Assessing Patient's Feelings About Their Pregnancy: A Preliminary Qualitative Exploration of Conversations Between Obstetric Clinicians and Pregnant Patients at the First Prenatal Visit ID 2683659

INTRODUCTION: During the first prenatal visit, some patients may feel overwhelmed, ambivalent, or undecided about continuing the pregnancy. Understanding a patient’s feelings about the pregnancy can allow obstetric clinicians to offer support, resources, and options. Few studies have empirically examined how obstetric providers assess patient’s feelings about their pregnancy. METHODS: We analyzed transcripts of audio-recorded patient–obstetric clinician first obstetric visits for discussions exploring the patient’s feelings, intentions, or desires regarding their pregnancy. These discussions were then coded for content and communication approach. RESULTS: We coded 100 transcribed visits. Discussions about pregnancy intent, desire, or feelings occurred in 70 visits. In 11 visits, the clinician used an open-ended neutral question (eg, “how are you feeling about this pregnancy?”). Fifteen clinicians expressed assumptions about the patient’s feelings regarding the pregnancy (eg, “congratulations!”). Fifty-seven clinicians specifically asked about intendedness (eg, “Was this a planned pregnancy?). Twenty-one addressed the topic with leading statements (eg, “but you want to keep the baby, right?”). Of the 53 patients that admitted to an unplanned pregnancy, only 42 (79%) of these conversations were further explored—29 (54%) specifically only asked about patient’s desire to continue the pregnancy; 13 (24%) provided additional options counseling, information, or support. CONCLUSION: Few obstetric clinicians explored the feelings and desires about the pregnancy during first obstetric visits. Further work is needed to explore improved methods of addressing how patients feel about their pregnancy.