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\begin{document}

\title{Implementation of the London Measure of Unplanned Pregnancy in routine
antenatal care in London: a mixed-methods evaluation}



\author[1]{Jennifer Hall}%
\author[1]{Catherine Stewart}%
\author[2]{Bryony Stoneman}%
\author[3]{Tamsin Bicknell}%
\author[4]{Helen Duncan}%
\author[1]{Judith Stephenson}%
\author[1]{Geraldine Barrett}%
\affil[1]{University College London Institute for Women's Health}%
\affil[2]{University College Hospital Women's Health Service}%
\affil[3]{Homerton Healthcare NHS Foundation Trust}%
\affil[4]{Office for Health Improvement and Disparities}%


\vspace{-1em}



  
  \date{May 22, 2024}


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\begin{abstract}
Objective: To evaluate the implementation of the London Measure of
Unplanned Pregnancy (LMUP) in antenatal care. Design: Mixed methods
evaluation of a pilot. Setting: Antenatal care at University College
London Hospital and Homerton Hospital, England, 2019-2022. Population:
Pregnant women attending antenatal care at one of the sites during the
evaluation. Methods: Quantitative and psychometric analysis of anonymous
data and qualitative analysis of interviews and focus groups with women
and midwives, using a Framework Analysis. Main Outcome Measures:
Acceptability of the inclusion of the LMUP, measured by completion rates
and women's and midwives opinions. Results: Completion of the LMUP at
UCLH stabilised at around 70\% and the LMUP performed as expected.
Asking the LMUP at antenatal booking appointments is feasible and
acceptable to women and midwives. Advantages of asking the LMUP,
highlighted by participants, include providing additional support and
personalising care. Midwives' concerns about judgment were
unsubstantiated; women with unplanned pregnancies valued such
discussions. Conclusions: These findings support the implementation of
the LMUP in routine antenatal care and show how it can provide valuable
insights into the circumstances of women's pregnancies. This can be used
to help midwives personalise care, and potentially reduce adverse
outcomes and subsequent unplanned pregnancy. Integration of the LMUP
into the Maternity Services Data Set, will establish national data
collection for a population-level measure of unplanned pregnancy,
serving as a key outcome measure for sexual and reproductive health and
enabling analysis of the prevalence, factors, and implications of
unplanned pregnancies across subpopulations to inform implementation.
Funding \emph{:} NIHR PDF-2017-10-021%
\end{abstract}%



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\textbf{Hosted file}

\verb`LMUP evaluation paper FINAL.docx`  available at \url{https://authorea.com/users/601119/articles/656650-implementation-of-the-london-measure-of-unplanned-pregnancy-in-routine-antenatal-care-in-london-a-mixed-methods-evaluation}

\textbf{Hosted file}

\verb`Figure 1.docx`  available at \url{https://authorea.com/users/601119/articles/656650-implementation-of-the-london-measure-of-unplanned-pregnancy-in-routine-antenatal-care-in-london-a-mixed-methods-evaluation}

\textbf{Hosted file}

\verb`Figure 2.docx`  available at \url{https://authorea.com/users/601119/articles/656650-implementation-of-the-london-measure-of-unplanned-pregnancy-in-routine-antenatal-care-in-london-a-mixed-methods-evaluation}

\textbf{Hosted file}

\verb`Table 1.docx`  available at \url{https://authorea.com/users/601119/articles/656650-implementation-of-the-london-measure-of-unplanned-pregnancy-in-routine-antenatal-care-in-london-a-mixed-methods-evaluation}

\textbf{Hosted file}

\verb`Table 2.docx`  available at \url{https://authorea.com/users/601119/articles/656650-implementation-of-the-london-measure-of-unplanned-pregnancy-in-routine-antenatal-care-in-london-a-mixed-methods-evaluation}

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