Factors affecting unintended pregnancy resolution from the perspectives of pregnant women and people: A systematic review of qualitative evidence.

BACKGROUND: Unintended pregnancy is a global issue with significant consequences for individuals and society. It impacts maternal and neonatal health, educational attainment, and interpersonal relationships. The decision-making process surrounding unintended pregnancies is complex, influenced by factors like ambivalence, societal norms, and maternal responsibilities. Understanding pregnant women and people's experiences is crucial to providing support and addressing barriers to access. Therefore, this systematic review aimed to consolidate and synthesize qualitative evidence regarding individual's experiences and the factors influencing their decision-making in unintended pregnancies. METHOD(S): Ten databases (PubMed, Embase, CINAHL Complete, Cochrane Library, PsycINFO (Ovid), Scopus, Web of Science Core Collection and Social Science Database (ProQuest), MedNar and ProQuest Dissertations and Theses Global) were systematically searched for published and unpublished primary qualitative studies from their inception to December 2022. Relevant qualitative data were extracted and meta-summarized using Sandelowski and Barroso's approach and analyzed using Thomas and Harden's thematic analysis framework. RESULTS: Eighteen studies met the inclusion criteria and were included in the review. Four themes were identified from the meta-synthesis: 1) Navigating the head and heart, 2) Involvement and influence of others, 3) Hindrance and help in decision-making, and 4) Growing and gaining. CONCLUSION: This review emphasized the significance of both internal and external factors in shaping pregnant women and people's experiences, and influencing their choices when faced with unintended pregnancies. Recognizing and addressing the multifaceted nature of these decisions; is crucial for different stakeholders such as healthcare professionals, and policymakers to better support pregnant women and people, and promote their well-being. This review sets the stage for future research and practice, emphasizing the ongoing need to empower pregnant women and people, ensure accessible and safe reproductive healthcare services, and promote informed decision-making.

Experiences of nurses managing parenthood and career. A systematic review and meta-synthesis.

AIM: Consolidate and synthesize evidence on working nurse-parent experiences of parenthood. BACKGROUND: Demands in healthcare strain the workforce, causing burnout and high turnover rates, especially among nurses. Balancing work and family responsibilites is even more challenging for nurse-parents. INTRODUCTION: Nursing is highly stressful, and the experiences of nurse-parents are under-researched highlighting the need to better understand and support nurse-parents in their dual roles. METHODS: Seven databases (PubMed, Embase, CINAHL, PsycINFO, ProQuest, Scopus, and Web of Science) were systematically searched for published and unpublished primary qualitative studies. Extracted data were meta-summarized and synthesized using Sandelowski and Barroso's approach. FINDINGS: Twelve peer-reviewed studies, conducted between 2007 and 2022, investigated the challenges faced by 339 female nurse-parents across various countries. The meta-synthesis revealed two main themes: (a) Clashes of dual roles, and (b) Accept, adapt, and compromise, which were supported by six subthemes. Nurse-parents struggled with dual roles, often neglected self-care, and experienced work-family conflicts. However, they learned to accept their situations, adapt by seeking help from family, friends, and colleagues, and compromise on career aspirations to prioritize their families. The importance of organizational support and flexibility in accommodating their dual roles was emphasized. DISCUSSION: Female nurse-parents face challenges in balancing their dual roles, resulting in fatigue, compromised self-care, and limited social interactions. The culture of self-sacrifice in nursing contributes to these challenges, impacting patient safety. Supportive interventions like mindfulness programs and exercise classes can promote well-being. Staffing shortages and shift work further affect the work-life balance for nurse-parents. CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY: Creating a supportive work environment for nurse-parents is crucial. Family-friendly shifts revised parental leave policies, and improved childcare support are needed. Supporting nurse-parents benefits their well-being and enhances patient care. Collaboration between healthcare organizations and policymakers is essential to address workforce shortages and implement changes.