Abstract

Little is known about young people’s experiences accessing healthcare for unintended pregnancy in the USA. To address this gap, we conducted in-depth interviews with 25 young people in California who had experienced at least one unintended pregnancy at or before 25 years of age. Participants were asked about their interactions with healthcare providers during the pregnancy, their thoughts on the determinants of their perceived quality of care, and the ways in which their healthcare experience could have been improved. Thematic analysis was used to organise information within and across interview transcripts. Two important determinants of participants' satisfaction with their healthcare experience were identified during analysis: (1) receiving comprehensive information about their pregnancy options and what to expect from each, and (2) having an empathetic, non-judgemental provider. Regarding abortion, participants described an unmet need for accurate information and frequent stigmatising experiences with dismissive and judgemental care providers. These findings highlight the importance of providing comprehensive, non-judgemental pregnancy options counselling to all pregnant people, regardless of age and desired pregnancy outcome; and reinforce the need for providers to consider ways in which their own bias may influence the quality of care they provide.

摘要

人们对美国年轻人因意外怀孕而获得医疗保健的经历知之甚少。为了解决这一差距，我们对加利福尼亚州的 25 名年轻人进行了深入采访，他们在 25 岁或之前至少经历过一次意外怀孕。参与者被问及他们在怀孕期间与医疗保健提供者的互动、他们对护理质量决定因素的看法，以及改善他们的医疗保健体验的方式。主题分析用于组织访谈记录内和访谈记录之间的信息。在分析过程中确定了参与者对其医疗保健体验满意度的两个重要决定因素：（1）接收有关其怀孕选择以及对每个怀孕选择的期望的全面信息，以及（2）拥有一个有同理心、不带评判性的提供者。关于堕胎，参与者描述了对准确信息的需求未得到满足，并且经常受到轻蔑和评判性护理提供者的污名化经历。这些发现强调了为所有孕妇提供全面、非评判性怀孕选择咨询的重要性，无论其年龄和期望的妊娠结果如何；并强调提供者需要考虑他们自己的偏见可能影响他们提供的护理质量的方式。