Use of dyadic longitudinal interviews in health services research: a case example

INTRODUCTION/BACKGROUND: Pregnancy loss (PL) is common (∼25% of pregnancies). PL has a negative psychological impact on women and growing evidence that partners are impacted too. Thus PL is a unique public health issue - a “couple” problem that affects both partners. With millions of pregnancies each year, a significant number of pregnant women and their partners will have experienced prior PL and may be vulnerable in pregnancy given their reproductive history. But are their needs met by the standard pregnancy care? This study used dyadic, longitudinal interviews to examine: what are couples’ perceptions of the health care and support provided in a subsequent pregnancy after PL and do their needs change across a pregnancy? The combination of dyadic and longitudinal methods is rarely used in health services research, but seems especially well-placed to examine how needs for health care change across the pregnancy and the perception of both partners. METHODS: Semi-structured dyadic interviews were conducted with 15 couples over four time periods across a new pregnancy after PL (after pregnancy test and once in each trimester). Couples were recruited from a national cohort of couples with PL. Interviews were held in person or via Zoom in Denmark. Qualitative dyadic and longitudinal interview data were analyzed using thematic analysis with a focus on identification of common themes within and across couples and trimesters. RESULTS AND ANALYSIS: Dyadic data showed that both partners experienced anxiety and worry about the safety of the fetus and possibility of miscarrying. Longitudinal data revealed that couples believed that standard pregnancy care in the first trimester of pregnancy was insufficient for their needs. They wished for ongoing access to regular scans and close monitoring to provide reassurance and detect problems early. They reported that their needs for care were met through antenatal care provided in the later stages of pregnancy. KEY MESSAGES: • Dyadic longitudinal interviews generate nuanced data about a shared experience of receiving health care across a pregnancy. • A better understanding of needs can inform development and provision of effective health care and support to fill identified gaps and promote overall family, maternal and infant health.