What Women Want From Their Doctors About Pregnancy Options Counseling [3F

Abstract

INTRODUCTION: The recommendations on pregnancy options counseling by many professional organizations conflict with some doctors’ desire to exercise their personal beliefs. To understand a patient-centered framework for pregnancy options counseling, we explored pregnant women’s preferences for pregnancy options counseling from doctors. METHODS: We conducted semi-structured interviews with 28 pregnant women recruited from a prenatal clinic and an abortion clinic. We asked women about recent discussions—or lack thereof—about pregnancy options (parenting, adoption and abortion) with a doctor, and what they would want their doctor to discuss about pregnancy options. We analyzed transcripts using modified grounded theory. RESULTS: Most participants, in both prenatal and abortion care, said doctors should discuss pregnancy options, including abortion, with pregnant women. In counseling, participants wanted physicians to: 1) respect patient autonomy, 2) avoid assumptions about a woman’s desired pregnancy outcome, and 3) consider the patient as a whole person. In general, participants wanted their doctors to assess a pregnancy’s particular circumstances to determine the appropriateness of options counseling. A few participants reported not wanting options counseling. Explaining this preference, they cited preservation of privacy, having already made a decision for the pregnancy, or not wanting to discuss abortion. Regarding best practices for providing options counseling, participants said it should be done in a routine manner, with discretion, and early in pregnancy. CONCLUSION: Pregnant women seeking both prenatal and abortion care broadly support options counseling. These findings suggest options counseling that includes discussion of abortion is consistent with providing patient-centered care and supports women’s preferences.