Deciding treatment for miscarriage - experiences of women and healthcare professionals
Sammanfattning
Introduction: Women experiencing miscarriage are offered
a choice of different treatments to terminate their wanted
pregnancy at a time when they are often shocked and
distressed. Women’s and healthcare professionals’ experiences
of the decision-making process are not well
described. We aimed to gain insight into this process and
the circumstances that may affect it.
Method: A qualitative study using a grounded theory
approach. Data were obtained through semi-structured
interviews with six women who had chosen and completed
either surgical, medical or expectant treatment for
miscarriage and five healthcare professionals involved in
the decision-making at an emergency gynaecological
department in Denmark. An inductive explorative
method was chosen due to limited knowledge about the
decision-making process, and a theoretical perspective
was not applied until the final analysis.
Results: Despite information and pretreatment counselling,
choice of treatment was often determined by unspoken
emotional considerations, including fear of seeing
the foetus or fear of anaesthesia. These considerations
were not discussed during the decision-making process,
which was a time when the women were under time
pressure and experienced emotional distress. Healthcare
professionals did not explore women’s considerations for
choosing a particular treatment and prioritised information
differently. We found theory about coping and decision-
making in stressful situations useful in increasing
our understanding of the women’s reactions. In relation
to theory about informed consent, our findings suggest
that women need more understanding of the treatments
before making a decision. This study is limited due to a
small sample size, but it generates important findings that
need to be examined in a larger sample.
Conclusion: Frequently, women did not use information
provided about treatment pros and cons in their decisionmaking
process. Because of unspoken thoughts, and
women’s needs being unexplored by healthcare professionals,
information did not target women’s needs and
their reasoning remained unapparent. Published by arrangement with John Wiley & Sons.