ENHANCING CARE FOR LACTATION AFTER A SECOND-TRIMESTER ABORTION OR FETAL LOSS: A QUALITATIVE STUDY

Objectives

Encountering breastmilk secretion following abortion or fetal loss in the second trimester can be physically and emotionally challenging. Options for lactation in this setting are to expectantly manage, suppress using behavioral modifications, pharmacologically suppress, and to express and discard or donate milk. Little is known about the lactation preferences among second-trimester abortion and fetal loss patients. This study sought to explore lactation preferences of these patients via the experiences and practices of their healthcare providers, and to enhance support around lactation options counseling for this population.

Methods

This was a qualitative study involving semi-structured interviews with a purposively recruited sample of nine providers and community partners who interact with second-trimester abortion/fetal loss patients. Thematic analysis was used to identify and interpret meaningful patterns across the dataset.

Results

Three key themes were identified: (1) lactation guidance in the second trimester should be tailored to varying patient situations, (2) more provider education on lactation specific to the second-trimester population is desired, and (3) while milk donation by second trimester patients was rare, stakeholders perceived the experience as being positive for those who chose to donate.

Conclusions

Providers are encouraged to seek ways to communicate all lactation options to patients that may be interested. Provision of an informational brochure, enhanced coordination with lactation consultants, and increased educational opportunities for providers around second trimester lactation can help advance such efforts.