Uncertainty in Postpartum Permanent Contraception Decision-Making: Physician and Patient Perspectives.
Womens Health Issues
; 2024 Aug 01.
Article
en En
| MEDLINE
| ID: mdl-39095244
ABSTRACT
PURPOSE:
We sought to understand how patients and physicians conceptualize uncertainty in the permanent contraception decision-making process. BASIC PROCEDURES In 2022-2023, we interviewed postpartum patients with a documented desire for permanent contraception (n = 81) and their delivering physicians (n = 67). Eligible patients gave birth at one of our four study hospitals in California, Ohio, Illinois, and Alabama. We used rapid content analysis and thematic content analysis to develop and refine themes related to uncertainty in permanent contraceptive decision-making. MAINFINDINGS:
Most patients reported full certainty in their decision regarding permanent contraception, although some expressed doubts. After receiving permanent contraception, some patients discussed grief but overall affirmed their decision. One patient said they wished they had considered other contraceptive options. Physicians reported using a range of strategies to safeguard from patient regret, including ensuring patients were 100% certain with their decision, inferring certainty based on their characteristics, asking patients to think through all scenarios that could affect decision-making, and repeat counseling during multiple interactions. PRINCIPALCONCLUSIONS:
Patient experiences reveal the depth, fluidity, and nuance of patients' contraceptive decision-making processes. Physicians sometimes failed to grapple with this nuance by centering potential regret in their counseling. Personalized and supportive contraceptive counseling that acknowledges the complexity of contraceptive decision-making is imperative. Shared decision-making can help ensure patients can make informed and autonomous decisions about their reproductive lives.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Womens Health Issues
Asunto de la revista:
GINECOLOGIA
/
OBSTETRICIA
/
SAUDE DA MULHER
Año:
2024
Tipo del documento:
Article