This study explores how to improve care and support for women with diabetes who become pregnant after having previously lost a baby

 

For women who have diabetes, the risk of having a stillbirth or neonatal death is increased. Research has shown that helping these women to prepare for pregnancy can reduce this risk, by taking folate supplements and carefully controlling blood glucose levels. However, in reality such activities are often difficult to consistently carry out, meaning that the risk is not as well managed as it possibly could be. This becomes particularly apparent when a woman becomes pregnant after having previously lost a baby. Therefore, the overall aim of the study is to produce a set of recommendations for healthcare professionals that will help to improve care and better prepare diabetic women for pregnancy after a previous loss.

During the study the researcher will review all the existing research to find out what currently happens during conversations with bereaved parents before a future pregnancy, and what other guidance exists for how these conversations and related care could be improved. To explore the experiences of healthcare professionals and parents, one-to-one interviews will take place which will then be analysed to find common themes in these experiences.   

This will inform the production of a final set of recommendations for healthcare professionals that will help to improve care and better prepare women with diabetes for pregnancy after a previous loss. Sands has been involved by providing expert advice to help shape the study and has supported the recruitment of participants to the study.

More Information

Why do we need this research?

Women with diabetes can have a higher risk of developing problems in pregnancy that may affect both mum and baby. There is a lot of information about how women with diabetes can prepare for pregnancy, but the information does not talk about the challenges of becoming pregnant again after a woman has lost a baby. This study will try to understand what it was like to become pregnant again after baby loss.

An important aspect of this process is to consider the conversations that healthcare professionals have with parents in the period following a baby loss. Not much is known about the amount or type of information given to parents during these discussions and how this affects decisions around planning and preparing for future pregnancies. Previous research has shown that in some cases planning and preparation for future pregnancies can reduce the risk of subsequent problems and losses, especially for women with diabetes, therefore it is crucial to better understand how conversations can help or hinder such planning and preparation.  

 

What are the aims of this study?

The overall aim of this study is to produce a set of recommendations for healthcare professionals that will help to improve care and better prepare women with diabetes for pregnancy after a previous loss.

To achieve this, the research will explore and better understand the experiences of preparing for pregnancy after baby loss among women with pre-existing diabetes, and the perspectives of health professionals (e.g. diabetes specialist nurses and midwives, obstetricians, diabetes physicians, primary care staff) who provide pre/pregnancy care to these women.

 

What will the researchers do?

During the study the researcher will review all the existing research to find out what currently happens during conversations with bereaved parents before a future pregnancy, and what other guidance exists for how these conversations and related care could be improved. To explore the experiences of healthcare professionals and parents, one-to-one interviews will take place which will then be analysed to find common themes in these experiences.   

Parents will be invited to take part in a confidential, one-off interview to talk about their experience of becoming pregnant after a baby loss, whilst healthcare professional (including nurses, midwives, doctors and GPs) will also take part in confidential, one-off interviews to discuss their experiences of providing information to parents.

The existing evidence and themes identified from the sets of interviews will be combined to produce a set of recommendations to help improve care and better prepare diabetic women for pregnancy after a previous loss.

 

What do we expect from the study?

The overall aim of the study is to produce a set of recommendations for healthcare professionals that will help to improve care and better prepare diabetic women for pregnancy after a previous loss.

The research has been steadily progressing with the review of existing research having been completed (see below) and the interviews with healthcare professionals and parents completed. The bulk of the analysis has not yet been undertaken, but the very early findings from the interviews suggest that there are no clear pathways within the healthcare system for providing information and support to bereaved, diabetic women around future pregnancy.

Sands will continue to support the research study and advise on how best to share and promote the final recommendations.

 

Research papers

This is a link to the systematic review paper of existing research evidence.

 

Additional information:

Lead researcher - Ella Dyer

Institution - Newcastle University

Funder - Economic and Social Research Council (ESRC)

Duration - September 2018 – ongoing

 

More information is available on the study website.

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