P093Patient-centered metrics for quality of reproductive healthcare

Abstract

<h3>Objectives</h3> Current measures of quality of reproductive healthcare, such as rates of unintended pregnancy and contraceptive uptake, neglect to incorporate patients' lived experiences and reproductive autonomy. We sought to explore alternative metrics that center patient preferences. <h3>Methods</h3> We conducted five focus groups and eight interviews with participants (n=30), who identified as women, were aged 18–45, lived in New York State, and had visited a primary care provider in the last year, recruited from a third-party firm. The guides asked about ideal clinical interactions when preventing or planning pregnancy and measuring the quality of such interactions. We queried for using reproductive autonomy as a measure, defined as "whether the patient got the reproductive health service or counseling that they wanted to get, while having all the information about and access to their options, and not feeling forced into anything." <h3>Results</h3> Participants wanted care that was non-judgmental and respectful. Desires for discussions on preventing compared to planning pregnancy were qualitatively distinct. For prevention, many preferred unbiased information about contraceptive options to help make their own decisions. For pregnancy planning, many desired comprehensive information and provider input and support throughout their pregnancy. Although collaboration was desired for both, for contraceptive use, participants perceived themselves as the ultimate decision maker. There was considerable support for using reproductive autonomy as a measure of quality. <h3>Conclusions</h3> Patients had distinct desires in their preferred approach to discussions about preventing versus planning pregnancy. Reproductive autonomy may be a superior metric for quality of reproductive healthcare generally.