Type 1 diabetes women's views about preconception care: A qualitative study†

Abstract

Background: Pregnancy in women with Type 1 diabetes mellitus (T1DM) is associated with increased complications for both baby and mother; such complications can be reduced with careful pregnancy planning. Preconception care (PCC) enhances pregnancy outcomes by helping women to optimize their glycaemic control, through supportive intervention. However, despite these benefits, the uptake and adherence to PCC is low. This qualitative study aimed to generate a better understanding as to why women may not utilize PCC, by eliciting the views and experiences of women with T1DM in relation to PCC. Methods/sample: A sample of six women of reproductive age with T1DM undertook semi-structured interviews exploring their views on PCC. These interviews were tape-recorded, transcribed (verbatim) and analysed using interpretative phenomenological analysis to elicit themes that explicated the women's orientation and behaviour in relation to PCC. Results: The analysis identified five key themes: the fear of complications (both for the mother and the baby); the style of communication from health care professionals (HCPs); the support of significant others; personal autonomy; and women's beliefs about PCC. Conclusion: Overall, the findings suggest that women's uptake of, and engagement with, PCC is enhanced when HCPs adopt a supportive and positive approach, which addresses their anxieties in pregnancy preparation and encourages the health behaviours necessary for a good outcome for their baby.