Defining dimensions of pregnancy intendedness.

BACKGROUND: The classification scheme used by the National Survey of Family Growth (NSFG) is a well-established system for defining the intendedness of pregnancy, but its clinical relevance is uncertain. The purpose of this study was to explore how women conceptualize the intention status of their pregnancies and how their concepts relate to the classification scheme used by the NSFG. METHODS: This qualitative study used in-depth, semistructured, open-ended interviews with 27 pregnant women seeking prenatal care or abortion. Sampling was based on ethnicity (Caucasian or Hispanic), education, religiosity, and NSFG intention status (intended, mistimed, or unwanted). RESULTS: Five qualitative dimensions of pregnancy intendedness emerged: preconception desire for pregnancy, steps taken to prepare for pregnancy, fertility behavior and expectations, postconception desire for pregnancy, and adaptation to pregnancy and baby. The relationship of these qualitative dimensions to the NSFG categories was varied and complex, particularly for the NSFG mistimed category. Women indicated that their partners had a strong influence on preconception and postconception desire for pregnancy. CONCLUSION: Further research is needed to develop measures of pregnancy intendedness that accurately reflect the needs and priorities of women. Research that addresses male perspectives and influence is of particular importance.

Exploring the concepts of intended, planned, and wanted pregnancy.

BACKGROUND: A variety of terms have been used to define the intention status of pregnancies. The purpose of this study was to explore how women relate to these terms and how they define the intention status of their pregnancies. Improved understanding of how women use these terms may enhance communication between physicians, patients, and families. METHODS: This qualitative study used in-depth semistructured interviews to explore how women defined the intention status of current, past, and hypothetical pregnancies. Eighteen women who were seeking prenatal care, elective abortion, or pregnancy testing were interviewed. Most of the subjects were interviewed in the first trimester of a current pregnancy. Four researchers independently reviewed the interview transcripts and summarized the points made by each subject. RESULTS: Three major themes emerged from the interviews: (1) definitions of terms related to pregnancy varied substantially among women and seemed to be highly correlated to social and cultural influences; (2) the concepts of wanted and unwanted pregnancy were qualitatively distinct from the concepts of planned and unplanned pregnancies and seemed to be more relevant to the decision to continue or abort the pregnancy; and (3) attitudes of the male partners toward the pregnancies were very influential in how women defined their pregnancies. CONCLUSIONS: Physicians should explore the attitudes and circumstances of pregnant women, rather than focusing on whether the pregnancy was planned. Support from the significant other and the woman's underlying values about parenthood seem to be of particular importance. Our results also suggest that further studies are needed to determine the best method for measuring the intention status of pregnancy for research and policy.

PIP: This qualitative study using in-depth semistructured interviews determined how women define the intention status of current, past, and hypothetical pregnancies. The study population included 18 women, primarily in their first trimester, seeking prenatal care, elective abortion, or pregnancy testing. Findings demonstrated three major themes emerging from the interviews: 1) definition of terms related to pregnancy varied substantially among women and seemed to be highly correlated to social and cultural influences; 2) the concepts of wanted and unwanted pregnancy were qualitatively distinct from the concepts of planned and unplanned pregnancy and seemed to be more relevant to the decision to continue or abort the pregnancy; and 3) attitudes of male partners toward the pregnancies were very influential in how women defined their pregnancies.

The treatment of hemorrhagic gastritis with cimetidine.

Thirteen patients in whom bleeding from hemorrhagic gastritis was not controlled by a variety of therapeutic modalities were treated with cimetidine. Twelve of the 13 patients stopped bleeding. Three subsequently rebled, two of whom required an operation to control the bleeding. The average amount of blood transfused per patient before treatment with cimetidine was 16 units and after cimetidine, 1.6 units. Nine of the 13 patients died, but only one of them died of hemorrhage. The remaining eight patients died of a combination of sepsis and multiple organ failure. We observed no adverse side-effects after the administration of cimetidine. Cimetidine is a safe and reliable means to control bleeding from hemorrhagic gastritis. Once the diagnosis of hemorrhagic gastritis is established, treatment with cimetidine should be begun and continued until the underlying stress which initiated the bleeding is controlled.