Table 3.

Participants’ recommendations for optimal frequency, timing, and mode of counseling

Recommended strategies for optimizing counseling	Examples of participant responses
Frequent antenatal counseling	The more, the better. Because things change throughout pregnancy – your emotions change, you change mentally, physically, emotionally, so you need that each month. It helps - just like telling someone something in January, when December comes, they probably forgot half the things you told them in January! But if you consistently tell them in each month, when December comes, it’s like, yeah, I know what to do, yeah! We talked about this several times, I’m educated [now], I know what’s going on, I know what I want, and nothing’s better than knowing what you want. (24y.o., 2 children) I think it’s all the time, to be honest, just like how I got it – in the beginning, I got while I was in labor, you know, I got it afterwards. It’s like a constant question, what’s gonna be your contraception, what are you gonna do. I think that’ll work, if you keep getting it drilled in your head…(24y.o., 3 children)
Balancing “too much” counseling with regular reminders	Because over here they…well, you know…they consistently, you know, what do you want to do? Have you been thinking about it? Ohh, ohh, ohh. You know, every appointment they would, you know, it’s not like they would drill it in my head but you know…they would bring it up. (34y.o., 4 children) They wouldn’t saturate you, you know, they wouldn’t be like ‘lalala,’ but they did enough. You know, and then they would see your reaction and they would go from there. (34y.o., 4 children)
Limiting further counseling when a decision has been reached	I already had my mind set on what I was getting [a tubal ligation]…nothing could have changed my mind. (29y.o., 3 children) I pretty much knew about it so there was nothing to ask. They asked me what did I know about it and I basically told them, so there really wasn’t much to talk about because I already knew about birth control. (22y.o., 1 child)
Using a multimodal teaching approach	Talking and reading materials. I mean, if you mention something to me and you give me literature on it and I’m open to hearing what you have to say first, then I will go home and research it myself. And then I’ll come back and I, we can discuss it again. So I think that’s the best method. (28y.o., 1 child) More than one thing. Telling me, giving me things to read, seeing visual, going to the internet and researching. (20y.o., 1 child)