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Published: 2020-08-16

Six steps for breaking bad news in a case of reproductive choice during pregnancy

Municipal non-profit enterprise "Kyiv Maternity Hospital №1"
Bogomolets National Medical University
Doctor's communication skills breaking bad news protocol reproductive choice perinatal loss pregnancy


Introduction. Medical competence and effectiveness of treatment depends not only on "hard skills" - timely diagnosis and treatment selection according to the latest protocols, but also on "soft skills" - communication skills of the doctor, which constantly should be improved.

The issue of reproductive choice in obstetric or gynecological practice is an emotional challenge for the family. Only the patient and her partner can make the right decision, taking into account their resources available and moral values. The medical information should be provided according to objective data rather than from the subjective position of the doctor. Braking bad news is also a challenge for the doctor.

Aim. To implement in routine practice the protocol of consistent communication of the obstetrician-gynecologist with the patient, starting from the telephone invitation to a face-to-face consultation and ending with further follow-up with the family.

Method. A literature search for key words in scientific literature databases was conducted and a protocol for braking bad medical news was adapted in accordance with the request of an obstetrician-gynecologist in a situation of reproductive choice.

Results. The protocol includes six consecutive steps to build an interview between an obstetrician-gynecologist and a patient in a women's clinic. Those steps are: setting up the interview, assessing the patient’s perception, obtaining the patient’s invitation, giving knowledge and information to the patient, addressing responses, strategy and summary. Specific examples of dialogues, phrases to use, and phrases to avoid in the communication process  are suggested. The article also presents the communication tools on how to work out denial, explanation, "here and now" and burn out prevention techniques.

Conclusion. We should be acknowledge the importance of the doctor's good communication skills at all stages of caring for families at risk of perinatal loss. The protocol of braking bad news in obstetric and gynecological practice is a classic one, it has already passed the test of time in world medical practice. Its further implementation in Ukraine is an important step.

Full-text of the article is available for this locale: Українська.


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How to Cite

Бут Т, Франкова І. Six steps for breaking bad news in a case of reproductive choice during pregnancy. PMGP [Internet]. 2020Aug.16 [cited 2021Nov.27];5(3):e0504261. Available from: