Research Projects: 4 Mixed method research of crisis pregnancy counselling

Research Brief 4

A mixed methods study exploring women's experience of crisis pregnancy counselling.

This document outlines issues to be considered for a research project designed to explore and systematically delineate women's self-reported experiences of crisis pregnancy counselling services.

It is expected that this study will also be able to explore the characteristics and reasons that distinguish women who choose to avail of crisis pregnancy counselling services and those who do not.

Background
This research follows directly from a piece of work commissioned by the Crisis Pregnancy Programme in 2002 that examined current and best practice in crisis pregnancy counselling and aimed to identify good practice and areas for service development. Crisis pregnancy counselling services are provided by agencies in receipt of funding from the government , GPs and private counselling centres. It was acknowledged that missing from the picture generated from this data was women's experience of crisis pregnancy counselling, whether this experience matched their expectations, what was positively and negatively evaluated and what they would like to see improved.
Qualitative and quantitative research undertaken by the Crisis Pregnancy Programme in the development of materials for its +options information campaign suggested strongly that women perceive a need for information on crisis pregnancy supports and counselling services. Many women in this series of small research projects suggested that they would be likely to seek information on crisis pregnancy counselling if they themselves or a friend were experiencing a crisis pregnancy.
Other in-depth research, such as Mahon, Conlon & Dillon's (1998) study mapping women's responses to crisis pregnancy demonstrated that only 38 out of 87 women interviewed sought information/counselling from a counselling service before they travelled to the UK for an abortion. Not all of these women were happy with the service they received.

More women who were contemplating adoption availed of counselling services, although this was likely to be after rejecting abortion as an option. Ongoing counselling helped these women reach a decision between lone motherhood or adoption.

Counselling featured to a much lesser degree again in the accounts of women opting to have their baby alone. These women cited inaccessibility and fears of directional counselling as reasons for not seeking counselling. Mahon et. al's (1998) work did not aim to systematically evaluate women's experiences of crisis pregnancy counselling or analyse the differentiating factors between women who opt to use such services and those who do not.

Research Aims:
This research proposes to build upon findings from research, including research commissioned by the Crisis Pregancy Agency in 2002 and Mahon et. al's (1998) work, by designing a study that will collect in-depth information from women who sought and availed of crisis pregnancy counselling while pregnant.

It is aimed to explicitly delineate women's needs and expectations with respect to crisis pregnancy counselling and to evaluate their experience of it. It will also be possible to interview a smaller number of women in order to gain insight into the reasons why some women choose not to avail of these services.

This study also proposes to gather quantitative data that enables alternative data to be generated on measures outlined above, but will also allow for a comparison between women who choose to contact a crisis pregnancy counselling agency and those who choose not to.

Research Objectives:
This research will function to elaborate what specific aspects of crisis pregnancy counselling was experienced as good or bad by women who had a crisis pregnancy. This information will embellish in important ways research already conducted by the Crisis Pregnancy Programme. It will also feed directly into planning and improved service development initiatives undertaken by The Crisis Pregnancy Agency.

This research will also allow for an examination of women's expectations, needs and experiences of non-directive and part-directive crisis pregnancy counselling services. It will also function to increase our understanding of women's experiences of crisis pregnancy counselling services provided by GPs.

This research will also enable an elaboration of the factors associated with why some women seek out crisis pregnancy counselling and others do not. It will also allow for a description of the wider support structures and networks in women's lives and how these relate to crisis pregnancy counselling.

Deliverables:
This research will allow for a greater understanding of women's needs in this context and how these needs can best be met.

A series of recommendations relating to practice, process and information of crisis pregnancy counselling will be generated from this data. This will allow for use of robust research evidence to guide and inform the planning and promotion of services and supports.

Ethical considerations:
Ethical issues need to be addressed fully in any bid submitted including ways of overcoming the same.

Methodological and sampling considerations
It is proposed that to gain in-depth information on women's expectations, reactions to and experience of crisis pregnancy counselling, that semi-structured in-depth interviews are conducted with women. A series of interviews should also be conducted with women who choose not to avail or seek counselling services, in order to explore the reasons behind this decision. Suggested numbers of women to be interviewed need to be elaborated in the tender bid.

As with most research that requires the participation of women with crisis pregnancy, sampling frames and recruitment is a sensitive and difficult issue. It is suggested that qualitative and quantitative data can be gathered by sampling a) women attending public antenatal clinics b) women in residential homes for the duration of their pregnancy; c) women having an abortion in the UK.

Details of procedures outlining how participants will be recruited (and how many) requires elaboration in the submitted bid.

It is suggested that for the quantitative aspect of this research that a questionnaire be administered to a sample of women attending a) public ante natal classes and b) Irish women attending UK abortion clinics. Prospective respondents in ante-natal clinics will need to be screened and filtered, in that only women who experienced an unexpected, unintended or crisis pregnancy, (where crisis pregnancy counselling may have been appropriate) need to be included. In the UK questionnaires need to be administered to all women who travelled from Ireland in a random selection of abortion clinics for a designated period. Suggested sample sizes, and accompanying rationale need to be outlined in tender bids.

Links with relevant partners and those co-operating with the research will be facilitated by the CPA.
Issues specific to recruitment, sampling frame and size, partnerships and research links need to be addressed in bids submitted.

Budget guidance:
The proposed budget for this research is in the region of €50,000 - €70,000 including of VAT.

Timeframe:
It is expected that this research be completed in 7 - 9 months.

Linked Research:
The aims and objectives of this research are linked to research brief 2 and brief 7.
Please refer to the Invitation to Tender letter for information relating to expected outputs, reporting arrangements, ethical consideration, terms of reference, contacts and details for submission and content of tender bids. This information is elaborated in section 2.2 of the Invitation to Tender letter.

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