participants left their EC visit with ECPs and seven with the IUD as EC option. Women chose ECPs because they were familiar and easily accessible. Reasons for not adopting the copper IUD included having had prior negative experiences with the IUD, concerns about its side effects and the placement procedure, and lack of awareness about the copper IUD. Women who chose the IUD as EC did so primarily because of its long-term efficacy, invisibility, lack of hormones, longer window of post-coital utility, and a desire to not rely on ECPs. Women who chose the IUD as EC had not had prior negative experiences with the IUD, had already been interested in the IUD, and were ready and able to have it placed that day. Conclusions: This study highlights that women have varied and well-considered reasons for choosing each EC method. Both ECPs and the copper IUD are important and acceptable EC options, each with their own features offering benefits to patients. Efforts to destigmatize repeated use of ECPs and validate women's choice of either EC method are needed to support women in their EC method decision-making.

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Decision satisfaction among women choosing a method of pregnancy termination in the setting of fetal anomalies and other pregnancy complications: A qualitative study

Cited by 23 publications

References 23 publications

Receiving a prenatal diagnosis of Down syndrome by phone: a qualitative study of the experiences of pregnant couples

Receiving a prenatal diagnosis of Down syndrome by phone: a qualitative study of the experiences of pregnant couples

Role of Social and Informational Support while Deciding on Pregnancy Termination for Medical Reasons

Exploring young women’s reasons for adopting intrauterine or oral emergency contraception in the United States: a qualitative study

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