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Introduction of the London Measure of Unplanned Pregnancy at the booking visit and the midwives’ perspective

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      Background

      Pregnancy planning and preconception care benefit women, their children, and future generations. The London Measure of Unplanned Pregnancy (LMUP) is a tool that can be used in antenatal care to identify women with unintended pregnancies, who require improved access to such services. This tool has recently been implemented into routine antenatal care in two Sydney Maternity centres.

      Objective

      To explore midwives’ attitudes to the LMUP and their understanding of its application to their scope of practice following 12 months after it was introduced into the booking visit.

      Methods

      A qualitative study using in-depth semi structured interviews with midwives from the two maternity care centres in Sydney, New South Wales, Australia. All midwives performing antenatal booking visits were eligible to take part. Interviews were transcribed, analysed, and coded to define key themes. Recruitment ceased when thematic saturation was reached.

      Results

      Ten midwives from the two maternity centres were interviewed. Midwives support the inclusion of the LMUP into the booking visit and felt it was in their scope of practice to be using the tool. Time constraints, the impact of COVID-19 and lack of structured referral pathways were identified barriers to the implementation of the LMUP in routine care.

      Conclusions

      Midwives support the inclusion of the LMUP into the antenatal booking visit and see that it falls within their scope of practice. Service barriers were identified at the individual, organisational and external context levels. These need to be addressed to enhance the potential of this tool.
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