Reasons, experiences and expectations of women with delayed medical care for ectopic pregnancies in Chinese urban edges: a qualitative study

Abstract

ObjectiveTo explore the experiences of patients with ectopic pregnancies with delayed medical care, with the goals to promote timely access to care, reduce subsequent physical and psychological impacts, and provide recommendations for improved management of ectopic pregnancies.DesignA qualitative study.SettingA 1000-bed urban edge hospital located in the suburban area of Guangzhou, China, between December 2022 and February 2023.Participants21 patients with delays in seeking medical care for ectopic pregnancy.Primary and secondary outcome measuresSemistructured, in-depth, face-to-face interviews were conducted to understand the experience and expectations of these women.ResultsThree main themes emerged, including delaying medical care, physical and psychological experiences, and expectations of their healthcare providers. Each of these main themes had several subthemes. The central theme of reasons for delaying medical care had five subthemes, including lack of knowledge on early symptoms of ectopic pregnancy, family dynamics and circumstances, traditional fertility ideology and intentions, avoidance of medical treatment behaviour, and medical delays. The main theme of physical and psychological experiences had two subthemes, including learnings from the experiences and negative impacts of the experiences. The main theme of expectations of their healthcare providers included three subthemes that were reducing the length of outpatient examinations and waiting times, increasing public understanding of early symptoms of ectopic pregnancy and increasing male awareness of safe contraceptive methods.ConclusionsA lack of knowledge about the early symptoms of ectopic pregnancy was the main reason for delays in seeking medical care and had a dual impact on patients’ physical and mental health, affecting their recovery and future healthcare. A collective effort from patients, families, healthcare providers and medical institutions is required for better medical education, family support, specialised professional training and local fertility policy to decrease the incidence of delayed medical care and achieve satisfactory pregnancy outcomes.