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Views of clinicians towards providing contraceptive advice and contraception to women following early pregnancy loss: a qualitative study
  1. Nandaja Narayanan1,
  2. John Joseph Reynolds-Wright2,
  3. Sharon T Cameron2,3
  1. 1Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK
  2. 2Chalmers Centre for Sexual and Reproductive Health, NHS Lothian, Edinburgh, UK
  3. 3MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
  1. Correspondence to Nandaja Narayanan, Edinburgh Medical School, The University of Edinburgh, Edinburgh EH16 4TJ, UK; n.narayanan{at}sms.ed.ac.uk

Abstract

Introduction National guidelines advise that clinicians caring for women post-pregnancy should give women opportunities to discuss contraception, regardless of pregnancy outcome, and provide contraception to women who choose to take up a method. This study aimed to explore knowledge, views and needs of Early Pregnancy Unit (EPU) clinicians around discussing and offering contraception and discussing pregnancy intendedness with women after early pregnancy loss using a qualitative approach.

Methods Semi-structured, audio-recorded interviews with 11 clinicians from a single regional EPU in Edinburgh, Scotland. Interviews were transcribed verbatim and analysed thematically.

Results Clinicians were reluctant to discuss contraception as they believed women would find the topic overwhelming and distressing. Thoughts on discussing pregnancy intendedness were polarised; some considered it insensitive, and others essential. Barriers to discussing contraception and providing it were numerous and included time pressure, and inadequate knowledge and training on contraception. Participants suggested training on contraception, closer working with sexual and reproductive health (SRH) services, and availability of information on contraception specifically aimed at women who have experienced an early pregnancy loss could facilitate discussions and method provision.

Conclusions EPU clinicians require ongoing training and support to be effective at discussing pregnancy intendedness and discussing and providing post-pregnancy contraception. This will require close working with SRH services and development of sensitive information around contraception for women experiencing an early pregnancy loss.

  • Abortion, Spontaneous
  • Counseling
  • family planning services
  • Nurse-Patient Relations
  • Physician-Patient Relations
  • Reproductive Behavior

Data availability statement

No data are available. Due to the small number of study participants and the potential for identification, no further data are available.

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Data availability statement

No data are available. Due to the small number of study participants and the potential for identification, no further data are available.

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Footnotes

  • Twitter @doctorjjrw

  • Contributors NN collected and analysed the data. JJRW assisted in developing the data collection tools and analysed the data. STC conceived the study originally. All authors contributed to writing the article. JJRW is the guarantor for the article.

  • Funding The study was conducted by staff at the Medical Research Council (MRC) Centre for Reproductive Health which is supported by grant MR/N022556/1.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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