# How, when, and who should ask about pregnancy intentions in primary care? A qualitative study of women’s preferences

## TL;DR

The study explores how and when to ask women about their pregnancy intentions in primary care settings, finding that open questions in relevant contexts are generally acceptable.

## Contribution

The study introduces a framework for acceptable methods and contexts for discussing pregnancy intentions in primary care.

## Key findings

- Women prefer open questions about pregnancy intentions in face-to-face consultations when the rationale is clear.
- Digital methods are valued for privacy and convenience, depending on the target population.
- Acceptability increases when discussions are contextualized within women's health consultations and include follow-up.

## Abstract

For health services to help people plan for or prevent pregnancy, health professionals need an acceptable way to identify individuals’ preferences.

To assess women’s views on the acceptability of specific questions about pregnancy preferences when asked by health professionals in a variety of primary care contexts.

One-to-one in-depth interviews with 13 women aged 18–48 from across the UK, involving role-play scenarios and ranking exercises. Interviews covered a range of settings and health professionals, different question wording, and ways of asking (in person or digitally). We conducted a thematic Framework Analysis, focussing on themes relating to feelings and preferences.

Women were generally open to being asked about pregnancy preferences if they understood the rationale, it was asked in a relevant context, such as in women’s health-related consultations, and there was follow-up. After signposting, an open question, such as ‘How would you feel about having a baby in the next year?’ was preferred in a face-to-face context as it enabled discussion. While some women valued a face-to-face discussion with a health professional, for others the privacy and convenience of a digital option was preferred; methods should be tailored to the target population.

Discussion of pregnancy preferences via a range of formats is acceptable to, and valued by, women in the UK across a range of primary care settings. Acceptability to health professionals and feasibility of implementation needs further exploration and would benefit from greater public awareness of the benefits of pregnancy planning.