Women's experiences of early pregnancy assessment unit services: a qualitative investigation
Open accessAbstract
Objective: To explore the experiences of women who had used an Early Pregnancy Assessment Unit (EPAU) service in the UK and make recommendations for their improvement. Design: Qualitative interview study. Setting: Early Pregnancy Assessment Units in the UK. Sample: A maximum variation sample of women who had consented to be interviewed having attended one of 26 EPAUs involved in the VESPA study in 2018. Methods: In‐depth telephone interviews with 38 women. A thematic framework analysis was conducted, with a focus on how experiences varied according to EPAU service configuration and clinical pathway. Main outcome measures: Women's experiences of EPAU services. Results: We found that EPAUs are highly valued, and women's experiences were generally positive. However, women reported a range of issues that negatively affected their experience. These included difficulties accessing the service, insensitive management of the investigation and treatment options of pregnancy loss, poor communication, insufficient information and a lack of support for their psychological health. These issues were not strongly associated with EPAU configuration or clinical pathway. Conclusions: Recommendations to improve women's experiences include the separation of EPAUs from general maternity services, and we make suggestions on how to remove barriers to access by reviewing opening hours, how to provide sensitive patient management, such as automatically cancelling appointments and scans following pregnancy loss, and how to improve communication, both with women and their partners as well as with other parts of the health service. Tweetable abstract: Early Pregnancy Assessment Units are highly valued by women but aspects of their care experiences, particularly around sensitive management of pregnancy loss, could be improved.
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Pregnancy loss and perinatal death can be devastating, with wide-ranging and frequently long-lasting effects on the psychological wellbeing of parents and those around them.
“Though usually an occasion of great joy, pregnancies can be physically and emotionally turbulent when women experience complications [1], or go onto suffer a miscarriage, stillbirth, or neonatal death, the effects of which are often devastating.”
From Preliminary findings on the experiences of care for parents who suffered perinatal bereavement during the COVID-19 pandemic (2021) · cites this paper as [1]
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- Authors
- Hall, J., Silverio, S., Barrett, G., Memtsa, M., Goodhart, V, Bender‐Atik, R., Stephenson, J., & Jurkovic, D.
- Affiliations
- Faculty of Population Health Sciences Elizabeth Garrett Anderson Institute for Women's Health School of Life and Medical Sciences University College London London UK
- Department of Women & Children's Health Faculty of Life Sciences & Medicine School of Life Course Sciences King's College London St Thomas' Hospital London UK
- University College London (GB)
- University College London Hospitals NHS Foundation Trust (GB)
- The Miscarriage Association Wakefield UK
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2021-09-07
- Volume
- 128
- Issue
- 13
- Pages
- 2116-2125
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- PMC
- PMC9292489
- OpenAlex
- W3195600029
- Cited by
- 23
- References
- 27
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 5 · 2023: 4 · 2022: 2 · 2021: 2
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Liverpool John Moores University (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Health Services and Delivery Research Programme (14/04/41)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
- Keywords
- women's experiences, miscarriage, patient experience, access to services, communication, psychological support, care pathways, obstetric care
- MeSH terms
- Abortion, Spontaneous, Abortion, Induced, Adult, Female, United Kingdom, Health Services Accessibility, Humans, Interviews as Topic, Maternal Health Services, Pregnancy, Patient Satisfaction, Qualitative Research, Pregnant People, Pregnant Women, Young Adult
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