Developing recommendations to improve the experience of unplanned pregnancy: results from a multiphase study.

Abstract

BACKGROUND: Unplanned pregnancy is considered one of the most important health, social, and economic challenges in the field of reproductive health, which can have multiple negative effects on women’s physical and psychological health and social relationships. This study aimed to develop interventions to improve the experience of women with unplanned pregnancy. METHODS: This study is part of a mixed-methods research with an exploratory sequential design. The study was conducted in two phases. In the first phase, a qualitative study was performed to clarify women’s perceptions and experiences of unplanned pregnancy from the perspective of the participants (13 women with unplanned pregnancies, three midwives, and one gynecologist) and to identify their perceived needs. The participants were selected using purposive sampling. The inclusion criteria were unplanned pregnant women aged 18–45 years old and without any diagnosed physical or mental disorders. Semi-structured interviews were analyzed using conventional content analysis following the steps proposed by Graneheim and Lundman. Then, through a literature review, the components of pregnancy experiences and related proposed interventions were identified. In the second phase, the data obtained from both the qualitative phase and the literature review of the first phase were integrated, and 38 initial interventions were developed. Subsequently, these interventions were evaluated through three Delphi rounds by 15 experts from the fields of midwifery, obstetrics, and reproductive health, selected based on their experience of at least 5 years, academic position, and professional expertise. RESULTS: Thirty-two interventions were agreed upon and grouped into four domains: (1) education, counseling, and awareness-raising (such as providing prenatal health education, nutritional guidance, and psychological counseling) (2), improving the quality of care (such as ensuring respectful and personalized care, and continuously monitoring maternal needs) (3), strengthening maternal–fetal attachment (such as encouragement to talk and interact with the fetus), and (4) family and social support (such as partner education package and virtual peer support). The experts scored the interventions according to feasibility and importance. CONCLUSION: The 32 interventions developed and refined through expert consensus can serve as an evidence-based framework to enhance the experience of unplanned pregnant women, especially in communities with legal restrictions on abortion. These findings offer practical guidance for policymakers on how to train healthcare providers to deliver individualized care and holistic support that addresses the diverse needs of women. Additionally, healthcare systems should prioritize the development and dissemination of educational materials that cover the comprehensive topics identified in this study.