An exploration of knowledge and attitudes related to pre-pregnancy care in women with diabetes

• Published in: Diabetic medicine 2010-12, Vol.27 (12), p.1385-1391
• Main Authors: Spence, M., Alderdice, F. A., Harper, R., McCance, D. R., Holmes, V. A.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Counseling; diabetes; Diabetes Mellitus, Type 1 - psychology; Diabetes Mellitus, Type 2 - psychology; Diabetes, Gestational - psychology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Female; Focus Groups; Fundamental and applied biological sciences. Psychology; Health Knowledge, Attitudes, Practice; Humans; Medical sciences; pre-conception counselling; pre-pregnancy care; Pregnancy; Prenatal Care; Surveys and Questionnaires; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology; Young Adult
• ISSN: 0742-3071; 1464-5491; 1464-5491
• DOI: 10.1111/j.1464-5491.2010.03117.x

Diabet. Med. 27, 1385–1391 (2010) Aims  Pre‐pregnancy care optimizes pregnancy outcome in women with pre‐gestational diabetes, yet most women enter pregnancy unprepared. We sought to determine knowledge and attitudes of women with Type 1 and Type 2 diabetes of childbearing age towards pre‐pregnancy care. Methods  Twenty‐four women (18 with Type 1 diabetes and six with Type 2 diabetes) aged 17–40 years took part in one of four focus group sessions: young nulliparous women with Type 1 diabetes (Group A), older nulliparous women with Type 1 diabetes (Group B), parous women with Type 1 diabetes (Group C) and women with Type 2 diabetes of mixed parity (Group D). Results  Content analysis of transcribed focus groups revealed that, while women were well informed about the need to plan pregnancy, awareness of the rationale for planning was only evident in parous women or those who had actively sought pre‐pregnancy advice. Within each group, there was uncertainty about what pre‐pregnancy advice entailed. Despite many women reporting positive healthcare experiences, frequently cited barriers to discussing issues around family planning included unsupportive staff, busy clinics and perceived social stereotypes held by health professionals. Conclusions  Knowledge and attitudes reported in this study highlight the need for women with diabetes, regardless of age, marital status or type of diabetes, to receive guidance about planning pregnancy in a motivating, positive and supportive manner. The important patient viewpoints expressed in this study may help health professionals determine how best to encourage women to avail of pre‐pregnancy care.