Plans for children often derailed by chronic illness

More than four million Australian women of childbearing age are living with chronic conditions like diabetes, cystic fibrosis and asthma, and many are not aware of the implications their illness has for childbearing, according to new research.

Around 1,500 women of childbearing age across Australia took part in the Monash University survey. It found that women living with a chronic illness were more likely to report having had unintended pregnancies, having had an abortion and falling pregnant at a younger age.

The study found that even though women with a chronic illness expected to have fewer children than women who did not have a chronic illness, they were less likely to have consulted a healthcare provider about fertility management prior to becoming pregnant.

Lead researcher Dr Sara Holton, from the School of Public Health and Preventive Medicine, said many women with a chronic illness could benefit from personalised reproductive health information in order to make informed decisions about contraception and childbearing.

“It is likely that women’s consultations with a healthcare provider are focused on managing or treating their disease and, therefore, women with a chronic illness may not be receiving pertinent or timely advice about managing their fertility,” Dr Holton said.

“As a result, women with a chronic illness may not have the opportunity to ask questions or make informed decisions or plans about childbearing. Women with a chronic illness may also assume that they will have difficulty conceiving because of their illness and therefore, do not need to use contraception.”

Dr Holton said although almost a third of Australian women of childbearing age had a chronic illness, little research has addressed their fertility management experiences, such as their childbearing desires, contraceptive use, pregnancy experiences and outcomes, and use of reproductive health care.

“The findings of this study have implications for healthcare providers and women with a chronic illness and highlight the importance of addressing possible assumptions about the inability of women with a chronic illness to become pregnant, and ensuring women receive information about suitable methods of contraception and pre-pregnancy care,” Dr Holton said.

The findings of this study were published in the Maternal and Child Health Journal.

Dr Sara Holton is a Research Fellow at Monash University whose research investigates psychosocial aspects of women’s reproductive lives including the impact of a chronic health condition on their childbearing.

Monash University’s School of Public Health and Preventive Medicine is co-located with the Alfred Hospital in Prahran, Victoria. The institute teaches undergraduate and postgraduate students in public health and medicine. It comprises over 1,000 staff involved in teaching and research, with medical research capabilities in large population-based studies and clinical registries (bio-banks). Research areas include cancer, trauma, ageing, women’s health and chronic disease, among others.

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