Improving care in pregnancy after reproductive loss in women with diabetes: an interdisciplinary exploration of patient experiences and health profess

背景：糖尿病妇女妊娠流产、死产或婴儿死亡的风险增加，但周密的妊娠准备可以降低风险。人们对丧失生育能力后的丧亲过程的认识和了解日益增加，但是，在现有的指导中缺乏关于计划和准备再次怀孕的具体讨论。目前，在了解产后丧亲支持应如何考虑糖尿病的背景，并与支持准备后续妊娠联系方面存在差距。目的：采用定性方法，从父母和卫生专业人员的经验角度探讨糖尿病患者生育能力丧失后的孕前准备情况。重点将放在失去婴儿后的产后检查和下次怀孕时的第一次产前检查之间的这段时间。方法：在硕士学位的基础上，博士研究将包括四个综合阶段：1)研究文献综述和发表的生殖丧失后妊娠期护理指南；2)与卫生专业人员进行半结构化访谈；3)与经历过生育损失并成功完成再次妊娠的糖尿病妇女及其伴侣进行半结构化访谈；4)整合研究结果和建议制定。产出/影响：这项研究将进一步发展对糖尿病背景下生殖损失的社会科学理解。与死产和新生儿死亡慈善机构Sands的合作，将加强研究结果的知识转移和交流，以改善对怀孕期间或怀孕后不久失去婴儿的糖尿病妇女的支持。

Background: Women with diabetes have an increased risk of pregnancy ending in miscarriage, stillbirth or infant death, but risks can be reduced with careful pregnancy preparation. There has been a growing awareness and understanding of the bereavement process following reproductive loss, however, specific discussion of planning and preparing for another pregnancy is lacking in existing guidance. There is currently a gap in understanding of how postnatal bereavement support should consider the context of diabetes and link with support for preparation for a subsequent pregnancy. Aim: To investigate, using qualitative methods, experiential perspectives of parents and health professionals on preparing for pregnancy after reproductive loss, in the context of diabetes. The focus will be on the period between the postnatal review following the loss of a baby and the first antenatal appointment in the next pregnancy. Methods: Building on the MSc, the doctoral study will comprise four integrated phases: 1) literature review of research studies and published guidance on inter-pregnancy care after reproductive loss; 2) semi-structured interviews with health professionals; 3) semi-structured interviews with women with diabetes, and their partners, who have experienced reproductive loss and have successfully completed a further pregnancy; 4) Integration of findings and recommendation development. Outputs/Impact: The research will further develop social science understandings of reproductive loss in the context of diabetes. Collaboration with Sands, the stillbirth and neonatal death charity, will enhance knowledge transfer and communication of the findings, to improve support for women with diabetes who have lost a baby during or shortly after pregnancy.