Reproductive Life Planning: Raising the Questions
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COMMENTARY
Reproductive Life Planning: Raising the Questions Jessica E. Morse1 · Merry‑K. Moos1,2
© Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract Introduction Unintended pregnancy has been a concerning public health problem for decades. As we begin to understand the complexities of pregnancy intention and how women experience these pregnancies, reproductive life planning offers a paradigm shift. Methods Reproductive life planning is a patient-centered approach that places a patient’s reproductive preferences—whether concrete or ambivalent—at the forefront of her clinical care. Results This process grants women and men the opportunity to consider how reproduction fits within the context of their broader lives. Within a clinical encounter, reproductive life planning allows counseling and care to be tailored to patient preferences. Discussion Although there is great potential for positive public health impacts in unintended pregnancy, contraceptive use and improved preconception health, the true benefit lies within reinforcing reproductive empowerment. Despite recommendations for universal adoption, many questions remain regarding implementation, equity and outcomes. Keywords Reproductive life planning · Unintended pregnancy · Reproductive justice · Patient-centered care · Preconception health
Significance Reproductive life planning is a patient-centered approach to addressing reproductive preferences. It offers a new approach to the issue of unintended pregnancy and presents the possibility of patient empowerment if applied in a universal and just manner.
Introduction The promise of reproductive life planning (RLP) is that women, men and couples will have a structured opportunity to explore their values and preferences about whether or when to have children and be empowered to articulate those desires to their health care providers so they can collaborate
to make them reality. The potential for public health benefit—a reduction in unintended pregnancy and improvement of preconception health—is large. However, women’s health advocates have wisely cautioned against potential harms. We suggest that the promise of RLP lies within providing a vehicle for patient reproductive empowerment and agency. Reproductive life planning—if implemented in a patientcentered way—addresses reproductive desires within the greater context of people’s lives. Translating these broader concepts into clinical practice will require practitioners to respect the full spectrum or reproductive preferences while providing the health education needed to assure that decisions are well-informed. Providers will need to be mindful of the unintended and potentially alienating consequences of this new approach to assessing fertility preferences.
Pregnancy Intentions * Jessica E. Morse [email protected] 1
Department of Obstetrics & Gynecology, University of North Carolina School of Medicine, Campus Box 7570, Chapel Hill, NC 27599‑7570, USA
Center for Maternal and Infant Health, University of North Caroli
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