PREGAFTERPL · Couples' experience and need for medical care and psychosocial support during pregnancy after prior pregnancy loss

Couples' experience and need for medical care and psychosocial support during pregnancy after prior pregnancy loss

Pregnancy loss (PL) occurs in about 25% of pregnancies. PL is the spontaneous loss of a pregnancy before approximately 22 weeks and “early” PL is before the end of the first trimester (12 weeks). Previous research shows that women and their partners are unhappy with existing treatment and care they receive after PL and wish for more information, follow-up and support. A new pregnancy after PL can be stressful for women and their partners given they fear another PL. Unfortunately, support interventions targeted to pregnancy after PL are virtually non-existent. We need to understand when women and partners are most in need of targeted care in order to promote overall well-being and best outcomes for couples and their future child. To address this issue, the EU-funded PREGAFTERPL project conducted a qualitative longitudinal study with pregnant couples with one or two prior PLs to improve our understanding of couples’ experiences and needs for medical care, psychosocial support and follow-up during a pregnancy after PL(s). Couples were interviewed after a positive pregnancy test and once in each trimester to also shed light on common reactions and ways of coping during pregnancy after PL. The findings were integrated into a new support intervention co-developed with stakeholders and patients and informed the development of workshops for clinicians to inform and enhance care provided to these couples. The study was conducted in Denmark, which has a public health care system. Standard pregnancy care includes an ultrasound scan at 12 and 20 weeks. Antenatal care is provided by midwives with an intake appointment around week 15 with the majority of contact with midwife in the second half of pregnancy (20+ weeks). For those who can afford it, individual scans can be purchased at private clinics. In summary, results from PREGAFTERPL show an early PL creates an increased need for monitoring and care in a subsequent pregnancy. These findings underscore that PL care should extend into a new early pregnancy after one or two PL(s). Our qualitative longitudinal study highlights a gap in pregnancy care for those with a history of one to two PLs in the first months of a new pregnancy when both partners are anxious about another PL. The study showed that after the 20-week mark, couples felt safety in the antenatal care program and more secure about the pregnancy as the weeks progressed. Couples wished for sensitivity, empathy and understanding from health care professionals about their history of PL. They wished for more information and support about common reactions and coping strategies. We used a three-stage intervention development model informed by the Medical Research Council’s guidance to co-produce and prototype test an information and support tool intervention for pregnancy after PL with stakeholders and patients (women and partners) to meet the need identified by couples in the qualitative longitudinal study. We also developed two workshops and an educational video to educate health care professionals about these couples’ needs and recommendations for enhanced care.

Текст от CORDIS, на английски · Данни: CORDIS, © Европейски съюз