Lived experiences of women prescribed low dose aspirin for preeclampsia prevention: a phenomenological study

Abstract

Background Preeclampsia is a prevalent issue causing significant suffering and deaths in Uganda. The Ministry of Health has introduced a policy mandating the use of low-dose aspirin for its prevention. Being a new intervention, the acceptability of this drug among the women for whom it is prescribed is still unexplored in Southwestern Uganda. This study aimed to explore the lived experiences of women on low-dose aspirin during their most recent pregnancy, identify any challenges encountered and recommend appropriate solutions. Methods We used a descriptive phenomenological design to explore the lived experiences of women. Data was collected using purposive sampling from women in the antenatal clinic and postnatal units of a tertiary hospital in Southwestern Uganda. A self-developed interview guide and an audio recorder were used to collect data. Data collection continued until saturation was reached at 16 participants. Participants provided narratives about their knowledge of preeclampsia, their perceived susceptibility, severity, benefits, barriers and their experiences with aspirin prescription (use, or non-use). Analysis was done using the Colaizzi’s’ method of analyzing qualitative data. Data was collected in two months between the 4th of October and the 20th of December 2025. Results The study included 16 participants (mean age, 31 years; SD, 6.3; range, 22–43). Most participants were married, residents of Mbarara city and had attained secondary education. The parity ranged from 1 to 8 (mean = 4, SD = 2). Half of the participants had experienced an abortion, and 5 (31.3%) had lost 75% or more of their previous pregnancies. Aspirin 75mg and 150 mg were initiated at a mean gestation age of 20 weeks (SD 1.8), and 81% (95% CI: 0.53-0.94) of those who used aspirin progressed to preeclampsia. This study generated five themes: perceived clinical benefit and self-efficacy, suboptimal provider guidance, delayed LDA initiation, resilient therapeutic optimism and side effects-based non-adherence. Conclusion This study highlights perceived barriers and implementation challenges that may contribute to suboptimal uptake of aspirin prophylaxis and the high prevalence of preeclampsia in Southwestern Uganda. Mitigating these challenges requires consistent capacity building for maternal healthcare providers, robust community sensitization, and incorporating a screening tool within the antenatal card. In addition, improving medication adherence through active follow-up and strengthening health systems are essential to promote early antenatal care utilization. Future research can establish the population-specific risk factors for southwestern Uganda to adjust the general screening tool provided by the Ministry of Health so as to address preeclampsia at the regional level.