title: Addressing potential pitfalls of reproductive life planning with patient-centered counseling.
abstract: Engaging women in discussions about reproductive goals in health care settings is increasingly recognized as an important public health strategy to reduce unintended pregnancy and improve pregnancy outcomes. "Reproductive life planning" has gained visibility as a framework for these discussions, endorsed by public health and professional organizations and integrated into practice guidelines. However, women's health advocates and researchers have voiced the concern that aspects of the reproductive life planning framework may have the unintended consequence of alienating rather than empowering some women. This concern is based on evidence indicating that women may not hold clear intentions regarding pregnancy timing and may have complex feelings about achieving or avoiding pregnancy, which in turn may make defining a reproductive life plan challenging or less meaningful. We examine potential pitfalls of reproductive life planning counseling and, based on available evidence, offer suggestions for a patient-centered approach to counseling, including building open and trusting relationships with patients, asking open-ended questions, and prioritizing information delivery based on patient preferences. Research is needed to ensure that efforts to engage women in conversations about their reproductive goals are effective in both achieving public health objectives and empowering individual women to achieve the reproductive lives they desire.
authors: Departments of Obstetrics and Gynecology and Health Services, University of Washington Schools of Medicine and Public Health, Seattle, WA; Health Services Research and Development, Puget Sound Health Care System, Department of Veterans Affairs, Seattle, WA. Electronic address: lcallega@uw.edu.
authors: Lisa S
authors: LS
authors: Callegari
authors: Lyndon B. Johnson School of Public Affairs, University of Texas at Austin, Austin, TX.
authors: Abigail R A
authors: AR
authors: Aiken
authors: Departments of Family and Community Medicine, Obstetrics, Gynecology, and Reproductive Sciences, and Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA.
authors: Christine
authors: C
authors: Dehlendorf
authors: School of Nursing, University of California Los Angeles, Los Angeles, CA.
authors: Patty
authors: P
authors: Cason
authors: Center for Research on Health Care, University of Pittsburgh, Pittsburgh, PA; Center for Health Equity, Research, and Promotion, Department of Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA.
authors: Sonya
authors: S
authors: Borrero
mesh_terms: D003267:Contraception; D003376:Counseling / Q000379:methods*; D005193:Family Planning Services / Q000379:methods*; D005260:Female; D006040:Goals; D006801:Humans; D018802:Patient-Centered Care / Q000379:methods*; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D016742:Preconception Care; D011247:Pregnancy; D060728:Reproductive Health
keywords: One Key Question; PATH questions; family planning; patient-centered care; patient-centered counseling; preconception care; pregnancy planning; reproductive autonomy; reproductive goals counseling; reproductive life plan; reproductive life planning