Shared decision‐making for women facing an unplanned pregnancy: A qualitative study

Abstract

This study aimed to explore the competencies of health care practitioners who promote shared decision-making (SDM)-based care for women facing an unplanned pregnancy in Japan. We conducted semistructured interviews with 12 care providers who are pioneers in care for women facing an unplanned pregnancy and adopted a modified grounded theory approach for data analysis. A three-step model for shared decision making in practice (team talk, option talk, and decision talk) was used as a reference. The answers given by the care providers were analyzed to identify the competencies involved in shared decision making. We identified three stages: (i) building trust and promoting women's expression; (ii) discussing women's real needs; and (iii) exploring the intentions and goals expressed by women and finding the best choices while promoting women's autonomy in decision-making. The coordination between the support of partners, families, and professionals, and the care provided to strengthen women's identities facilitated shared decision making. Women facing an unplanned pregnancy can benefit from interventions designed to improve shared decision making. A key component of shared decision making-based care relates to practitioners' raised awareness toward their roles and responsibilities: developing good communication skills and fostering collaboration between all stakeholders.

Midwifery scale to support shared decision‐making for unplanned pregnancies: A cross‐sectional study

“…Previously, we investigated the decision-making support experience of unplanned pregnancy of women through care providers (Ueno et al, 2020). The study suggested that women with unplanned pregnancies benefit from interventions designed to improve SDM and the need for IP-SDM modelÀbased care.…”

“…One study reported that care providers involved with unplanned pregnancies could apply SDM to make autonomous decisions while restoring women's identity. (Ueno et al, 2020). Motivated by these observations on SDM, that study worked with parents and professionals to emphasize the need for midwifery care and improve its practice.…”

“…At the individual level, midwives perceive that unplanned pregnancies are a private matter, which has conflicting values with women and conflicts with both female and fetal advocacy that give rise to negative emotions and attitudes (Okubo, 2003; Ueno et al, 2020).…”

“…At the individual level, midwives perceive that unplanned pregnancies are a private matter, which has conflicting values with women and conflicts with both female and fetal advocacy that give rise to negative emotions and attitudes (Okubo, 2003;Ueno et al, 2020). Such a barren environment is likely to deprive midwives of their enthusiasm and motivation to work and impede their ability to provide high-quality care (Suleiman et al, 2020).…”

“…One study reported that care providers involved with unplanned pregnancies could apply SDM to make autonomous decisions while restoring women's identity. (Ueno et al, 2020).…”