Women's Preferences in Early Pregnancy Loss Management: A Focus on Psychological Considerations Using the Analytic...

Area of Science:

• Reproductive Health
• Psychological Medicine
• Decision Science

Background:

• Early pregnancy loss (EPL) carries a significant emotional burden.
• Psychological aspects are often underrepresented in EPL management decision support.
• Understanding women's criteria for choosing EPL management is vital.

Purpose of the Study:

• To identify criteria women use when choosing between expectant, medical, and surgical management of EPL.
• To specifically investigate the importance of psychological aspects in EPL management decisions.

Main Methods:

• A mixed-methods study utilizing the Analytic Hierarchy Process (AHP).
• Criteria identification through literature review and focus groups.
• Structured telephone interviews with 37 women with EPL history using pairwise comparisons.
• Quantitative analysis of criterion weights and consistency, with logistic regression for factors influencing consistency.

Main Results:

• 'Minimizing psychological distress' was the most important criterion (weight=0.381).
• Sub-criteria importance varied by management preference: 'natural process' for expectant, 'avoiding hospital' for medical, and 'short completion time' for surgical.
• Sixty-five percent of participants showed acceptable preference consistency; lower education negatively impacted consistency.

Conclusions:

• Women's preferences for EPL management are influenced by differing definitions of psychological distress.
• The AHP method provided nuanced insights into individual decision-making for EPL.
• Individualized counseling and shared decision-making are essential, considering emotional factors in EPL management.