I felt so much conflict instead of joy: An analysis of narratives from pregnant people in British Columbia who declined care recommendations
Abstract Background No Canadian studies to date have examined the experiences of people who decline care during pregnancy and birth. The current analysis bridges this gap by describing narratives from 892 people in British Columbia (BC) who refused a test or procedure that their care provider recommended. Methods In the Changing Childbirth in BC study, childbearing people designed a mixed-methods study that captured experiences of receiving maternity care, including novel items describing provider-patient interactions. We conducted a descriptive quantitative content analysis of 1540 open ended comments about declining care recommendations. Results Close to half of people who participated in the survey (n = 892; 46%) declined a test or procedure. Participants most commonly declined genetic or gestational diabetes testing, ultrasounds, induction of labour, pharmaceutical pain management during labour, and eye prophylaxis for the newborn. Some people reported that care providers accepted or supported their decision, and others described pressure and coercion from providers. These negative interactions resulted in childbearing people feeling invisible, disempowered and in some cases traumatized. Loss of trust in healthcare providers were also described by childbearing people whose preferences were not respected whereas those who felt informed about their options and supported to make decisions about their care reported positive birth experiences. Conclusions Declining care is common during pregnancy and birth and care provider reactions and behaviours greatly influence how childbearing people experience these events. Our findings confirm that clinicians need further training in person-centred decision-making, including respectful communication even when choices fall outside of standard care..
| Medienart: |
|
|---|
Preprint| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
ResearchSquare.com - (2022) vom: 28. Juli Zur Gesamtaufnahme - year:2022 |
|---|
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Stoll, Kathrin [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| doi: |
10.21203/rs.3.rs-35291/v1 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
XRA034534466 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | XRA034534466 | ||
| 003 | DE-627 | ||
| 005 | 20230429180855.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 220113s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.21203/rs.3.rs-35291/v1 |2 doi | |
| 035 | |a (DE-627)XRA034534466 | ||
| 035 | |a (ResearchSquare)10.21203/rs.3.rs-35291/v1 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Stoll, Kathrin |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a I felt so much conflict instead of joy: An analysis of narratives from pregnant people in British Columbia who declined care recommendations |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 520 | |a Abstract Background No Canadian studies to date have examined the experiences of people who decline care during pregnancy and birth. The current analysis bridges this gap by describing narratives from 892 people in British Columbia (BC) who refused a test or procedure that their care provider recommended. Methods In the Changing Childbirth in BC study, childbearing people designed a mixed-methods study that captured experiences of receiving maternity care, including novel items describing provider-patient interactions. We conducted a descriptive quantitative content analysis of 1540 open ended comments about declining care recommendations. Results Close to half of people who participated in the survey (n = 892; 46%) declined a test or procedure. Participants most commonly declined genetic or gestational diabetes testing, ultrasounds, induction of labour, pharmaceutical pain management during labour, and eye prophylaxis for the newborn. Some people reported that care providers accepted or supported their decision, and others described pressure and coercion from providers. These negative interactions resulted in childbearing people feeling invisible, disempowered and in some cases traumatized. Loss of trust in healthcare providers were also described by childbearing people whose preferences were not respected whereas those who felt informed about their options and supported to make decisions about their care reported positive birth experiences. Conclusions Declining care is common during pregnancy and birth and care provider reactions and behaviours greatly influence how childbearing people experience these events. Our findings confirm that clinicians need further training in person-centred decision-making, including respectful communication even when choices fall outside of standard care. | ||
| 650 | 4 | |a Biology |7 (dpeaa)DE-84 | |
| 650 | 4 | |a 570 |7 (dpeaa)DE-84 | |
| 700 | 1 | |a Wang, Jessie J. |e verfasserin |4 aut | |
| 700 | 1 | |a Niles, Paulomi |e verfasserin |4 aut | |
| 700 | 1 | |a Wells, Lindsay |e verfasserin |4 aut | |
| 700 | 1 | |a Vedam, Saraswathi |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t ResearchSquare.com |g (2022) vom: 28. Juli |
| 773 | 1 | 8 | |g year:2022 |g day:28 |g month:07 |
| 856 | 4 | 0 | |u https://doi.org/10.1186/s12978-021-01134-7 |z lizenzpflichtig |3 Volltext |
| 856 | 4 | 0 | |u http://dx.doi.org/10.21203/rs.3.rs-35291/v1 |z kostenfrei |3 Volltext |
| 912 | |a GBV_XRA | ||
| 912 | |a SSG-OLC-PHA | ||
| 951 | |a AR | ||
| 952 | |j 2022 |b 28 |c 07 | ||