Pregnancy intention screening may take different forms depending on the patient’s needs and the relationship between the patient and her/his clinician. Regardless of the format, pregnancy intention screening should be patient-centered.
- Screen for pregnancy intention as part of initial and continuing health assessments. Pregnancy intention screening/counseling should assess the patient’s current desire to become pregnant.1-4
- Routinely ask patients about satisfaction with their current method and extent to which current method aligns with pregnancy intention. Method satisfaction is a key factor associated with continuation/discontinuation.2-4
- Recognize that pregnancy intentions are often complex and multi-dimensional.
- Many patients experience ambivalence regarding pregnancy and parenting desires.
- Facets of pregnancy intention may include the strength of patient’s motivations in avoiding pregnancy, their expected emotional reaction if s/he were to become or cause their partner to become pregnant, and the perceived support of the partner.1-4
- Provide preconception and/or contraception services, based on the patient’s pregnancy intention, during the current visit, in subsequent visit(s), or through coordinated referral.1-6
- Some populations, such as males, adolescents, and LGBT patients, may be less likely to receive pregnancy and parenting intention screening in a typical clinic setting.
- Research on the effectiveness of existing pregnancy intention screening tools and methods among special populations is ongoing but limited. Some adaptation may be necessary to ensure that screening is culturally appropriate and patient-centered.
Several pregnancy intention screening tools are used in different clinical and non-clinical settings. Numbers one and two below are the most commonly-recommended tools.
- One Key Question®, developed by the Oregon Foundation for Reproductive Health and strongly supported by the Oregon Health Authority: http://www.onekeyquestion.org
- Reproductive life plan resources, Centers for Disease Control and Prevention, Preconception Health and Health Care: http://www.cdc.gov/preconception/reproductiveplan.html
- Motivational Interviewing (MI) can be applied to contraception counseling. https://www.arhp.org/uploaddocs/Client%20 Centered%20Contraception%20Counseling%20.pdf and http://www.acog.org/-/media/Committee-Opinions/ Committee-on-Health-Care-for-Underserved-Women/co423. pdf?dmc=1&ts=20170407T2144229678
- Providing Quality Family Planning Services (QFP), Recommendations of CDC and U.S. Office of Population Affairs, 2014, pages 5-7: http://www.cdc.gov/mmwr/pdf/rr/rr6304.pdf
- Before, Between and Beyond Pregnancy, The National Preconception Curriculum and Resources Guide for Clinicians: http://beforeandbeyond.org/toolkit
- Preconception health and health care, resources from the Centers for Disease Control and Prevention: http://www.cdc.gov/ preconception/index.html