Enhancing Care for Lactation After a Second Trimester Abortion or Fetal Loss: A Qualitative Study.

Abstract

Background: Milk secretion following abortion or fetal loss in the second trimester is common and can be physically and emotionally challenging. To date, research surrounding lactation after loss has focused on those experiencing a third trimester stillbirth or loss of an infant.

Research aim: To explore lactation counseling and support in the unique care setting of second trimester abortion or fetal loss patients.

Methods: This was a qualitative study involving semi-structured interviews with nine providers and community partners who intersect with second trimester abortion and fetal loss patients, recruited at an academic medical center in the northeast United States. Thematic analysis was used to identify and interpret meaningful patterns across the dataset.

Results: Five themes were identified: (1) Lactation guidance in the second trimester should be tailored to unique patient characteristics, (2) Varying care scenarios for second trimester abortion and fetal loss dictate the feasibility of offering lactation guidance, (3) An educational brochure would help second trimester abortion and fetal loss patients access necessary lactation information at their desired timing, (4) Providers feel they could benefit from more information on lactation in the second trimester, (5) While donation of milk by patients undergoing second trimester abortion and fetal loss was rare, stakeholders perceived the experience as positive for patients who chose to do it.

Conclusion: Diverse patient scenarios and time-sensitive care schemes are important considerations for lactation options counseling in the second trimester. Distribution of an informational brochure, coordination between departments, and educational opportunities for providers can enhance lactation support in the second trimester.