{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T03:08:16Z","timestamp":1792292896691,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T00:00:00Z","timestamp":1630972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002001","name":"Health Services and Delivery Research Programme","doi-asserted-by":"publisher","award":["14\/04\/41"],"award-info":[{"award-number":["14\/04\/41"]}],"id":[{"id":"10.13039\/501100002001","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the experiences of women who had used an Early Pregnancy Assessment Unit (EPAU) service in the UK and make recommendations for their improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Qualitative interview study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Early Pregnancy Assessment Units in the UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>A maximum variation sample of women who had consented to be interviewed having attended one of 26 EPAUs involved in the VESPA study in 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In\u2010depth telephone interviews with 38 women. A thematic framework analysis was conducted, with a focus on how experiences varied according to EPAU service configuration and clinical pathway.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Women's experiences of EPAU services.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found that EPAUs are highly valued, and women's experiences were generally positive. However, women reported a range of issues that negatively affected their experience. These included difficulties accessing the service, insensitive management of the investigation and treatment options of pregnancy loss, poor communication, insufficient information and a lack of support for their psychological health. These issues were not strongly associated with EPAU configuration or clinical pathway.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Recommendations to improve women's experiences include the separation of EPAUs from general maternity services, and we make suggestions on how to remove barriers to access by reviewing opening hours, how to provide sensitive patient management, such as automatically cancelling appointments and scans following pregnancy loss, and how to improve communication, both with women and their partners as well as with other parts of the health service.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Early Pregnancy Assessment Units are highly valued by women but aspects of their care experiences, particularly around sensitive management of pregnancy loss, could be improved.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16866","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T16:18:54Z","timestamp":1629303534000},"page":"2116-2125","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Women's experiences of early pregnancy assessment unit services: a qualitative investigation"],"prefix":"10.1111","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2084-9568","authenticated-orcid":false,"given":"JA","family":"Hall","sequence":"first","affiliation":[{"name":"Faculty of Population Health Sciences Elizabeth Garrett Anderson Institute for Women's Health School of Life and Medical Sciences University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7177-3471","authenticated-orcid":false,"given":"SA","family":"Silverio","sequence":"additional","affiliation":[{"name":"Department of Women &amp; Children's Health Faculty of Life Sciences &amp; Medicine School of Life Course Sciences King's College London St Thomas' Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9738-1051","authenticated-orcid":false,"given":"G","family":"Barrett","sequence":"additional","affiliation":[{"name":"Faculty of Population Health Sciences Elizabeth Garrett Anderson Institute for Women's Health School of Life and Medical Sciences University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6274-0800","authenticated-orcid":false,"given":"M","family":"Memtsa","sequence":"additional","affiliation":[{"name":"Faculty of Population Health Sciences Elizabeth Garrett Anderson Institute for Women's Health School of Life and Medical Sciences University College London London UK"},{"name":"Women's Health Services Elizabeth Garrett Anderson Wing University College London Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3470-4025","authenticated-orcid":false,"given":"V","family":"Goodhart","sequence":"additional","affiliation":[{"name":"Faculty of Population Health Sciences Elizabeth Garrett Anderson Institute for Women's Health School of Life and Medical Sciences University College London London UK"},{"name":"Women's Health Services Elizabeth Garrett Anderson Wing University College London Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6751-5901","authenticated-orcid":false,"given":"R","family":"Bender\u2010Atik","sequence":"additional","affiliation":[{"name":"The Miscarriage Association Wakefield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8852-0881","authenticated-orcid":false,"given":"J","family":"Stephenson","sequence":"additional","affiliation":[{"name":"Faculty of Population Health Sciences Elizabeth Garrett Anderson Institute for Women's Health School of Life and Medical Sciences University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6487-5736","authenticated-orcid":false,"given":"D","family":"Jurkovic","sequence":"additional","affiliation":[{"name":"Faculty of Population Health Sciences Elizabeth Garrett Anderson Institute for Women's Health School of Life and Medical Sciences University College London London UK"},{"name":"Gynaecology Diagnostic and Outpatient Treatment Unit Elizabeth Garrett Anderson Wing University College London Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,7]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"505","article-title":"Early pregnancy assessment units","volume":"58","author":"Shillito J","year":"1997","journal-title":"Br J Hosp Med"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9781107786127.004"},{"key":"e_1_2_7_4_1","unstructured":"The Association of Early Pregnancy Units.2020[https:\/\/www.aepu.org.uk\/]. Accessed 24 November 2020."},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e3180305ef4"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.302.6776.577"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2015.04.008"},{"key":"e_1_2_7_8_1","unstructured":"NICE guideline [NG126]. NICE guideline & Ectopic pregnancy and miscarriage. Diagnosis and initial management in early pregnancy of ectopic pregnancy and miscarriage. 2019 [https:\/\/www.nice.org.uk\/guidance\/ng126]."},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-023579"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3310\/hsdr08460"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.12.010"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315602867"},{"key":"e_1_2_7_13_1","first-page":"269","volume-title":"Qualitative Research Practice","author":"Spencer L","year":"2013"},{"key":"e_1_2_7_14_1","first-page":"295","volume-title":"Qualitative Research Practice","author":"Spencer L","year":"2013"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-13-117"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjom.1996.4.4.187"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.3109\/01443615.2016.1154510"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443619963851"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.3109\/01443615.2014.896324"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/02646831003587346"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/07481180802494032"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2006.04.024"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-011382"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/07481189408252642"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0089469"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/02646830512331330974"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1068-607X(00)00023-8"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-017802"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(03)00042-4"},{"key":"e_1_2_7_30_1","unstructured":"National Bereavement Care PathwayMiscarriage bereavement care pathway. 2020 [https:\/\/nbcpathway.org.uk\/]. Accessed 12 March 2021."},{"key":"e_1_2_7_31_1","volume-title":"Caring for Women Experiencing Pregnancy Loss: A New E\u2010learning Resource","author":"Miscarriage Association","year":"2021"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.16866","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1471-0528.16866","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.16866","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T02:33:42Z","timestamp":1693190022000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.16866"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,7]]},"references-count":30,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1111\/1471-0528.16866"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.16866","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,7]]},"assertion":[{"value":"2021-03-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}