Counseling women with early pregnancy failure: Utilizing evidence, preserving preference

Women's decision making regarding choice of second trimester termination method for pregnancy complications

“…Many studies have shown that women are more satisfied when they are allowed to choose between medical or surgical termination [16][17][18]. Data concerning satisfaction with second trimester methods are more limited.…”

Beyond usual care: the economic consequences of expanding treatment options in early pregnancy loss

“…In many settings, the only option available to women seeking active treatment of EPL is surgical evacuation in an OR, the most expensive approach, yet we know many women will choose other options. 2,[13][14][15][16]21 Increasing women's access to their preferred treatment approach is probably one of the most important things we can do to the improve quality of EPL care. Under many circumstances, it appears to be cost saving as well.…”

“…In most circumstances, EPL treatment decision making can be based on both clinical nuances and patient preferences. 21 Existing studies comparing the cost of EPL treatment approaches consistently show that uterine evacuation in an OR is more expensive than the alternative approaches; however, these studies do not adequately account for clinical circumstances or patient preferences, which influence uptake, adherence, service use, and ultimately treatment efficacy, all critically important in cost estimates but often overlooked. 22 A good example of this problem is the observation that treatment of EPL with misoprostol is significantly less effective in clinical practice than in clinical trials because of an unwillingness of many women to adhere to the treatment protocol.…”

Breaking bad news to antenatal patients with strategies to lessen the pain: a qualitative study

“…Carers tend not to listen, thereby failing to obtain feedback to clarify exactly what the patient requires, and becoming emotionally distant. This inability to adapt the communication of diagnostic information to the patient's own values and preferences can generate conflicts and dissatisfaction [11][12][13][14]. Attitudes and communicative skills play a fundamental and decisive role in addressing problems, helping patients overcome psychological distress and conveying realistic expectations [15].…”