Abstract Body

Background: One in five Dutch women experience an unplanned pregnancy (UP) in their lifetime, of which two third are unwanted (UWP). Information on annual incidence of UWP is limited and insight into the need for psychosocial (after) care is lacking. The general practitioner (GP) plays a prominent role in the care for women with an UWP. The data GP’s register about UWP and the care trajectories can be used to create more insight into care needs and the improvement of (after) care.

Aim(s): To create an overview of the prevalence of UWP and the reproductive and psychosocial care needs of woman with an UWP in The Netherlands.

Methods: Data were extracted from 36 general practices located in northern part of the Netherlands, in the period 2015 – 2019. Patient files were checked for the registration of International Classification of Primary care (ICPC) and Anatomical Therapeutic Chemical (ATC)-codes concerning reproductive and psychosocial health. Chi-square and Fishers exact test were used to calculate differences between woman with an UWP and/or abortion and women with a wanted pregnancy (WP).

Preliminary results: In total 49.479 women were included in the analyses, in total 781 (1.6%) had an UWP and/or abortion whereas 5833 (11.8%) had a registered WP. Results on contraceptive use and psychosocial problems in both groups are available to present at the World Organization of Family Doctors (WONCA).

Conclusions: Data registered by GP’s is a good source for more knowledge about UWP in the Netherlands and the need for reproductive and psychosocial (after) care. It offers insights in areas to improve care.

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Background and purpose: One in five Dutch women experience an unwanted pregnancy (UWP) in their lifetime. Over half of these women consult their general practitioner (GP) regarding the UWP. Despite the prominent role GPs play in the care for women and their partners, they have little experience in UWP-care. Both UWP-women and professionals working in abortion clinics have raised concerns about counselling and aftercare provided by GPs. Partners are underrepresented in literature and policy. The aims is to identify the experiences and needs of UWP-women and –men, to formulate recommendations to improve UWP-care.

Methods: The protocol was registered under PROSPERO number 196461. The search was performed in MEDLINE, PubMed, EMBASE, PsycINFO, CINAHL and Web of Science, using the keywords ‘Unwanted pregnancy’, ‘Decision-making’, ‘Counselling’, ‘Experience’ and ‘Needs’. In total 3,433 articles were screened for eligibility. After methodological quality appraisal 18 studies were included (from 6 countries, published between 2000 and 2019). Thematical analysis was performed.

Results: The results for UWP-women illustrate the need for accurate information, empowerment of decision ownership and sensitivity to their existential experiences. All three factors have been found to influence the mental wellbeing after termination of pregnancy. Influences on the wellbeing after carrying an UWP to term were not found. UWP-partners experiences are coloured by the level of involvement in the decision-making process and signify the need for organized support to aid for UWP-men.

Conclusions: The results indicate areas to improve UWP-care. Focus needs to be on the active support of women and partners by their health care providers, to improve the psychological outcome.