Development of a mother and baby unit contraception assessment tool.
Unplanned pregnancies are a unique, yet significant risk factor in perinatal mental health. Our aim was to create an assessment tool to assess mother's views on contraception as part of the discharge planning process. We used a quantitative-qualitative approach. A clinician-guided questionnaire was completed by patients prior to their discharge from hospital and analysed using Microsoft Excel. Semi-structured interviews were used to explore views regarding family planning in greater depth. Interviews were recorded and transcribed verbatim onto Microsoft Word. Emerging themes were identified using a grounded theory thematic analysis approach. Eighteen inpatients were assessed at the Bethlem Mother and Baby Unit over a 4-month period (May-August 2015). Half of the women stated that the pregnancy was unplanned. The most common contraception methods used were condoms, followed by no method/natural cycle technique. Forty-four percent felt unsure of contraception options available and were keen for further advice and referral to family planning services. Interestingly, almost all the women interviewed stated that their experience of perinatal mental illness had changed their views on having more children. The contraception assessment tool is a short, simple questionnaire that can be adopted across inpatient and community settings. In cooperating family, planning into the discharge care plan could be protective in preventing future unplanned pregnancies in women at high risk of perinatal mental illness relapse. Performing the assessment also provided an added opportunity for psycho-education regarding reproductive health and medication use during the perinatal period. The tool also encouraged liaison with GPs and local family planning services.
ST6 General Adult and Old Age Psychiatry, Camden and Islington NHS Foundation Trust, Highgate Mental Health Unit, Dartmouth Park Hill, London, N19 5NX, UK. c.jayarajah@nhs.net.
Chrishanthy Grace
CG
Jayarajah
Mother and Baby Unit, Bethlem Royal Hospital, Monks Orchard Rd, Beckenham, BR3 3BX, UK.
Trudi
T
Seneviratne
D000328:Adult; D001294:Attitude to Health; D003267:Contraception / Q000379:methods / Q000523:psychology; D003268:Contraception Behavior / Q000523:psychology*; D005193:Family Planning Services / Q000379:methods*; D005260:Female; D006801:Humans; D010351:Patient Discharge; D011247:Pregnancy; D049168:Pregnancy, Unplanned / Q000523:psychology*; D011314:Preventive Health Services / Q000379:methods; D060728:Reproductive Health; D012736:Sex Education / Q000379:methods; D011795:Surveys and Questionnaires; D006113:United Kingdom
Contraception; Family planning; Mental health; Perinatal; Postnatal; Psychiatry