Introduction Venous thromboembolism (VTE) is a major cause of maternal morbidity and mortality, and the use of preventive low-molecular-weight heparin (LMWH) can be challenging. Clinical guidelines recommend eliciting pregnant individuals’ preferences towards the use of LMWH and discussing the best option through a shared decision-making (SDM) approach. This study identifies identified individuals’ preferences concerning main health state, and categorizes attributes influencing the use of LMWH.

Design Convergent mixed-methods.

Participants Pregnant women or those planning a pregnancy with VTE recurrence risk. Intervention: A SDM intervention about LMWH thromboprophylaxis in pregnancy.

Analysis Quantitatively, we report preference scores assigned to each of the health states. Qualitatively, we categorized preference attributes using Burke’s pentad of motives framework: scene, agent, agency, act, and purpose. We use mixed-method convergent analysis to report findings using side-by-side comparison.

Results The least valued health state was to experience a pulmonary embolism (PE), followed by major obstetrical bleeding (MOB), deep vein thrombosis (DVT), and using daily injections of LMWH (valued as closest to a ‘healthy pregnancy’). Women’s previous experiences, access to care (scene) and shared decision-making (agent) affected preferences. LMWH’s benefits were noted, but substantial drawbacks were described (agency). The main goal was avoiding the risk of VTE (purpose). Side-by-side comparisons revealed concordance between motives and DVT and PE health states. Discordance appeared between using daily injections of LMWH and agent- and agency motives and between MOB and agency motives.

Discussion Mixed-methods provide a nuanced understanding of LMWH preferences in pregnancy, by quantifying health states preferences and exploring attributes qualitatively. Incorporating both methods may improve patient-centered care.

Conclusion Convergent mixed-method analysis helps to intuitively ‘tell the whole story’ of patient’s needs, desires, and values, ultimately facilitating discussions between patients and clinicians, promoting a SDM process, and leading patients to make the right decision that fits in their life.