Changes in pregnancy desire after a pregnancy scare in a random sample of young adult women in a Michigan county

Barber, Jennifer S.; Clark, Anne; Gatny, Heather

doi:10.1016/j.contraception.2021.06.017

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…Thus, longitudinal counseling that acknowledges and accepts changes in preferences and needs and correctly views contraceptive decision-making as a journey rather than a static process is ideal. [52][53][54] It is critical to begin the shared decision-making conversation in antepartum care, continue to revisit throughout pregnancy, and discuss and implement prior to postpartum discharge from the hospital. This is imperative given the barriers to outpatient postpartum care including social determinants of health compounded by potential expiration of insurance for some patients, policy-level barriers to permanent contraception, structural factors limiting access to LARCs, and misinformation regarding the safety of contraceptive methods postpartum.…”

Section: Contraceptive Decision-makingmentioning

confidence: 99%

Shared Decision-Making: The Way Forward for Postpartum Contraceptive Counseling

Bullington¹,

Sata²,

Arora³

2022

OAJC

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There are multi-level barriers that impact uptake of postpartum contraception and result in disparities, including clinical barriers such as provider bias. Fortunately, clinicians have direct control over their contraceptive counseling practices, and thus reducing structural barriers is actionable through high quality contraceptive counseling that equips patients with the knowledge and guidance they need to fulfill their reproductive desires. Yet, many commonly employed contraceptive counseling strategies, like One Key Question and WHO tiered contraceptive counseling, are not patient-driven, do not account for the important nuances of contraceptive choices, and are not focused specifically on the postpartum period. Given the history of eugenics and reproductive coercion in the US, supporting patient through their contraceptive decision-making process is especially vital. Additionally, contraceptive preferences vary based on patient-level factors and fluctuate over time and counseling should account for such differences. Shared contraceptive decision-making occurs when patients provide input on their values, desires, and preferences and clinicians share medical knowledge and evidence-based information without judgement. This approach is considered the most ethically sound form of counseling, as it maximizes patient autonomy. Shared decision-making also has clinical benefits, including increased patient satisfaction. In sum, shared contraceptive decision-making should be universally adopted to promote ethical, high-quality care and reproductive autonomy.

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Section: Contraceptive Decision-makingmentioning

confidence: 99%

Shared Decision-Making: The Way Forward for Postpartum Contraceptive Counseling

Bullington¹,

Sata²,

Arora³

2022

OAJC

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“… 20–22 Studies on pregnancy intention similarly focus on pregnancy outcomes of only delivery 23 , 24 or abortion 25–27 and exclude miscarriage. In addition, previous studies conflate measures of desire 28 and wantedness 26 , 29 with pregnancy intention.…”

Section: Introductionmentioning

confidence: 99%

A Multidimensional and Longitudinal Exploratory Study of the Stability of Pregnancy Contexts in the United States

Markowitz,

Lundsberg,

Gariepy

2024

Women's Health Reports

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Objective: Evaluate the longitudinal stability of six pregnancy contexts, including intention, in a diverse cohort of individuals experiencing delivery, abortion, or miscarriage. Methods: We enrolled individuals 16–44 years of age with pregnancies <24 weeks gestation in this longitudinal study between June 2014 and June 2015 in four US urban clinics. We assessed six pregnancy contexts (intention, wantedness, planning, timing, desirability, and happiness) at enrollment and 3-month follow-up. We constructed three-level categorical measures for each context defined as favorable, ambivalent, or unfavorable. We used Wilcoxon sign tests to evaluate changes in paired observations between pregnancy context measures over time and by pregnancy outcome. Results: Among 121 participants at median gestational age of 7 weeks and 3 days, we found intention, wantedness, planning, timing, and happiness remained unchanged from enrollment in early pregnancy to 3-month follow-up. Individuals demonstrated changes in desirability; pregnancy assessments shifted toward less desirable from enrollment to follow-up ( p = 0.01) ( i.e., desired to ambivalent, or ambivalent to undesired). Among participants choosing delivery (57%), assessments shifted toward more favorable planning ( i.e., unplanned to ambivalent, or ambivalent to planned) ( p < 0.01), and less favorable desirability ( i.e., desired to ambivalent or ambivalent to undesired) ( p < 0.01) at follow-up. Among participants choosing abortion (28%), assessments shifted toward more unfavorable planning ( i.e., planned to ambivalent, or ambivalent to unplanned) at follow-up ( p < 0.01). Conclusion: In multidimensional, longitudinal assessment, pregnant participants' perspectives on five of six pregnancy contexts remained unchanged between enrollment and 3-month follow-up; only desirability shifted. Pregnancy planning perspectives differed by pregnancy outcome. Human Research Subjects Protection Program: 1310012926.

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Pregnancy scares, pregnancy uncertainty, and abortion attitude change

Newmyer¹,

Yabiku²

2022

Social Science Research

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Changes in pregnancy desire after a pregnancy scare in a random sample of young adult women in a Michigan county

Cited by 3 publications

References 27 publications

Shared Decision-Making: The Way Forward for Postpartum Contraceptive Counseling

Shared Decision-Making: The Way Forward for Postpartum Contraceptive Counseling

A Multidimensional and Longitudinal Exploratory Study of the Stability of Pregnancy Contexts in the United States

Pregnancy scares, pregnancy uncertainty, and abortion attitude change

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