Murphy, HR and Temple, RC and Ball, VE and Roland, JM and Steel, S and Zill-E-Huma, R and Simmons, D and Royce, LR and Skinner, TC, East Anglia Study group for Improving Pregnancy Outcomes in women with Diabetes (EASIPOD), Personal experiences of women with diabetes who do not attend pre-pregnancy care, Diabetic Medicine, 27, (1) pp. 92-100. ISSN 0742-3071 (2010) [Refereed Article]
The definitive published version is available online at: http://www3.interscience.wiley.com/
Aims To explore the views of women who did not attend pre-pregnancy care (PPC), in particular their accounts of contraception, previous pregnancies and the influence of healthcare advice.
Methods We conducted semi-structured interviews with 29 pregnant women (21 with Type 1 diabetes, eight with Type 2 diabetes) at three UK specialist diabetes antenatal clinics. Interviews explored women’s journeys to becoming pregnant, including use of contraception, their views regarding diabetes and pregnancy and the factorswhich encouraged and discouraged them from attending PPC.
Results All women had some understanding of the issues concerning diabetes during pregnancy, predominantly regarding the benefits of PPC (90%) and optimal glycaemic control (80%) and risks of malformation (48%) and macrosomia (35%). Most were not regularly using contraception (70%), having stopped deliberately (45%), become unintentionally less rigorous (28%) or experienced side effects ⁄ contraindications (14%). Knowledge concerning the risks of pregnancy (90%) and past preconception counselling (38%) did not encourage women to attend PPC, and neither did personal experience of miscarriage, malformation or stillbirth in women with previous poor pregnancy outcome (41%). Barriers included conceiving faster than anticipated (45%), fertility concerns (31%), negative experiences with health professionals (21%), desire for a 'normal' pregnancy (17%) and the logistics of attending (10%).Conclusions More integrated diabetes and reproductive health/ contraceptive advice, increased awareness of the potentially short time between stopping contraception and conception and more intensive support between pregnancies are required, particularly for women with previously poor outcomes. Research is also needed into how communication between health professionals and women with diabetes can be improved.
|Item Type:||Refereed Article|
|Keywords:||diabetes, pregnancy, prepregnancy care, pre-conception counselling, contraception|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Reproductive medicine|
|Research Field:||Reproductive medicine not elsewhere classified|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Skinner, TC (Professor Timothy Skinner)|
|Web of Science® Times Cited:||56|
|Deposited By:||Research Division|
|Downloads:||15 View Download Statistics|
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