Receiving unexpected news about a pregnancy during an antenatal scan appointment, is difficult and distressing for expecting parents, and challenging for healthcare staff to communicate. When distressing news is shared, such as that a baby in the womb is not developing as expected, it is important that parents understand what the implications of the news might mean, including for the future health of their baby. While some conditions may be less serious, others may cause life changing illness or disability or even result in the loss of the baby's life. Parents often require support in making informed decisions, for example about whether to have more tests, some of which may pose a risk for the baby, or whether to continue with the pregnancy.

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For patients with mental health conditions, this already sensitive situation is even more challenging. They may be overwhelmed, making it harder to understand information about the implications and outlook for their unborn babies, and make decisions about next steps. Also, albeit well-intentioned, staff may not explain the news clearly in an attempt to avoid causing emotional distress to their patients, with implications for any choices or decisions they have to make.

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To date, no research has looked at the best way for healthcare staff to communicate and discuss difficult news with women with mental health conditions and support informed decision-making. 

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The idea for this project came from members of the East London patient and public advisory group “Katie’s Team” who are active and equal partners in this ‘Co-produced’ research. With researchers and health professionals working alongside Katie’s Team and women with mental health conditions, our goal is to improve communication so that, in the future, these women can be better supported during antenatal scans and discussions to  make informed decisions.

 

Our research is drawing upon the experience of people that have been in this situation, including patients/significant others and staff, to help us improve our services.

The research plan is as follows:

• In May 2023, we began recording consultations of communicating unexpected news during pregnancy in our units, with both parties’ consent. We will look at how healthcare professionals conduct the consultation (e.g., words/tone they use) and how patients react to the news (e.g., questions they ask). 

• Interviewing women with mental health conditions (and/or their significant others) who received unexpected news regarding the baby during pregnancy to learn about their experience and ask them for suggestions to improve care. We began recruiting women in September 2023. Separately, we will interview staff to learn from their experiences, understand challenges and gather recommendations.

• Finally, we will invite women, their significant others and healthcare professionals to a joint workshop in 2024 to share the findings from filmed consultations and interviews. We will ask them to work together to create detailed recommendations for improving communication during pregnancy. 

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In the future we plan to carry out further research to investigate whether these recommendations put into practice have a positive impact on the experience of women with mental health conditions, their significant others and staff. Additionally, the research will explore the possibility of adapting these recommendations to other groups of pregnant patients with specific communication needs.

 

The study is funded by National Institute for Health and Care Research.

 

If you would like further information and/or you are interested in participating, please email: i.karapanos@qmul.ac.uk

 

Twitter:  https://twitter.com/understandstudy                     

 

IG: understand_study

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