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A qualitative study exploring the factors that influence the uptake of pre-pregnancy care among women with type 2 diabetes

Research output: Contribution to journalArticle

Rita Forde, Jacqueline Collin, A. Brackenridge, Mark Chamley, Kate Hunt, Angus Forbes

Original languageEnglish
JournalDiabetic Medicine
Early online date4 Jul 2019
DOIs
Accepted/In press23 May 2019
E-pub ahead of print4 Jul 2019

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King's Authors

Abstract

Aim
To elicit the views and experiences of women with Type 2 diabetes and healthcare professionals relating to the pregnancy and pre‐pregnancy care they have received or provided.

Methods
A qualitative study using in‐depth semi‐structured interviews with women with Type 2 diabetes (n=30) and healthcare professionals (n=22) from primary and specialist care. Women were purposively sampled to include different experiences of pregnancy and pre‐pregnancy care. Data were transcribed verbatim and analysed thematically using Framework Analysis.

Results
The median age of the women was 37 years, and most were obese (median BMI 34.9 kg/m2), of black or Asian ethnicity (n=24, 80%) and from areas of high deprivation (n=21, 70%). Participating healthcare professionals were from primary (n=14), intermediate (n=4) and secondary (n=4) care. Seven themes expressing factors that mediate reproductive behaviour and care in women with Type 2 diabetes were identified at the patient, professional and system levels. Type 2 diabetes was generally perceived negatively by the women and the healthcare professionals. There was a lack of awareness about the pre‐pregnancy care needs for this population, and communication between both groups was unhelpful in eliciting the reproductive intentions of these women. The themes also reveal a lack of systemic processes to incorporate pre‐pregnancy care into the care of women with Type 2 diabetes, and consequently, health professionals in primary care have limited capacity to provide such support.

Conclusion
If the current high levels of unprepared pregnancies in women with Type 2 diabetes are to be reduced, the reproductive healthcare needs of this group need to be embedded into their mainstream diabetes management.

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