UNDERSTAND:

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The news that a baby in the womb is not developing as expected is difficult and distressing for expecting parents, and challenging for healthcare staff to communicate. It is important that parents understand what the news might mean for the future health of their baby. While some conditions may be less serious, others may cause life changing illness 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 and make decisions. Also, staff may not explain the news clearly in an attempt to avoid causing emotional distress to their patients.

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To date, no research has looked at the best way for healthcare staff to communicate difficult news with these patients 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”. The goal of our research is for staff to work alongside women with mental health conditions to improve communication so that, in the future, these patients can be supported to better understand the outlook for their unborn babies and make informed decisions.

 

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

The plan is as follows:

• We will film 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). 

• We will interview women with mental health conditions (and/or their significant others) who received unexpected news during pregnancy to learn about their experience and ask them for suggestions to improve care. 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 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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This research will be co-produced with members of “Katie’s Team”. Future research will 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.