Personal experiences of women with diabetes who do not attend pre-pregnancy care

Murphy, H R, Temple, R C, Ball, V E, Roland, J M, Steel, S, Zill-E-Huma, R, Simmons, D, Royce, L R and Skinner, T C and East Anglia Study Group for Improving Pregnancy Outcomes in Women with Diabetes (EASIPOD) (2010) Personal experiences of women with diabetes who do not attend pre-pregnancy care. Diabetic Medicine, 27 (1). pp. 92-100. ISSN 0742-3071

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Abstract

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 factors which 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 pre-conception 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:	Article
Uncontrolled Keywords:	diabetes,pregnancy,prepregnancy care,pre-conception counselling,contraception,sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
Depositing User:	Pure Connector
Date Deposited:	25 May 2016 16:02
Last Modified:	19 Oct 2023 01:42
URI:	https://ueaeprints.uea.ac.uk/id/eprint/59074
DOI:	10.1111/j.1464-5491.2009.02890.x

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