Now is the chance: Patient-provider communication about unplanned pregnancy during the first prenatal visit

Rebecca Meiksin, Judy C. Chang, Tina Bhargava, Robert Arnold, Diane Dado, Richard Frankel, Keri L. Rodriguez, Bruce Ling, Susan Zickmund

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Objective: Unplanned pregnancy is associated with psychosocial stress, post-partum depression, and future unplanned pregnancies. Our study describes how topics related to unplanned pregnancy were addressed with patients during the first prenatal visit. Methods: We audio-recorded and transcribed initial prenatal visits between 48 patients and 16 providers from a clinic serving racially diverse, lower-socio-economic patients. We conducted a fine-grained thematic analysis of cases in which the patient's pregnancy was unplanned. Results: Of the 48 patients, 35 (73%) had unplanned pregnancies. Twenty-nine visits for unplanned pregnancies (83%) included discussion of the patient's feelings about the pregnancy. Approximately half (51%) of the visits touched on partner or other types of social support. Six patients (17%) were offered referrals to counseling or social services. Only four visits (11%) touched on future birth control options. Conclusion: Most initial prenatal visits for unplanned pregnancies included discussion of patient feelings about the pregnancy. However, opportunities to discuss future birth control and for more in-depth follow-up regarding social support and psychological risks associated with unplanned pregnancy were typically missed. Practice implications: Obstetrics care providers should be cautious about making assumptions and should consider discussing pregnancy circumstances and psychosocial issues in more depth when treating patients facing unplanned pregnancy.

Original languageEnglish (US)
Pages (from-to)462-467
Number of pages6
JournalPatient Education and Counseling
Volume81
Issue number3
DOIs
StatePublished - Dec 1 2010

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Keywords

  • Communication
  • Patient-provider relationship
  • Pregnancy
  • Prenatal care
  • Unplanned

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Meiksin, R., Chang, J. C., Bhargava, T., Arnold, R., Dado, D., Frankel, R., Rodriguez, K. L., Ling, B., & Zickmund, S. (2010). Now is the chance: Patient-provider communication about unplanned pregnancy during the first prenatal visit. Patient Education and Counseling, 81(3), 462-467. https://doi.org/10.1016/j.pec.2010.09.002